Avaliação da acurácia diagnóstica da angiotomografia coronária de múltiplos detectores

Abstract

Evaluation of the Diagnostic Accuracy of Coronary Computed Tomographic Angiography Introduction: Coronary computed tomographic angiography (CCTA) has been widely accepted as a non-invasive diagnostic tool for coronary artery disease (CAD). The objective of this study was to evaluate the diagnostic performance of CCTA and its influence on modification of percutaneous revascularization strategies. Method: The study included two groups of patients: a main group (MG), including 100 patients screened with a suspect of severe CAD by CCTA and indication for coronary cineangiography (CINE), and a control group (CG) for comparison, including 100 patients selected during the same period, with indication for CINE according to clinical criteria or by positive functional tests. We evaluated the performance of CCTA for the diagnosis of lesions > 50% in coronary segments, arteries and patients and the revascularization strategies adopted. Results: The sensitivity, specificity and positive and negative predictive values of CCTA were 86%, 95%, 71% and 100% for the coronary segments, 91%, 92%, 80% and 100% for the coronary arteries and 100%, 90%, 100% and 100% for patients, respectively. In the MG, percutaneous coronary intervention (PCI) was performed in 90% of the patients, whereas in the CG, percutaneous coronary intervention was performed in 43% of the patients (P = 0.01). Conclusion: CCTA had a high diagnostic performance in detecting CAD and allowed ad hoc PCI to be performed in 90% of the patients. This strategy, however, must await randomized studies to confirm these results.

Safety criteria for contrast administration in computed tomography cardiac angiography: perception of nursing

“…Furthermore, there may be leakage of the contrast media considered adverse place at intravenous drug administration event and, in most cases, involves smaller volumes than 10mL evolved without complications. However, large amounts such as 50ml or more, can cause tissue damage to the puncture site adjacent to the compartment syndrome (16) .…”

“…The fast development of computed tomography technique of multiple detectors allows the production of images quickly, reducing the risks of radiation, allowing the internal visualization of the arteries (16) . For this, iodinated contrast media is used, which is a radiopaque substance capable of improving sharpness of images.…”

Prognosis of Non-Significant Coronary Atherosclerotic Disease Detected by Coronary Artery Tomography

“…Novos avanços da TC levaram à capacidade de identificar e quantificar diretamente essas placas chamadas "vulneráveis", as quais Desde a introdução da TC, estudos foram publicados comparando o desempenho diagnóstico desse método com o padrão de referência, a angiocoronariografia invasiva. A alta acurácia diagnóstica (em torno de 90%) para detecção e exclusão de estenose coronariana à TC já foi estabelecida 7,8,11 . Muito embora a associação entre SCA e obstrução aterosclerótica clinicamente não significativa tenha sido descrita desde a década de 1970 12 , ainda não existe definição na literatura sobre o prognóstico e os fatores de risco, bem como sobre a capacidade de predição de eventos adversos coronarianos à TC para esse grupo de pacientes 8,13,14 .…”