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Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-slice Multi-Detector Computed Tomography

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Advances in Computed Tomography 2013年第3期2卷 112-120页

作者： Yoshiki Noda Ryo Matsutera Yoshinori Yasuoka Kiyoshi Kume Hidenori Adachi Susumu Hattori Ryo Araki Motohiro Kosugi Yasuaki Kohama Tetsufumi Nakashima Tatsuya Sasaki Cardiovascular Division Osaka Minami Medical Center National Hospital Organization Osaka Japan

Background: Factors that can predict the presence and number of noncalcified coronary plaques (NCP) in Japanese patients with zero coronary artery calcium scores (CACS) essentially remain undefined. Methods and Results: We assessed independent predictors of the presence and number of segments with NCP in 111 Japanese patients with zero CACS who underwent 64-slice multi-detector computed tomography at our hospital. Thirty five patients (32%) had NCP, and 24 patients (22%) had ≥ 2 NCPs. Multiple logistic regression analysis revealed that significant predictors for the presence of NCP were age (odds ratio [OR]: 1.06, 95% confidence interval [CI] 1.01 - 1.11, p = 0.021), male (OR: 3.61, 95% CI 1.40 - 9.35, p = 0.008) and diabetes mellitus (OR: 3.10, 95% CI 1.02 - 9.45, p = 0.046), and those for the presence of ≥ 2 NCPs were age (OR: 1.08, 95% CI 1.02 - 1.15, p = 0.007) and a current smoking habit (OR: 5.09, 95% CI 1.00 - 25.74, p = 0.049). Multiple linear regression analysis identified advanced age, male gender and diabetes mellitus as independent predictors of the number of NCPs. A novel score calculated from the above four predictors showed moderate accuracy for a diagnosis of NCP and ≥ 2 NCPs, with areas under receiver operating curves of 0.738 and 0.736, respectively. Conclusions: Male Japanese patients with zero CACS, advanced age, diabetes mellitus and a current smoking habit might have NCPs.

关键词： Zero Coronary Artery Calcium Score Number of Noncalcified Coronary Plaque 64-slice Multi-Detector Computed Tomography Japanese Patients

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Efficacy of high resolution computed tomography for detection of early healing in scaphoid fractures

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Open Journal of Clinical Diagnostics 2012年第3期2卷 51-55页

作者： Michael Di Ianni Jatin Kaicker Ke Wu Hema Choudur Department of Medical Imaging McMaster University Hamilton Canada

Background: While plain radiography is commonly used to assess scaphoid fracture, this imaging modality may not accurately demonstrate early bone healing. This investigation evaluates the utility of 64-slice CT in the detection of early fracture healing compared to plain radiographs and magnetic resonance imaging (MRI). Methods: Outpatients attending follow-up visits for scaphoid fractures at Hamilton General Hospital were included in this investigation. Inclusion criteria included outpatients over age of 18 who consented to attend a follow-up visit for the scaphoid fracture at 6 weeks for X-Ray, 64-slice CT and MRI scan to monitor fracture healing. Assessment of healing was independently interpreted by two radiologists specialized in musculoskeletal imaging. A total of 7 adult outpatients were accrued, with each case classified as healing, not healing, or equivocal for plain radiography and 64-slice CT scan. Results: For plain radiographs, the level of interrater agreement for evidence of healing was 57% (4/7) cases. When comparing this to CT scans, there was no discrepancy between radiologists as 100% (7/7) were found to have evidence of healing. The 64-slice CT scan demonstrated evidence of early trabecular continuity in all cases, including radiographs that were interpreted as equivocal. Conclusion: This study can be considered a pilot project for the efficacy of 64-slice CT in the assessment of early healing of scaphoid fractures. For clinicians, the multiplanar reconstruction images allows for more accurate assessment of fractures than plain radiography. CT scans are able to penetrate through bony callus that may obscure visualization of healing in plain radiography, demonstrate trabecular continuity better than plain radiographs, are readily accessible and provide faster imaging acquisition. The observations from this study may have implications in terms of duration and type of casting applied, timing of strengthening exercises, and avoiding unnecessary surge

关键词： Wrist Fracture Scaphoid Bone Fracture Scaphoid Bone Fracture Healing 64-slice CT Scans Trabecular Continuity

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