covid
Buscar en
Archivos de Cardiología de México
Toda la web
Inicio Archivos de Cardiología de México Usefulness of integrated dual-source multislice computed tomography and cardiac ...
Journal Information

Statistics

Follow this link to access the full text of the article

Usefulness of integrated dual-source multislice computed tomography and cardiac SPECT in a patient with previous myocardial infarction
Utilidad de la evaluación integral con tomografía multicorte de doble-tubo de rayos X y SPECT cardiaco en una paciente con antecedentes de infarto
Enrique Vallejoa, Hermes Ilarrazab, Oscar Quirozc, Carlos Rodríguezc, José Luis Ramírez-Ariasc
a Department of Nuclear Cardiology and Cardiac Hospital Ángeles del Pedregal.
b Department of Cardiac Rehabilitation, Instituto Nacional de Cardiología Ignacio Chávez.
c Department of Radiology, Hospital Ángeles del Pedregal, Mexico City.
Read
4355
Times
was read the article
742
Total PDF
3613
Total HTML
Share statistics
 array:20 [
  "pii" => "X1405994010493694"
  "issn" => "14059940"
  "estado" => "S300"
  "fechaPublicacion" => "2010-01-01"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Arch Cardiol Mex. 2010;80:33-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3089
    "formatos" => array:3 [
      "EPUB" => 37
      "HTML" => 2606
      "PDF" => 446
    ]
  ]
  "itemSiguiente" => array:16 [
    "pii" => "X1405994010493709"
    "issn" => "14059940"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Arch Cardiol Mex. 2010;80:36-40"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3531
      "formatos" => array:3 [
        "EPUB" => 46
        "HTML" => 3131
        "PDF" => 354
      ]
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "titulo" => "El impacto de la detección de disfunción endotelial en la aterosclerosis: estudio mediante tomografía por emisión de positrones"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "36"
          "paginaFinal" => "40"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Impact of the detection of endothelial dysfunction in atherosclerosis: Assessment by positron emission tomography"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "293v80n01-13149370fig1.jpg"
              "Alto" => 791
              "Ancho" => 895
              "Tamanyo" => 60007
            ]
          ]
          "descripcion" => array:1 [
            "es" => "Índice de vasodilatación endotelio dependiente en pacientes sanos y en pacientes con dislipidemia, síndrome antifosfolípido primario y diabetes mellitas."
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Erick Alexánderson-Rosas, Rodrigo Calleja-Torres, Alfonso Martínez-García, Pedro Alberto Lamothe-Molina, Juan Manuel Ochoa-López, Gabriela Meléndez, Eric Kimura-Hayama, Aloha Meave-González"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Erick"
              "apellidos" => "Alexánderson-Rosas"
            ]
            1 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "Calleja-Torres"
            ]
            2 => array:2 [
              "nombre" => "Alfonso"
              "apellidos" => "Martínez-García"
            ]
            3 => array:2 [
              "nombre" => "Pedro Alberto"
              "apellidos" => "Lamothe-Molina"
            ]
            4 => array:2 [
              "nombre" => "Juan Manuel"
              "apellidos" => "Ochoa-López"
            ]
            5 => array:2 [
              "nombre" => "Gabriela"
              "apellidos" => "Meléndez"
            ]
            6 => array:2 [
              "nombre" => "Eric"
              "apellidos" => "Kimura-Hayama"
            ]
            7 => array:2 [
              "nombre" => "Aloha"
              "apellidos" => "Meave-González"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1405994010493709?idApp=UINPBA00004N"
    "url" => "/14059940/0000008000000001/v0_201307091134/X1405994010493709/v0_201307091135/es/main.assets"
  ]
  "itemAnterior" => array:16 [
    "pii" => "X1405994010493686"
    "issn" => "14059940"
    "estado" => "S300"
    "fechaPublicacion" => "2010-01-01"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Arch Cardiol Mex. 2010;80:29-32"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3758
      "formatos" => array:3 [
        "EPUB" => 44
        "HTML" => 3353
        "PDF" => 361
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "titulo" => "Concordance of congenital heart defects in two pairs of monozygotic twins: pulmonary stenosis and tetralogy of Fallot"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "29"
          "paginaFinal" => "32"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Concordancia en los defectos cardiacos congénitos, en dos pares de gemelos monocigóticos: estenosis pulmonar y tetralogía de Fallot"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "293v80n01-13149368fig1.jpg"
              "Alto" => 754
              "Ancho" => 1000
              "Tamanyo" => 111246
            ]
          ]
          "descripcion" => array:1 [
            "en" => "A. Thirteen years-old monozygotic female twins with severe pulmonary valve stenosis."
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Carlos Alva, Felipe David Gómez, Santiago Jiménez-Arteaga, Lucelli Yáñez, Lilia Ochoa"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Alva"
            ]
            1 => array:2 [
              "nombre" => "Felipe David"
              "apellidos" => "Gómez"
            ]
            2 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Jiménez-Arteaga"
            ]
            3 => array:2 [
              "nombre" => "Lucelli"
              "apellidos" => "Yáñez"
            ]
            4 => array:2 [
              "nombre" => "Lilia"
              "apellidos" => "Ochoa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1405994010493686?idApp=UINPBA00004N"
    "url" => "/14059940/0000008000000001/v0_201307091134/X1405994010493686/v0_201307091134/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Usefulness of integrated dual-source multislice computed tomography and cardiac SPECT in a patient with previous myocardial infarction"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "33"
        "paginaFinal" => "35"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Enrique Vallejo, Hermes Ilarraza, Oscar Quiroz, Carlos Rodríguez, José Luis Ramírez-Arias"
        "autores" => array:5 [
          0 => array:3 [
            "nombre" => "Enrique"
            "apellidos" => "Vallejo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Hermes"
            "apellidos" => "Ilarraza"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Oscar"
            "apellidos" => "Quiroz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "Ram&#237;rez-Arias"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Department of Nuclear Cardiology and Cardiac Hospital Ángeles del Pedregal. "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Department of Cardiac Rehabilitation, Instituto Nacional de Cardiología Ignacio Chávez."
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Department of Radiology, Hospital Ángeles del Pedregal, Mexico City. "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Utilidad de la evaluaci&#243;n integral con tomograf&#237;a multicorte de doble-tubo de rayos X y SPECT cardiaco en una paciente con antecedentes de infarto"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "293v80n01-13149369fig1.jpg"
            "Alto" => 837
            "Ancho" => 958
            "Tamanyo" => 97453
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Retrospective ECG-gated dual-energy CT scan reconstruction&#59; merging 70&#37; of the 140-kV spectrum and 30&#37; of the 100-kV spectrum shown as volume rendering of the right coronary artery &#40;RCA&#41; &#40;A&#41;&#59; curved multiplanar reconstruction revealing the presence of two-highly calcified plaques in the RCA &#40;arrows in B and C&#41;&#44; and a longitudinal multiplanar image at the stent level in the RCA&#44; processed with a s edge-enhancing kernel &#40;B46f&#41; to optimize the visualization of the stent lumen which demonstrated a mild neointimal hyperplasia &#40;arrows in D&#41;&#46;"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Case history&#46; </span>A 62-year-old woman was evaluated at the outpatient clinic for shortness of breath and mild substernal heaviness&#44; which increased in severity with moderate exertion&#46; The patient had a history of hypertension and coronary artery disease &#40;CAD&#41;&#44; and had suffered an acute inferior myocardial infarction six years earlier&#44; for which she underwent bare-metal stenting in the distal right coronary artery &#40;RCA&#41;&#46; Her physical examination was normal and the ECG revealed normal sinus rhythm at 75 beats per minute&#44; with Q waves and T-wave inversion in leads II&#44; III and aVF&#46; Suspicion for in-stent restenosis was raised and she was scheduled for a coronary computed tomography angiogram &#40;coronary CT angiogram&#41; after consultation with a cardiologist&#46;</p><p class="elsevierStylePara">The patient underwent a cardiac CT with a dual-source CT system &#40;DSCT&#58; two X-ray sources and 64 detectors with temporal resolution of 83 ms&#59; SOMATOM Definition&#44; Siemens Medical Solutions&#44; Forchheim&#44; Germany&#41; in dual-energy mode for performing coronary CT angiogram &#44; and myocardial perfusion evaluation&#44; as recently described&#46;<span class="elsevierStyleSup">1-2</span> From the dual-energy scan&#44; 3 different image reconstructions were obtained using the automated dual-energy image reconstruction software of Syngo MultiModality Workplace &#40;Siemens&#41; and compared to previous reports&#46;<span class="elsevierStyleSup">1</span> The DSCT system delivers the lowest possible radiation dose in cardiac CT because DSCT images the heart two times faster&#59; furthermore&#44; adaptative ECG-pulsing delivers the necessary radiation amount for cardiac imaging in less than half the time required by the most dose-efficient single source CT scanners&#46; The protocol described is completed under 10 mSv&#44; which is lower than the dose of a single day SPECT scan&#46;<span class="elsevierStyleSup">2</span> No pharmacological heart rate control was used&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 1</span> coronary CT angiogram images revealed right dominant circulation with normal left main coronary artery and non-significant stenosis in the left anterior descending and circumflex arteries territory&#46; Analysis of the RCA showed two high-density calcified plaques with an intermediate stenosis in the middle segment of the RCA &#40;<span class="elsevierStyleBold">Figures 1B and 1C</span>&#41;&#46; Multiplanar images with a special post-processing B46f reconstruction filter showed a patent stent with a very mild neointimal hyperplasia &#40;thin dark line inside the stent lumen&#41; &#40;<span class="elsevierStyleBold">Figure 1D</span>&#41;&#46; Figure 2 coronary CT angiogram images demonstrated a subendocardial perfusion defect in the right coronary territory&#44; within the inferior and inferolateral wall of the left ventricle &#40;area that appears as a black thick line at the subendocardial region&#41; &#40;<span class="elsevierStyleBold">Figures 2B&#44; 2C and 2D</span>&#41;&#46;</p><p class="elsevierStylePara"><img src="293v80n01-13149369fig1.jpg" alt="Figure 1&#46; Retrospective ECG-gated dual-energy CT scan reconstruction&#59; merging 70&#37; of the 140-kV spectrum and 30&#37; of the 100-kV spectrum shown as volume rendering of the right coronary artery &#40;RCA&#41; &#40;A&#41;&#59; curved multiplanar reconstruction revealing the presence of two-highly calcified plaques in the RCA &#40;arrows in B and C&#41;&#44; and a longitudinal multiplanar image at the stent level in the RCA&#44; processed with a s edge-enhancing kernel &#40;B46f&#41; to optimize the visualization of the stent lumen which demonstrated a mild neointimal hyperplasia &#40;arrows in D&#41;&#46;"></img></p><p class="elsevierStylePara"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 1&#46;</span></span><span class="elsevierStyleItalic">Retrospective ECG-gated dual-energy CT scan reconstruction&#59; merging 70&#37; of the 140-kV spectrum and 30&#37; of the 100-kV spectrum shown as volume rendering of the right coronary artery &#40;RCA&#41; &#40;A&#41;&#59; curved multiplanar reconstruction revealing the presence of two-highly calcified plaques in the RCA &#40;arrows in B and C&#41;&#44; and a longitudinal multiplanar image at the stent level in the RCA&#44; processed with a s edge-enhancing kernel &#40;B46f&#41; to optimize the visualization of the stent lumen which demonstrated a mild neointimal hyperplasia &#40;arrows in D&#41;&#46;</span></p><p class="elsevierStylePara"><img src="293v80n01-13149369fig2.jpg" alt="Figure 2&#46; Exercise stress TC-99m sestamibi SPECT perfusion images demonstrated an inferior and inferolateral transmural infarct with mild ischemia extending from base to apex &#40;Arrows in A&#41;&#46; Retrospective ECG-gated dual-scan CT multiplanar reformations in short-axis &#40;B&#41;&#44; vertical-axis &#40;C&#41; and horizontal-axis &#40;D&#41; views of dual-energy CT-based images showing a subendocardial perfusion defect &#40;arrows&#41; in the inferior wall of the left ventricle&#46;"></img></p><p class="elsevierStylePara"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Figure 2&#46;</span></span><span class="elsevierStyleItalic">Exercise stress TC-99m sestamibi SPECT perfusion images demonstrated an inferior and inferolateral transmural infarct with mild ischemia extending from base to apex &#40;Arrows in A&#41;&#46; Retrospective ECG-gated dual-scan CT multiplanar reformations in short-axis &#40;B&#41;&#44; vertical-axis &#40;C&#41; and horizontal-axis &#40;D&#41; views of dual-energy CT-based images showing a subendocardial perfusion defect &#40;arrows&#41; in the inferior wall of the left ventricle&#46;</span></p><p class="elsevierStylePara">Due to clinical history and the findings of coronary CT angiogram &#40;RCA with two intermediate stenoses&#41;&#44; the patient was scheduled for SPECT myocardial perfusion imaging &#40;SPECT MPI&#41;&#46; Exercise-stress Tc-99m sestamibi SPECT MPI demonstrated an inferior and inferolateral transmural infarct extended from base to apex with mild ischemia &#40;<span class="elsevierStyleBold">Figure 2A</span>&#41;&#46; Gated SPECT images showed inferior and inferolateral akinesia with normal left ventricular ejection fraction&#46; The patient was managed medically without symptoms during follow-up evaluations&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Discussion</span></p><p class="elsevierStylePara">Cardiac imaging has become the cornerstone in the workup of patients with suspected or known CAD&#46; The integration of multimodality imaging represents a natural extension of current imaging paradigms for diagnosing CAD&#44; assessing risk and guiding therapeutic decision-making&#46; The latest generation of multidetector CT scanners and the software configuration of 64-section CT scanners provide an appealing alternative for noninvasive luminal assessment in patients with chest pain&#46;<span class="elsevierStyleSup">3&#44;4</span> However&#44; a major limitation of MSCT is that only anatomic information is obtained&#44; whereas no information on the hemodynamic significance of CAD is evaluated&#46;<span class="elsevierStyleSup">5&#44;6 </span>As a result&#44; a wide discrepancy may be present between anatomic and functional testing results&#46; </p><p class="elsevierStylePara">Recently&#44; it has been published that single dual-energy CT provides morphological information on coronary artery luminal integrity and&#44; using the different imaging spectra contained within the same scan&#44; allows the reproducible differentiation of iodine distribution within the myocardium to delineate myocardial perfusion defects&#44; in good correlation with standard techniques&#46;<span class="elsevierStyleSup">1</span> In our case&#44; DS-MSCT demonstrated a very high diagnostic performance to exclude in-stent restenosis when using a dual-energy protocol&#46; Furthermore&#44; due to the higher spatial resolution of DS-MSCT&#44; compared to SPECT&#44; dual-energy CT images clearly demonstrated subendocardial distribution of the myocardial perfusion defect&#44; in contrast to the transmural defect seen within the SPECT images&#46; As a result&#44; the integration of a dual-energy CT protocol imaging to evaluate myocardial blood pool during the assessment of coronary anatomy in this patient&#44; may redefine the diagnostic power of DS-MSCT&#46;</p><p class="elsevierStylePara">However&#44; myocardial blood deficits demonstrated with DS-MSCT cannot differentiate between reversible ischemia and scar with current imaging protocols&#44; because coronary CT angiogram is acquired only at rest&#59; this is true for any relative or absolute evaluation of myocardial perfusion reserve &#40;MPR&#41;&#46; Recently&#44; it has been described an experimental protocol using DS-MSCT to assess both stress and rest myocardial perfusion&#44; in order to identify areas of infarcted or ischemic myocardium&#46;<span class="elsevierStyleSup">7</span> However&#44; disadvantages of CT perfusion imaging protocols include&#58; a&#41; radiation exposure&#44; b&#41; administration of a large volume of iodinated contrast&#44; c&#41; poor contrast resolution&#44; d&#41; artifacts that can result in false positive images&#44; e&#41; unable to quantify myocardial blood flow&#44; and f&#41; they are highly dependent on appropriate bolus timing&#46; Therefore&#44; to further define the sequelae of coronary atherosclerosis&#44; functional testing for assessment of MPR is ideally performed by nuclear perfusion imaging&#46; Advantages of cardiac SPECT imaging over other cardiovascular imaging modalities &#40;cardiovascular magnetic resonance&#44; contrast echocardiography and computed tomography&#41; include an extensive literature supporting efficacy and prognostic value&#44; standardized protocols for performing studies&#44; published user guidelines and appropriated criteria&#44; as well as a proven cost effectiveness for diagnosis&#44; management and risk assessment&#46;<span class="elsevierStyleSup">8</span></p><p class="elsevierStylePara">Thus&#44; rather than being competitive&#44; MSCT and SPECT imaging should be considered to be complementary for both diagnostic and a prognostic perspective&#44;<span class="elsevierStyleSup">9</span> as it has been shown in this case&#46; The use of the latest generation of multidetector CT scanners and developing novel imaging protocols&#44; combined SPECT and MSCT cardiac imaging&#44; will play a prominent role to detect&#44; quantify&#44; and characterize both clinical and subclinical atherosclerosis&#44; with potential reduction of radiation burden&#46; </p><hr></hr><p class="elsevierStylePara"><span class="elsevierStyleItalic">Corresponding author&#58;</span><br></br> Enrique Vallejo&#46;<br></br> Nuclear Cardiology and Cardiac CT&#44; Hospital &#193;ngeles del Pedregal&#46; Camino a Santa Teresa 1055-C No&#46; 645&#44; Col&#46; H&#233;roes de Padierna&#44; C&#46;P&#46; 10700&#44; M&#233;xico&#44; D&#46;F&#46;&#44; M&#233;xico&#46;<br></br> Phone and Fax number&#58; 5255 5135 2984&#46;<br></br><span class="elsevierStyleItalic">E mail&#58;</span> vallejo&#46; <a href="mailto&#58;enrique&#64;gmail&#46;com" class="elsevierStyleCrossRefs">enrique&#64;gmail&#46;com</a></p><p class="elsevierStylePara">Received&#58; March 20&#44; 2009&#59;<br></br> accepted&#58; August 20&#44; 2009</p>"
    "pdfFichero" => "293v80n01a13149369pdf001.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec192683"
          "palabras" => array:1 [
            0 => "SPECT cardiaco&#59; Angiotomograf&#237;a Coronaria&#59; Tomograf&#237;a con Dos Tubos de Rayos X"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec192682"
          "palabras" => array:1 [
            0 => "Cardiac SPECT&#59; CT Angiography&#59; Dual-Source CT"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "We present the case of a 62-year-old woman with chest pain and a history of an inferior myocardial infarction for which she underwent stenting in the right coronary artery&#46; Patient was evaluated by cardiac SPECT and the recently introduced dual-source computed tomography &#40;DSCT&#41; system &#40;equipped with two X-ray tubes and two corresponding detectors&#41;&#44; in order to detect ischemia associated to stent restenosis&#46; In this case&#44; DSCT demonstrated a very high diagnostic performance to exclude in-stent restenosis&#44; using a dual-energy protocol&#44; and clearly showed subendocardial distribution of the myocardial perfusion defect&#44; in contrast with the transmural defect seen in the SPECT images&#46; As a result&#44; the integration of a dual-energy CT protocol for the evaluation of myocardial blood pool during the assessment of coronary anatomy in this patient&#44; may redefine the diagnostic power of DSCT&#46;"
      ]
      "es" => array:1 [
        "resumen" => "Se presenta el caso de una mujer de 62 a&#241;os de edad con dolor tor&#225;cico en estudio y antecedente de infarto de la pared inferior&#44; por lo cual se le coloc&#243; una pr&#243;tesis endovascular &#40;stent&#41; en arteria coronaria derecha&#46; La paciente fue evaluada con tomograf&#237;a por emisi&#243;n de positrones &#40;SPECT&#41; cardiaco y con tomograf&#237;a multicorte de dos tubos de rayos X &#40;DSCT&#41; con el fin de descartar isquemia asociada a reestenosis en la pr&#243;tesis&#46; En esta investigaci&#243;n se demostr&#243; que la DSCT permite gran precisi&#243;n diagn&#243;stica para excluir reestenosis en la pr&#243;tesis cuando se aplica un protocolo de doble energ&#237;a y tambi&#233;n para demostrar la distribuci&#243;n subendoc&#225;rdica del infarto previo&#44; en comparaci&#243;n con el defecto transmural detectado en el estudio SPECT&#46; En consecuencia&#44; integrar las im&#225;genes de la anatom&#237;a coronaria con las de perfusi&#243;n mioc&#225;rdica obtenidas mediante DSCT aumenta el valor diagn&#243;stico de la tomograf&#237;a multicorte&#46;"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "293v80n01-13149369fig1.jpg"
            "Alto" => 837
            "Ancho" => 958
            "Tamanyo" => 97453
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Retrospective ECG-gated dual-energy CT scan reconstruction&#59; merging 70&#37; of the 140-kV spectrum and 30&#37; of the 100-kV spectrum shown as volume rendering of the right coronary artery &#40;RCA&#41; &#40;A&#41;&#59; curved multiplanar reconstruction revealing the presence of two-highly calcified plaques in the RCA &#40;arrows in B and C&#41;&#44; and a longitudinal multiplanar image at the stent level in the RCA&#44; processed with a s edge-enhancing kernel &#40;B46f&#41; to optimize the visualization of the stent lumen which demonstrated a mild neointimal hyperplasia &#40;arrows in D&#41;&#46;"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "293v80n01-13149369fig2.jpg"
            "Alto" => 837
            "Ancho" => 962
            "Tamanyo" => 155967
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Exercise stress TC-99m sestamibi SPECT perfusion images demonstrated an inferior and inferolateral transmural infarct with mild ischemia extending from base to apex &#40;Arrows in A&#41;&#46; Retrospective ECG-gated dual-scan CT multiplanar reformations in short-axis &#40;B&#41;&#44; vertical-axis &#40;C&#41; and horizontal-axis &#40;D&#41; views of dual-energy CT-based images showing a subendocardial perfusion defect &#40;arrows&#41; in the inferior wall of the left ventricle&#46;"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:9 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Ruzsics B"
                            1 => "Lee H"
                            2 => "Zwerner PL"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "Eur Radiol 2008"
                        "volumen" => "18"
                        "paginaInicial" => "2114"
                        "paginaFinal" => "2124"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Dual-source cardiac computed tomography image quality and dose considerations&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Achenbach S"
                            1 => "Anders K"
                            2 => "Kalender WA&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "Eur Radiol 2008"
                        "volumen" => "18"
                        "paginaInicial" => "1188"
                        "paginaFinal" => "1198"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Leber AW"
                            1 => "Johnson T"
                            2 => "Becker A"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "Eur Heart J 2007"
                        "volumen" => "28"
                        "paginaInicial" => "2354"
                        "paginaFinal" => "2360"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Usefulness of noninvasive cardiac imaging using dual-source computed tomography in an unselected population with high prevalence of coronary artery disease&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Heuschmid M"
                            1 => "Brugstahler C"
                            2 => "Reimann A"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "Am J Cardiol 2007"
                        "volumen" => "100"
                        "paginaInicial" => "587"
                        "paginaFinal" => "592"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Left ventricular function and myocardial perfusion reserve in patients with ischemic heart disease&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Tio RA"
                            1 => "Dabeshlim A"
                            2 => "Siebelink HM&#46;J"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "J Nucl Med 2009"
                        "volumen" => "50"
                        "paginaInicial" => "214"
                        "paginaFinal" => "219"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Limitations of computed tomography coronary angiography J Am Coll Cardiol 2008&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Nissen SE&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "volumen" => "52"
                        "paginaInicial" => "2145"
                        "paginaFinal" => "2147"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Cardiac myocar-dial perfusion imaging using dual source computed tomography&#46; Int J Cardiovasc Imaging 2009 &#40;in press&#41;&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Blankstein R"
                            1 => "Okada DR"
                            2 => "Rocha-Filho JA"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "doi:10"
                        "fecha" => "1007/s10554-009-9438-1"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Combining myocardial perfusion imaging with computed tomography for diagnosis of coronary artery disease&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Mahmarian JJ&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "Curr Opin Cardiol 2007"
                        "volumen" => "22"
                        "paginaInicial" => "413"
                        "paginaFinal" => "421"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Diagnostic performance of fusion of myocardial perfusion imaging &#40;MPI&#41; and computed tomography coronary angiography&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Santana CA"
                            1 => "Garcia EV"
                            2 => "Faber TL"
                            3 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "J Nucl Cardiol 2009"
                        "volumen" => "16"
                        "paginaInicial" => "201"
                        "paginaFinal" => "211"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/14059940/0000008000000001/v0_201307091134/X1405994010493694/v0_201307091134/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "14593"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Comunicaciones breves"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/14059940/0000008000000001/v0_201307091134/X1405994010493694/v0_201307091134/en/293v80n01a13149369pdf001.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1405994010493694?idApp=UINPBA00004N"
]
Article information
ISSN: 14059940
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 1 2 3
2024 October 26 7 33
2024 September 9 7 16
2024 August 16 8 24
2024 July 21 4 25
2024 June 8 2 10
2024 May 15 7 22
2024 April 14 5 19
2024 March 35 6 41
2024 February 23 3 26
2024 January 13 9 22
2023 December 25 5 30
2023 November 25 3 28
2023 October 56 4 60
2023 September 15 7 22
2023 August 16 4 20
2023 July 11 4 15
2023 June 14 2 16
2023 May 27 6 33
2023 April 17 1 18
2023 March 9 1 10
2023 February 17 1 18
2023 January 12 3 15
2022 December 24 3 27
2022 November 24 5 29
2022 October 30 9 39
2022 September 23 4 27
2022 August 23 4 27
2022 July 21 8 29
2022 June 19 5 24
2022 May 15 6 21
2022 April 11 7 18
2022 March 16 8 24
2022 February 14 4 18
2022 January 13 6 19
2021 December 15 10 25
2021 November 5 10 15
2021 October 14 9 23
2021 September 8 8 16
2021 August 13 7 20
2021 July 6 4 10
2021 June 12 6 18
2021 May 17 9 26
2021 April 62 4 66
2021 March 34 8 42
2021 February 24 7 31
2021 January 9 7 16
2020 December 13 7 20
2020 November 15 2 17
2020 October 10 1 11
2020 September 13 2 15
2020 August 13 2 15
2020 July 6 3 9
2020 June 11 2 13
2020 May 27 7 34
2020 April 11 8 19
2020 March 9 2 11
2020 February 6 1 7
2020 January 13 5 18
2019 December 13 11 24
2019 November 2 4 6
2019 October 7 6 13
2019 September 5 8 13
2019 August 8 3 11
2019 July 3 1 4
2019 June 19 9 28
2019 May 53 21 74
2019 April 25 8 33
2019 March 2 5 7
2019 February 5 4 9
2019 January 1 1 2
2018 December 0 1 1
2018 November 3 4 7
2018 October 5 4 9
2018 September 10 2 12
2018 August 5 2 7
2018 July 9 1 10
2018 June 1 0 1
2018 May 2 2 4
2018 April 4 1 5
2018 March 17 1 18
2018 February 8 0 8
2018 January 15 3 18
2017 December 6 0 6
2017 November 2 1 3
2017 October 8 1 9
2017 September 3 0 3
2017 August 5 2 7
2017 July 4 0 4
2017 June 14 2 16
2017 May 14 1 15
2017 April 4 1 5
2017 March 8 46 54
2017 February 11 5 16
2017 January 13 0 13
2016 December 15 1 16
2016 November 12 0 12
2016 October 23 2 25
2016 September 10 1 11
2016 August 10 0 10
2016 July 10 2 12
2016 June 40 9 49
2016 May 28 12 40
2016 April 28 7 35
2016 March 33 14 47
2016 February 34 12 46
2016 January 39 13 52
2015 December 43 15 58
2015 November 27 11 38
2015 October 47 7 54
2015 September 35 3 38
2015 August 79 3 82
2015 July 76 6 82
2015 June 50 1 51
2015 May 58 8 66
2015 April 39 3 42
2015 March 30 2 32
2015 February 33 0 33
2015 January 30 5 35
2014 December 42 4 46
2014 November 54 5 59
2014 October 43 5 48
2014 September 44 2 46
2014 August 40 2 42
2014 July 35 2 37
2014 June 68 2 70
2014 May 46 1 47
2014 April 30 5 35
2014 March 55 16 71
2014 February 71 10 81
2014 January 51 14 65
2013 December 56 7 63
2013 November 47 8 55
2013 October 65 8 73
2013 September 52 14 66
2013 August 45 6 51
2013 July 52 7 59
2013 June 19 4 23
2013 May 37 4 41
2013 April 24 6 30
2013 March 17 3 20
2013 February 9 4 13
2013 January 3 1 4
2012 December 5 1 6
2012 November 1 1 2
2012 October 3 1 4
2010 January 432 0 432
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos