• Title/Summary/Keyword: 관상동맥 CT

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Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report- (관상동맥질환을 동반한 대동맥류 수술치험 1례)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.724-728
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    • 1997
  • We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

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Performance evaluation of vessel extraction algorithm applied to Aortic root segmentation in CT Angiography (CT Angiography 영상에서 대동맥 추출을 위한 혈관 분할 알고리즘 성능 평가)

  • Kim, Tae-Hyong;Hwang, Young-sang;Shin, Ki-Young
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.9 no.2
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    • pp.196-204
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    • 2016
  • World Health Organization reported that heart-related diseases such as coronary artery stenoses show the highest occurrence rate which may cause heart attack. Using Computed Tomography angiography images will allow radiologists to detect and have intervention by creating 3D roadmapping of the vessels. However, it is often complex and difficult do reconstruct 3D vessel which causes very large amount of time and previous researches were studied to segment vessels more accurate automatically. Therefore, in this paper, Region Competition, Geodesic Active Contour (GAC), Multi-atlas based segmentation and Active Shape Model algorithms were applied to segment aortic root from CTA images and the results were analyzed by using mean Hausdorff distance, volume to volume measure, computational time, user-interaction and coronary ostium detection rate. As a result, Extracted 3D aortic model using GAC showed the highest accuracy but also showed highest user-interaction results. Therefore, it is important to improve automatic segmentation algorithm in future

Fusion of 3D Cardiac SPECT and 64-Channel-CT Angiography Using Personal Computer in Functionally Relevant Coronary Artery Stenosis (개인용 컴퓨터를 이용한 기능 유관성 관상동맥 협착증의 삼차원 심장스펙트 사진과 64채널 전산화 단층 혈관촬영사진과의 융합)

  • Bahk, Yong-Whee
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.252-254
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    • 2007
  • Image fusion is fast catching attention as Wagner pointed out in his 2006 version of the recent progress and development presented at the annual meeting of Society of Nuclear Medicine. Prototypical fusion of bone scan and radiograph was already attempted at in 1961 when Fleming et al. published an article on strontium-85 bone scan. They simply superimposed dot scan on radiograph enabling simultaneous assessment of altered bone metabolism and local bone anatomy. Indeed the parallel reading of images of bone scan and radiography, CT, MRI or ultrasonography has been practiced in nuclear medicine long since. It is fortunate that recent development of computer science and technology along with the availability of refined CT and SPECT machines has permitted us to open a new avenue to digitally produce precise fusion image so that they can readily be read, exchanged and disseminated using internet. Ten years ago fusion was performed using Bresstrahlung SPECT/CT and it is now achievable by PET/CT and SPECT/CT software and SPECT/CT hardware. The merit of image fusion is its feasibility of reliable assessment of morphological and metabolic change. It is now applicable not only to stationary organs such as brain and skeleton but also to moving organs such as the heart, lung and stomach. Recently, we could create useful fusion image of cardiac SPECT and 64-channel CT angiograph. The former provided myocardial metabolic profile and the latter vascular narrowing in two patients with coronary artery stenosis and myocardial ischemia. Arterial stenosis was severe in Case 1 and mild in Case 2.

A Case of Aberrant Right Subclavian Artery (Arteria Lusoria) with Chest Tightness and Coughing (요골동맥을 통한 관상동맥촬영 중 진단된 편위된 우측쇄골하동맥 1예)

  • Han, Seung-Hee;Kim, Su-Young;Park, Hye-Kyong;Park, Jong-Sung
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.61-64
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    • 2012
  • The left aortic arch with an aberrant right subclavian artery, or arteria lusoria, is the most common aortic arch anomaly, occurring in 0.5-2.5% of individuals. In such cases, the angular course of the arteria lusoria to the ascending aorta imposes difficulty in passing a guide wire to the ascending aorta during right transradial catheterization. Here, the case of a 53-year-old woman with intermittent chest tightness and coughing is reported. Aberrant right subclavian artery (arteria lusoria) was diagnosed via aortogram during right transradial coronary angiography. Compression of the esophagus and trachea by the aberrant right subclavian artery was demonstrated by chest computed tomography (CT).

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Automatic Extraction of Ascending Aorta and Ostium in Cardiac CT Angiography Images (심장 CT 혈관 조영 영상에서 대동맥 및 심문 자동 검출)

  • Kim, Hye-Ryun;Kang, Mi-Sun;Kim, Myoung-Hee
    • Journal of the Korea Computer Graphics Society
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    • v.23 no.1
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    • pp.49-55
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    • 2017
  • Computed tomographic angiography (CTA) is widely used in the diagnosis and treatment of coronary artery disease because it shows not only the whole anatomical structure of the cardiovascular three-dimensionally but also provides information on the lesion and type of plaque. However, due to the large size of the image, there is a limitation in manually extracting coronary arteries, and related researches are performed to automatically extract coronary arteries accurately. As the coronary artery originate from the ascending aorta, the ascending aorta and ostium should be detected to extract the coronary tree accurately. In this paper, we propose an automatic segmentation for the ostium as a starting structure of coronary artery in CTA. First, the region of the ascending aorta is initially detected by using Hough circle transform based on the relative position and size of the ascending aorta. Second, the volume of interest is defined to reduce the search range based on the initial area. Third, the refined ascending aorta is segmented by using a two-dimensional geodesic active contour. Finally, the two ostia are detected within the region of the refined ascending aorta. For the evaluation of our method, we measured the Euclidean distance between the result and the ground truths annotated manually by medical experts in 20 CTA images. The experimental results showed that the ostia were accurately detected.

Giant Coronary and Axillary Aneurysms in an Infant with Kawasaki Disease Associated with Thrombocytopenia (혈소판 감소증이 지속된 영아 가와사끼병 환아에서 발생한 거대관상동맥류와 액와동맥류)

  • Seo, Sei Young;Oh, Jin Hee;Kim, Jong-Hyun;Han, Ji-Whan;Lee, Kyung-Yil;Koh, Dae Kyun
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.901-906
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    • 2005
  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children. Yet the etiology of KD is still unknown and diagnosis depends on the exclusion of other diseases and the clinical manifestations meeting the defined criteria. Young infants frequently show atypical clinical courses and are frequently complicated with coronary aneurysms. Some cases show thrombocytopenia, which is known as one of the risk factors for complications with coronary aneurysms. So, a high index of suspicion is the most important factor for the diagnosis of KD in very young infants or adolescents whose clinical courses are equivocal. We report herein on a case of KD in an 80-day-old female infant with fever and seizure with bloody stool; laboratory findings were those of sepsis with disseminated intravascular coagulopathy. In spite of aggressive treatments, fever and thrombocytopenia persisted for two weeks and huge coronary aneurysms developed at the third week in all three major coronary arteries; the diameter of the right one was as large as the aortic annulus. Three months later, huge pulsatile masses developed in both axillas; these were found to be huge axillary aneurysms defined very clearly on multi-detector CT scan. She has been under follow up with antiplatelets and anticoagulation therapy with poor regression of the aneurysms.

Assessment of Prognosis and Risk Stratification in Coronary Artery Disease (관상동맥질환의 예후 및 위험도 평가)

  • Lim, Seok-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.222-228
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    • 2009
  • Risk stratification and assessment of prognosis in patients with known or suspected CAD is of crucial important for the practice of contemporary medicine. Noninvasive testing such as myocardial perfusion scintigraphy, coronary artery calcium scoring or CT coronary angiography is increasingly being used to determine the need for aggressive medical therapy and to select patients for catheterization. The integrated anatomic and functional information may provide more additional information for the cardiologist or other clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The development of SPECT/CT or PET/CT hybrid systems is therefore of important value for the nuclear cardiology.

Noninvasive Imaging of Pericardium (심막의 영상 소견)

  • Bae Young Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.337-350
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    • 2020
  • The clinical manifestation of pericardial disease is similar to that of coronary artery disease and aortic disease. Therefore, a timely and accurate diagnosis is necessary. The pericardium is a 2-layered membrane that envelops the heart and great vessels, and there are numerous anatomic variations and pathologic conditions. Large or unusually located pericardial recesses can be easily mistaken for abnormal findings. Additionally, primary pericardial diseases resulting from infections, tumors, and injuries are possible; further, diseases can quickly spread along the pericardium. Echocardiography is generally the first imaging tool used to evaluate the pericardium. However, it has limited windows and poor resolution. Besides, the evaluation of postoperative echocardiography is sometimes limited. Currently, CT and MR imaging are useful for evaluating pericardial diseases. Detailed knowledge of the pericardium is important for interpreting the images and clinical results.