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Prospective Study on Clinical Outcome of Coronary CT Angiography in Patients with Suspected Coronary Artery Disease: Three-year Follow-up Study |
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K SUNIL KUMAR, J NAVEEN, RIMIKI CHALLAM, S SUBHASCHANDRA 1. Assistant Professor, Department of Radiology, Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, Karnataka, India. 2. Assistant Professor, Department of Radiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India. 3. Radiologist, Department of Radiology, Civil Hospital, Shillong, Meghalaya, India. 4. Professor, Department of Radiology, Regional Institute of Medical science, Imphal, Manipur, India. |
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Correspondence Address : Dr. K Sunil Kumar, Hridevi Institute of Medical Sciences and Research Hospital, Tumkur, Karnataka, India. E-mail: drsunilkumark@yahoo.in |
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| ABSTRACT |  | ||||||||||||||||||||||||||||||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||||||||||||||||||||||||||||||
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| Keywords : Adverse cardiac event, Calcium score, Significant stenosis | |||||||||||||||||||||||||||||||||||||||||||||
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| INTRODUCTION |
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Prevalence of CAD in India is around 14% in urban population and around 7% in rural population (1),(2). Imaging modalities available for evaluation of suspected CAD are conventional angiography, CTA, magnetic resonance coronary angiography, Single Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) and cardiac MRI (3). CTA has sensitivity of 93-100% , specificity of 91 to 96% and negative predictive value of 96 to 100% for detecting significant stenosis ( >50% stenosis) [4-12]. Prognosis of the patient with CAD is currently done based on SPECT and PET findings. Patients with normal SPECT scan have low mortality rate of 0.6 -1% and patients with abnormal scan have death or infarction rate of 5.9% (14),(14). Role of CTA in prognosis of patients with CAD is not well established with few studies in the literature and most of them have shown no or less than 1% adverse cardiac events in patients with normal CTA or non-significant stenosis (15),(16),(17),(18),(19). In this study, the prognostic value of CTA was assessed in patients with possible CAD. | |||||||||||||||||||||||||||||||||||||||||||||
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| TABLES AND FIGURES |
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Original article / research
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