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Cardiac CTA

D J Murphy, A Aghayev, M L Steigner
Non-invasive cross-sectional imaging techniques play a crucial role in the assessment of the varied manifestations of vascular disease. Vascular imaging encompasses a wide variety of pathology. Designing vascular imaging protocols can be challenging owing to the non-uniform velocity of blood in the aorta, differences in cardiac output between patients, and the effect of different disease states on blood flow. In this review, we provide the rationale behind-and a practical guide to-designing and implementing straightforward vascular computed tomography (CT) and magnetic resonance imaging (MRI) protocols...
March 14, 2018: Insights Into Imaging
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Nam Ju Lee, Harold Litt
PURPOSE OF REVIEW: To compare outcomes between registries and randomized controlled trials of coronary computed tomographic angiography (CCTA)-based versus standard of care approaches to the initial evaluation of patients with acute chest pain. RECENT FINDINGS: Randomized trials have demonstrated CCTA to be a safe and efficient tool for triage of low- to intermediate-risk patients presenting to the emergency department with chest pain. Recent studies demonstrate heterogeneous result using different standard of care approaches for evaluation of hard endpoints in comparison with standard evaluation...
March 8, 2018: Current Cardiology Reports
Takanori Masuda, Takeshi Nakaura, Yoshinori Funama, Tomoyasu Sato, Toru Higaki, Masao Kiguchi, Yukari Yamashita, Naoyuki Imada, Kazuo Awai
Objective: To evaluate the effect of patient characteristics on popliteal aortic contrast enhancement at lower extremity CT angiography (LE-CTA) scanning. Materials and Methods: Prior informed consent to participate was obtained from all 158 patients. All were examined using a routine protocol; the scanning parameters were tube voltage 100 kVp, tube current 100 mA to 770 mA (noise index 12), 0.5-second rotation, 1.25-mm detector row width, 0.516 beam pitch, and 41...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
S Aguadé Bruix, A Roque Pérez, H Cuéllar Calabria, M N Pizzi
Infective endocarditis (IE) is a serious pathology with a poor prognosis, whose mortality has not changed significantly despite advances in its diagnosis and treatment in the last 30years. The diagnostic capacity of the modified Duke criteria in prosthetic endocarditis and/or devices does not exceed 50%, so new tools are necessary for the diagnosis of this entity in this context. The18 F-FDG PET/CTA combines a highly sensitive technique to detect inflammatory-infectious activity and a technique with high anatomical resolution to assess the structural lesions associated with endocarditis...
February 26, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
Toru Higaki, Takeshi Nakaura, Masafumi Kidoh, Hideaki Yuki, Yasuyuki Yamashita, Yuko Nakamura, Fuminari Tatsugami, Yasutaka Baba, Makoto Iida, Kazuo Awai
Arterial peak enhancement on contrast-enhanced CT (CECT) images is thought to be higher in patients with low cardiac function. Using computer simulations, we tested the hypothesis that the relationship between the cardiac index and the aortic peak CT number (PCTN) is affected by the contrast material (CM) injection duration. We created computer simulation software for the contrast enhancement of various organs and vessels based on the Bae pharmacokinetics model and implemented models for CM transmission within organs and CM diffusion in blood plasma based on the osmotic pressure...
2018: PloS One
I Vernikouskaya, W Rottbauer, J Seeger, B Gonska, V Rasche, Jochen Wöhrle
OBJECTIVES: The aim of this study was to adapt patient-specifically a co-registration procedure for image fusion (IF) of a pre-interventional CT dataset with real-time X-ray (XR) fluoroscopy during transfemoral transcatheter aortic valve implantation (TAVI), enabling improved performance of the procedure. BACKGROUND: The ability to use 3D models of the respective anatomies to complement the anatomic information obtained by XR fluoroscopy and provide a greater degree of real-time anatomical guidance holds great potential for complex cardiac interventions, especially for TAVI procedures with cerebral protection...
February 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
Z Chen, F Shi, M Zhang, X Gong, L Lin, M Lou
BACKGROUND AND PURPOSE: The multisegment clot sign has been observed at the site of large-artery occlusion in patients with acute ischemic stroke. This study aimed to assess its occurrence rate and relationship with stroke etiologies in patients with acute intracranial large-artery occlusion. MATERIALS AND METHODS: We included consecutive patients with acute ischemic stroke who had acute intracranial large-artery occlusion and underwent perfusion CT within 8 hours after stroke onset...
February 15, 2018: AJNR. American Journal of Neuroradiology
Liyun Zhao, Sijie Zhou, Taibing Fan, Bin Li, Weijie Liang, Haoju Dong
OBJECTIVE: To assess the clinical value of three-dimensional (3D) printing technology for treatment strategies for complex double outlet right ventricle (DORV). METHODS: Twenty-five patients with complex double outlet right ventricle were enrolled in this study. The patients were divided into two groups: 3D printing group (eight patients) and a non-3-D printing control group (17 patients). The cardiac images of patients in the 3D printing group were transformed to Digital Imaging and Communications and were segmented and reconstructed to create a heart model...
January 2018: Journal of Cardiac Surgery
Matthias Koopmann, Liane Hinrichs, Jan Olligs, Michael Lichtenberg, Lars Eckardt, Dirk Böse, Stefan Möhlenkamp, Johannes Waltenberger, Frank Breuckmann
BACKGROUND: Atrial fibrillation (AF) and coronary artery disease (CAD) may be encountered coincidently in a large portion of patients. However, data on coronary artery calcium burden in such patients are lacking. Thus, we sought to determine the value of cardiac computed tomography (CCT) in patients presenting with new-onset AF associated with an intermediate pretest probability for CAD admitted to a chest pain unit (CPU). METHODS: Calcium scores (CS) of 73 new-onset, symptomatic AF subjects without typical clinical, electrocardiographic, or laboratory signs of acute coronary syndrome (ACS) admitted to our CPU were analyzed...
January 24, 2018: European Journal of Medical Research
Laurens E Swart, Asbjørn M Scholtens, Wilco Tanis, Koen Nieman, Ad J J C Bogers, Fred J Verzijlbergen, Gabriel P Krestin, Jolien W Roos-Hesselink, Ricardo P J Budde
The timely diagnosis of prosthetic heart valve endocarditis remains challenging yet of utmost importance. 18F-fluorodeoxyglucose (18 F-FDG) positron emission/computed tomography (PET/CT) and cardiac computed tomography angiography (CTA) were recently introduced as additional diagnostic tools in the most recent ESC guidelines on infective endocarditis. However, how to interpret PET/CT findings with regard to what is to be considered abnormal, what the potential confounders may be, as well as which patients benefit most from these additional imaging techniques and how to best perform them in these often-complex patients, remains unclear...
January 16, 2018: European Heart Journal
Kazuhiro Nakao, Teruo Noguchi, Yasuhide Asaumi, Yoshiaki Morita, Tomoaki Kanaya, Masashi Fujino, Hayato Hosoda, Shuichi Yoneda, Shoji Kawakami, Toshiyuki Nagai, Kensaku Nishihira, Takahiro Nakashima, Reon Kumasaka, Tetsuo Arakawa, Fumiyuki Otsuka, Michio Nakanishi, Yu Kataoka, Yoshio Tahara, Yoichi Goto, Haruko Yamamoto, Toshimitsu Hamasaki, Satoshi Yasuda
BACKGROUND: Despite the success of HMG-CoA reductase inhibitor (statin) therapy in reducing atherosclerotic cardiovascular events, a residual risk for cardiovascular events in patients with coronary artery disease (CAD) remains. Long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are promising anti-atherosclerosis agents that might reduce the residual CAD risk. Non-contrast T1-weighted imaging (T1WI) with cardiac magnetic resonance (CMR) less invasively identifies high-risk coronary plaques as high-intensity signals...
January 8, 2018: Trials
Qianjun Jia, Jianzheng Cen, Jinglei Li, Jian Zhuang, Hui Liu, Qun Zhang, Xiaoqing Liu, Meiping Huang, Changhong Liang
OBJECTIVES: To assess the frequency and anatomy of retro-oesophageal aortopulmonary collateral arteries (REMs) in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA-VSD-MAPCAs). METHODS: A total of 130 consecutive PA-VSD-MAPCA patients with preoperative CT angiography (CTA) data who underwent cardiac surgery were included. A detailed analysis of MAPCA anatomy was performed using CTA. RESULTS: A REM was identified in 82/130 included patients (63 %)...
January 5, 2018: European Radiology
Mathias H Sørgaard, Jesper J Linde, J Tobias Kühl, Henning Kelbæk, Jens D Hove, Gitte G Fornitz, Tem B S Jørgensen, Merete Heitmann, Charlotte Kragelund, Thomas F Hansen, Jawdat Abdulla, Thomas Engstrøm, Jan S Jensen, Yaffah T Wiegandt, Dan E Høfsten, Lars V Køber, Klaus F Kofoed
OBJECTIVES: The authors sought to perform a randomized controlled trial to evaluate the clinical efficacy of combined examination with coronary computed tomography angiography (CTA) and computed tomography perfusion imaging (CTP) compared to coronary CTA alone. BACKGROUND: Stress myocardial CTP may increase diagnostic specificity when added to coronary CTA in patients suspected of having ischemic heart disease. METHODS: Patients recently hospitalized for acute-onset chest pain, in whom acute coronary syndrome had been ruled out by normal electrocardiograms, normal troponin levels, and relief of symptoms, and who had a clinical indication for outpatient noninvasive testing, were screened for inclusion in the CATCH-2 (CArdiac cT in the treatment of acute CHest pain 2) trial (NCT02014311)...
December 8, 2017: JACC. Cardiovascular Imaging
Christof Burgstahler, Hans Cipowicz, Christoph Thomas, Christoph Schabel, Stefanie Mangold, Dominik Ketelsen, Claus D Claussen, Andreas M Niess, Ilias Tsiflikas
The aim of the study was to evaluate the diagnostic accuracy of carotid ultrasound (CU) to predict coronary atherosclerosis in asymptomatic male marathon runners. A total of 49 male marathon runners older than 45 years(mean age 53.3±7.2 years, range 45-74 years) received CU and cardiac CT angiography(CTA) including calcium scoring(CS). Results of CU and CTA were classified binary: 1. Absence of atherosclerosis and 2. presence of atherosclerosis. The extend of atherosclerosis was not primary end-point of the study...
December 14, 2017: Scandinavian Journal of Medicine & Science in Sports
Thomas J Stocker, Simon Deseive, Marcus Chen, Jonathon Leipsic, Martin Hadamitzky, Ronen Rubinshtein, Erik L Grove, Xiang-Ming Fang, John Lesser, Pál Maurovich-Horvat, Hugo Marques, Daniele Andreini, Ramzi Tabbalat, Joon-Won Kang, Joachim Eckert, Patricia Dickson, Signe H Forsdahl, Jess Lambrechtsen, Roberto C Cury, Jörg Hausleiter
BACKGROUND: Cardiac computed tomography angiography (cardiac CTA) is an increasingly used versatile imaging method to evaluate coronary and cardiac morphology. Owing to improvements in technology, image quality has continuously improved over the last 10-20 years. At the same time, numerous non-randomized and randomized studies have been performed to reduce the associated radiation exposure. Currently, it is unclear if the advances in technology and knowledge about radiation reduction translated into reduced levels of cardiac CTA radiation dose in daily clinical practice as well as a wide utilization of dose-saving strategies...
January 2018: Journal of Cardiovascular Computed Tomography
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Grigorios Korosoglou, Mohamed Marwan, Sorin Giusca, Axel Schmermund, Steffen Schneider, Oliver Bruder, Jörg Hausleiter, Stephen Schroeder, Alexander Leber, Tobias Limbourg, Gitsios Gitsioudis, Johannes Rixe, Ralf Zahn, Hugo A Katus, Stephan Achenbach, Jochen Senges
BACKGROUND: Coronary computed tomography angiography (coronary CTA) provides non-invasive evaluation of the coronary arteries with high precision for the detection of significant coronary artery disease (CAD). AIM: To investigate whether irregular heart rhythm including atrial fibrillation and premature beats during data acquisition influences (i) radiation and contrast media exposure, (ii) number of non-evaluable coronary segments and (iii) diagnostic impact of coronary CTA...
January 2018: Journal of Cardiovascular Computed Tomography
Alwaleed Al-Dairy, Yousef Rezaei, Maziar Gholampour Dehaki, Anita Sadeghpour, Zia Totonchi, Hamidreza Pouraliakbar, Alireza Alizadeh Ghavidel
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac malformation. We report three cases of ALCAPA who survived to adulthood. The first case was a 51-year-old woman who complained of typical chest pain that was diagnosed with ALCAPA using cardiac catheterization and coronary computed tomographic angiography (CTA). The second case was a 30-year-old woman with a history of surgery for atrial septal defect at 10 years old who presented with progressive exertional dyspnea...
November 2017: Iranian Journal of Medical Sciences
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