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Unlabelled: Transient ischemic dilation (TID) in the setting of abnormal stress-rest cardiac SPECT myocardial perfusion imaging (MPI) has been linked with increased cardiovascular risk. However, the significance of TID in the setting of an otherwise normal SPECT MPI study has not been clearly established. In this study, cardiac CT was used to evaluate the prevalence of atherosclerotic lesions and the severity of coronary artery stenosis in patients with TID of the left ventricle with or without associated myocardial perfusion defects on SPECT MPI., Methods: The study population consisted of 1,553 consecutive patients who had undergone both cardiac CT and SPECT MPI within 1 mo between January 1, 2006, and September 1, 2011. Patients included in the study group had a pathologic TID value defined as ≥1.18 for men and ≥1.22 for women. Coronary CT angiography was used to evaluate each coronary segment for the presence and composition of atherosclerotic plaque and the degree of coronary stenosis. TID-positive patients were compared with a 2:1 risk-factor-matched-pair control cohort without TID., Results: TID was identified in 30 patients who were compared with TID-negative risk-factor-matched controls (n = 60). When compared with the TID-negative control cohort, TID-positive patients had no significant differences in the presence and extent of atherosclerosis, the degree of coronary artery stenosis, or the calcium score at cardiac CT. Similarly, there were no significant differences in these CT measures in TID-positive patients with a normal perfusion study (n = 20) when compared with TID-negative patients with a normal perfusion study (n = 48). In addition, there was no significant difference in the incidence of major adverse cardiac events when comparing both the TID-positive patients and the TID-negative control cohort and when comparing patients who were TID-positive with normal perfusion with patients who were TID-negative with normal perfusion., Conclusion: The presence of TID with an otherwise normal SPECT MPI study does not translate into a greater extent of coronary artery disease as assessed by cardiac CT or increased risk for future major adverse cardiac events., (© 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.)

Objective: The objective of our study was to evaluate radiation dose and quantitative image quality parameters at high-pitch CT angiography (CTA) of the aorta compared with conventional CTA., Materials and Methods: We studied the examinations of 110 patients (65 men and 45 women; mean age ± SD, 64 ± 15 years) who had undergone CTA of the entire aorta on a second-generation dual-source CT system; 50 examinations were performed in high-pitch mode. The mean arterial attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) were calculated for the high-pitch CTA and conventional CTA groups. Radiation exposures were compared., Results: All studies were considered of diagnostic quality. At high-pitch CTA, the mean tube voltage and tube current-exposure time product were 118 ± 7 kV (SD) and 197 ± 78 mAs compared with 120 ± 1 kV and 258 ± 78 mAs, respectively, at conventional CTA (p < 0.05). The mean volume CT dose index, dose-length product, and effective dose were 8.1 ± 2.4 mGy, 561.1 ± 178.6 mGy × cm, and 9.6 ± 3.0 mSv at high-pitch CTA and 18.3 ± 7.7 mGy, 1162.6 ± 480.1 mGy × cm, and 19.8 ± 8.2 mSv at conventional CTA (p < 0.001). Attenuation was similar for both protocols, whereas significantly less contrast medium was injected for high-pitch CTA than for standard-pitch CTA (87.3 ± 16 mL vs 97.9 ± 16 mL, respectively; p < 0.01). The SNR and CNR were significantly lower in the high-pitch CTA examinations (p < 0.01), whereas the FOM was nonsignificantly higher. Twenty patients underwent both high-pitch CTA and conventional CTA, with a 45% reduction in radiation dose (p < 0.001)., Conclusion: High-pitch CTA of the aorta yields 45-50% reduction of radiation exposure as well as contrast medium savings with maintained vessel attenuation.