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Ct cardiology

Jean-François Sarrazin, François Philippon, Mikaël Trottier, Michel Tessier
Cardiovascular implantable electronic device (CIED) infection and prosthetic valve endocarditis (PVE) remain a diagnostic challenge. Cardiac imaging plays an important role in the diagnosis and management of patients with CIED infection or PVE. Over the past few years, cardiac radionuclide imaging has gained a key role in the diagnosis of these patients, and in assessing the need for surgery, mainly in the most difficult cases. Both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and radiolabelled white blood cell single-photon emission computed tomography/computed tomography (WBC SPECT/CT) have been studied in these situations...
September 26, 2016: World Journal of Cardiology
Davide Patrini, Mohamed Amirali Gulamhussein, Pasquale Pellegrino, Marianna Redaelli, Jonathan Pararajasingham, David Lawrence, Nikolaos Panagiotopoulos
INTRODUCTION: Gossypiboma, also referred to as a textiloma, gauzoma or muslinoma describe a mass in the body composed of a central cotton core surrounded by a foreign body reaction. It has an estimated incidence of 1/1000-1/10000 surgeries, occurring in the abdomen (56%), pelvis (18%) and least commonly the thorax (11%) and represents an unfortunate event for both the patient and the operating surgeon with severe liability implications. PRESENTATION OF CASE: We report a case of a 49-year-old male with Marfan Syndrome who was admitted to the cardiology department with a four day history of shortness of breath and associated dull, non-radiating chest pain...
September 23, 2016: International Journal of Surgery Case Reports
Markus Schwaiger, Karl Kunze, Christoph Rischpler, Stephan G Nekolla
After the successful introduction of PET/CT as a multimodality imaging technique, PET/MR has subsequently emerged as an attractive instrumentation for applications in neurology, oncology, and cardiology. Simultaneous data acquisition combining structural, functional, and molecular imaging provides a unique platform to link various aspects of cardiac performance for the non-invasive characterization of cardiovascular disease phenotypes. Specifically, tissue characterization by MR techniques with and without contrast agents allows for functional parameters such as LGE, myocardial perfusion, and T1 maps as well as an estimate of extracellular volume...
September 22, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Alastair J Moss, Marc R Dweck, Andrew D Flapan
CLINICAL INTRODUCTION: A 33-year-old man with no history of coronary artery disease presented to the rapid access cardiology clinic with an episode of atypical anginal chest pain. He had a 15 pack-year history of smoking and a family history of myocardial infarction under the age of 55. Physical examination and exercise ECG testing were unremarkable. On assessment in the cardiology clinic, blood sampling was notable for an elevated high-sensitivity troponin I of 61 ng/L (99% upper reference level, 34 ng/L)...
September 15, 2016: Heart: Official Journal of the British Cardiac Society
Andrea Lovece, Pamela Milito, Emanuele Asti, Luigi Bonavina
Leiomyoma is the most common oesophageal tumour and is symptomatic in about half of the patients. Dysphagia is the most common symptom. A 41-year-old woman presented with recent onset of severe orthostatic hypertension. During the cardiological work-up, a mediastinal mass was found at transthoracic echocardiogram. Further investigation (upper gastrointestinal endoscopy, endoscopic ultrasonography, CT scan and cardiac MRI) confirmed the diagnosis of a large oesophageal submucosal mass compressing the supradiaphragmatic inferior vena cava...
2016: BMJ Case Reports
Jonathan A Pan, Michael Salerno
Over the past several years, there have been major advances in cardiovascular positron emission tomography (PET) in combination with either computed tomography (CT) or, more recently, cardiovascular magnetic resonance (CMR). These multi-modality approaches have significant potential to leverage the strengths of each modality to improve the characterization of a variety of cardiovascular diseases and to predict clinical outcomes. This review will discuss current developments and potential future uses of PET/CT and PET/CMR for cardiovascular applications, which promise to add significant incremental benefits to the data provided by each modality alone...
September 2, 2016: Diagnostics
Diana Paez, Amalia Peix, Pilar Orellana, Joao Vitola, Fernando Mut, Claudia Gutiérrez, Crosby Plaza, Tarik Becic, Maurizio Dondi, Enrique Estrada
The burden of cardiovascular diseases (CVDs) in the world is ever growing. They represent the first cause of death worldwide and in Latin America. Nuclear cardiology has a well-established role in the management of patient with CVDs and is being increasingly integrated into the healthcare systems in the region. However, there remains variability as to the infrastructure available across the countries, in terms of existing technology, radiopharmaceuticals, and human resources. The approximate number of gamma (γ) cameras in the region is 1348, with an average of 2...
August 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
M A Hill, P O'Neill, W G McKenna
Magnetic resonance imaging (MRI) is increasingly being used in cardiology to detect heart disease and guide therapy. It is mooted to be a safer alternative to imaging techniques, such as computed tomography (CT) or coronary angiographic imaging. However, there has recently been an increased interest in the potential long-term health risks of MRI, especially in the light of the controversy resulting from a small number of research studies reporting an increase in DNA damage following exposure, with calls to limit its use and avoid unnecessary examination, according to the precautionary principle...
August 22, 2016: European Heart Journal Cardiovascular Imaging
Won Woo Lee
Nuclear cardiology is one of the major fields of nuclear medicine practice. Myocardial perfusion studies using single-photon emission computed tomography (SPECT) have played a crucial role in the management of coronary artery diseases. Positron emission tomography (PET) has also been considered an important tool for the assessment of myocardial viability and perfusion. However, the recent development of computed tomography (CT)/magnetic resonance imaging (MRI) technologies and growing concerns about the radiation exposure of patients remain serious challenges for nuclear cardiology...
September 2016: Nuclear Medicine and Molecular Imaging
Catherine Hatzantonis, Marcin Czyz, Renata Pyzik, Bronek M Boszczyk
BACKGROUND: Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right heart chambers and pulmonary arteries. Patients may vary in presentation from asymptomatic or symptoms such as syncope to life-threatening complications...
August 17, 2016: European Spine Journal
Wolfgang Peter Fendler, Johannes Czernin, Ken Herrmann, Thomas Beyer
OBJECTIVES: Information has been collected from positron emission tomography/magnetic resonance imaging (PET/MRI) operational sites to identify its present and future applications. This may help to focus discussions on common interests of the PET/MRI community. METHODS: A web-based survey of PET/MRI users was conducted from June to October 2015. The survey was composed of 26 questions related to (A) the PET/MRI center, (B) present utilization and imaging protocols and (C) perspectives on key applications...
August 11, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Emanuela de Cillis, Annamaria Dachille, Francesco Giardinelli, Tommaso Acquaviva, Alessandro Santo Bortone
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) technique represents a real revolution in the field of interventional cardiology and medicine, in particular for the treatment of severe aortic valve stenosis in elderly patients or in patients when the periprocedural risk for the traditional surgical option is considered too high, as an alternative to the traditional aortic valve replacement. Although experience on the valves of the last generation is still limited in terms of time, the data currently available are definitely moving in the direction of a minimum hospital mortality (1%) as well as a drastic reduction in the incidence of complications when compared to the devices of the previous generation...
July 29, 2016: Surgical Technology International
Sahela Nasrin, Fathima Aaysha Cader, Md Salahuddin, Tahera Nazrin, Masuma Jannat Shafi
BACKGROUND: Massive pulmonary embolism (PE) is associated with significant mortality, especially if compounded by haemodynamic instability, right ventricular (RV) dysfunction and right atrial (RA) thrombus. Thrombolysis can be lifesaving in patients with major embolism and cardiogenic shock, and accelerates the resolution of thrombus. Only three fibrinolytic agents-namely streptokinase, urokinase, and recombinant tissue plasminogen activator (alteplase) have been approved in the treatment of PE, with studies demonstrating similar safety profiles...
2016: BMC Research Notes
Anand M Prabhakar, Alexander S Misono, Jennifer Hemingway, Danny R Hughes, Richard Duszak
PURPOSE: To examine changes in utilization of computed tomography (CT) angiography nationally and changing relative specialty roles in examination interpretation. MATERIALS AND METHODS: Service-specific claims data for region-specific CT angiography examinations were identified using Medicare Physician Supplier Procedure Summary Master Files from 2001 through 2014. Longitudinal national utilization rates were calculated using annual Medicare enrollment data for 2001-2013...
October 2016: Journal of Vascular and Interventional Radiology: JVIR
Eva Corredoira, Eliseo Vañó, Luis Alejo, Carlos Ubeda, Federico Gutiérrez-Larraya, Julia Garayoa
The aim of this study was to assess image quality and radiation dose of a biplane angiographic system with cone-beam CT (CBCT) capability tuned for pediatric cardiac procedures. The results of this study can be used to explore dose reduction techniques. For pulsed fluoroscopy and cine modes, polymethyl methacrylate phantoms of various thicknesses and a Leeds TOR 18-FG test object were employed. Various fields of view (FOV) were selected. For CBCT, the study employed head and body dose phantoms, Catphan 504, and an anthropomorphic cardiology phantom...
2016: Journal of Applied Clinical Medical Physics
J Alberto Neder, Denis E O'Donnell
There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Marcio Sommer Bittencourt, Edward Hulten, Tamar S Polonsky, Udo Hoffman, Khurram Nasir, Suhny Abbara, Marcelo Di Carli, Ron Blankstein
BACKGROUND: The most appropriate score for evaluating the pretest probability of obstructive coronary artery disease (CAD) is unknown. We sought to compare the Diamond-Forrester (DF) score with the 2 CAD consortium scores recently recommended by the European Society of Cardiology. METHODS: We included 2274 consecutive patients (age, 56±13 years; 57% male) without prior CAD referred for coronary computed tomographic angiography. Computed tomographic angiography findings were used to determine the presence or absence of obstructive CAD (≥50% stenosis)...
July 19, 2016: Circulation
Harvey S Hecht, Jagat Narula, William F Fearon
Invasive fractional flow reserve (FFR) is now the gold standard for intervention. Noninvasive functional imaging analyses derived from coronary computed tomographic angiography (CTA) offer alternatives for evaluating lesion-specific ischemia. CT-FFR, CT myocardial perfusion imaging, and transluminal attenuation gradient/corrected contrast opacification have been studied using invasive FFR as the gold standard. CT-FFR has demonstrated significant improvement in specificity and positive predictive value compared with CTA alone for predicting FFR of ≤0...
July 8, 2016: Circulation Research
Mariana Mihăilă, V Herlea, Camelia Dobrea, Ioana Lupescu, Gina Rusu Munteanu, Grethi Chiriac, L Micu, R Serescu, I Copaci
We present the case of a 76 year old female patient admitted in the Department of Cardiology for physical asthenia, profuse sweating and dyspnea with orthopnea for about one month. Clinical and paraclinical assessments performed at admission confirmed the diagnosis of cardiac tamponade. Surgical intervention was performed and 400 mL of clear effusion were drained. Post-operative evolution was marked by recurrence of symptoms, requiring after 3 weeks a new drainage of 600 mL of clear effusion, and biopsy of the pericardium was performed...
April 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
F André, S J Buß, H A Katus
Technological advances in computed tomography (CT) resulted in an expansion of (the spectrum of) indications and numbers of examination in cardiology. Thus, CT found it's way into cardiological clinical practice as well as in current guidelines. This article describes the state of the technology, current developments, and the clinical significance of cardiac CT. Determination of indications, conduct, and assessment of coronary CT affect the core content of cardiological expertise. On the basis of the expected further increase in coronary CT examinations, cardiologists need to be familiar with this modality...
August 2016: Herz
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