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Coronary artery cardiac computed tomography MRI

Silvana Molossi, Hitesh Agrawal
The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis...
June 16, 2017: Congenital Heart Disease
Min Jeong Kim, Yeonyee E Yoon, Jin Joo Park, Yeo Koon Kim, Eun Ju Chun, Sang Il Choi, Goo-Young Cho
Coronary magnetic resonance angiography (CMRA) allows a noninvasive assessment of the coronary anatomy without exposing the patients to radiation. It is also superior to coronary computed tomography angiography (CCTA) for the evaluation of luminal narrowing in heavily calcified coronary segments. We report a case with triple-vessel disease, but it could not be accurately assessed by CCTA because of calcification and lack of a significant perfusion defect or myocardial scarring on cardiac magnetic resonance imaging (MRI)...
May 2017: Korean Circulation Journal
Hyun Woo Chung, Sung Min Ko, Hweung Kon Hwang, Young So, Jeong Geun Yi, Eun Jeong Lee
OBJECTIVE: To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard...
May 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Yuki Tanabe, Teruhito Kido, Akira Kurata, Naoki Fukuyama, Takahiro Yokoi, Tomoyuki Kido, Teruyoshi Uetani, Mani Vembar, Amar Dhanantwari, Shinichi Tokuyasu, Natsumi Yamashita, Teruhito Mochizuki
We evaluated the image quality and diagnostic performance of late iodine enhancement computed tomography (LIE-CT) with knowledge-based iterative model reconstruction (IMR) for the detection of myocardial infarction (MI) in comparison with late gadolinium enhancement magnetic resonance imaging (LGE-MRI). The study investigated 35 patients who underwent a comprehensive cardiac CT protocol and LGE-MRI for the assessment of coronary artery disease. The CT protocol consisted of stress dynamic myocardial CT perfusion, coronary CT angiography (CTA) and LIE-CT using 256-slice CT...
April 13, 2017: International Journal of Cardiovascular Imaging
I Ben Ghorbel, N Belfeki, M H Houman
Behçet's disease (BD) is a multisystem inflammatory disorder. Intracardiac thrombus (ICT) formation is an uncommon but important complication of BD. Of the cases of Behçet's disease, we selected those with ICT. All patients fulfilled the diagnostic criteria of the International Study Group of Behçet's disease. The ICT in each case was confirmed by ultrasonography, computed tomography and MRI. Clinical features and laboratory parameters were determined. Among our 518 patients with BD, 8 were diagnosed as having intracardiac thrombus (ICT)...
December 16, 2016: Reumatismo
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
Mark Doyle, Gerald M Pohost, C Noel Bairey Merz, Leslee J Shaw, George Sopko, William J Rogers, Barry L Sharaf, Carl J Pepine, Diane V Thompson, Geetha Rayarao, Lindsey Tauxe, Sheryl F Kelsey, Robert W W Biederman
BACKGROUND: We introduce an algorithmic approach to optimize diagnostic and prognostic value of gated cardiac single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) modalities in women with suspected myocardial ischemia. The novel approach: bio-informatics assessment schema (BIAS) forms a mathematical model utilizing MPI data and cardiac metrics generated by one modality to predict the MPI status of another modality. The model identifies cardiac features that either enhance or mask the image-based evidence of ischemia...
October 2016: Cardiovascular Diagnosis and Therapy
Luca Presotto, Elena Busnardo, Luigi Gianolli, Valentino Bettinardi
Positron emission tomography (PET) is indicated for a large number of cardiac diseases: perfusion and viability studies are commonly used to evaluate coronary artery disease; PET can also be used to assess sarcoidosis and endocarditis, as well as to investigate amyloidosis. Furthermore, a hot topic for research is plaque characterization. Most of these studies are technically very challenging. High count rates and short acquisition times characterize perfusion scans while very small targets have to be imaged in inflammation/infection and plaques examinations...
December 2016: Quarterly Journal of Nuclear Medicine and Molecular 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
Nickalaus L Gramze, Dipan J Shah
PURPOSE OF REVIEW: Cardiac MRI is unique amongst the cardiac imaging modalities in its ability to directly image myocardial fibrosis using late gadolinium enhancement techniques. The ability to identify not only the presence of fibrosis but also its pattern of distribution within the myocardium can aid in distinguishing between ischemic and nonischemic causes of left ventricular dysfunction, as well as provide valuable prognostic information for patients with various etiologies of heart failure...
September 2016: Current Opinion in Cardiology
Kwang Nam Jin, Carlo N De Cecco, Damiano Caruso, Christian Tesche, Adam Spandorfer, Akos Varga-Szemes, U Joseph Schoepf
Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects...
October 2016: European Journal of Radiology
P Ong, U Sechtem
Just as in epicardial coronary stenosis, coronary microvascular dysfunction (CMD) also leads to an imbalance of myocardial oxygen supply and demand. The dysfunction is located at the level of the coronary microcirculation with vessel diameters < 500 µm and structural as well as functional alterations have been described. The underlying mechanisms are diverse, frequently overlap and are still incompletely understood. Among others, conditions such as chronic inflammation, estrogen deficiency and a genetic familial predisposition have been reported...
June 2016: Herz
Simon Lee, Santosh C Uppu, Irene D Lytrivi, Javier Sanz, Justin Weigand, Miwa K Geiger, Rajesh U Shenoy, Kanwal Farooqi, Khanh H Nguyen, Ira A Parness, Shubhika Srivastava
BACKGROUND: Anomalous aortic origin of a coronary artery from the wrong Sinus of Valsalva (AAOCA) is a rare congenital anomaly and is associated with sudden cardiac death. Morphologic features considered to be "high risk" are significant luminal narrowing, acute coronary angulation at its origin, intramural course, and long interarterial course. A consistent approach for characterization of these features is lacking. METHODS: A retrospective single-center review of all patients diagnosed with AAOCA using echocardiogram and computed tomography (CT)/magnetic resonance imaging (MRI) studies was performed...
2016: World Journal for Pediatric & Congenital Heart Surgery
Ibrahim Danad, Jackie Szymonifka, Jos W R Twisk, Bjarne L Norgaard, Christopher K Zarins, Paul Knaapen, James K Min
Aims: The aim of this study was to determine the diagnostic performance of single-photon emission computed tomography (SPECT), stress echocardiography (SE), invasive coronary angiography (ICA), coronary computed tomography angiography (CCTA), fractional flow reserve (FFR) derived from CCTA (FFRCT), and cardiac magnetic resonance (MRI) imaging when directly compared with an FFR reference standard. Method and results: PubMed and Web of Knowledge were searched for investigations published between 1 January 2002 and 28 February 2015...
April 1, 2017: European Heart Journal
G J Pelgrim, A Handayani, H Dijkstra, N H J Prakken, R H J A Slart, M Oudkerk, P M A Van Ooijen, R Vliegenthart, P E Sijens
Technological advances in magnetic resonance imaging (MRI) and computed tomography (CT), including higher spatial and temporal resolution, have made the prospect of performing absolute myocardial perfusion quantification possible, previously only achievable with positron emission tomography (PET). This could facilitate integration of myocardial perfusion biomarkers into the current workup for coronary artery disease (CAD), as MRI and CT systems are more widely available than PET scanners. Cardiac PET scanning remains expensive and is restricted by the requirement of a nearby cyclotron...
2016: BioMed Research International
Eduardo G Bertoldi, Steffan F Stella, Luis E Rohde, Carisi A Polanczyk
Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost-effectiveness information to aid physicians and decision-makers in selecting the most appropriate testing strategy. We used the state-transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex-ECG), stress echocardiography (ECHO), single-photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C-MRI) as the initial test...
May 2016: Clinical Cardiology
Florian Blaschke, Florian Krackhardt, Bherous Kherad, Burkert Pieske, Wilhelm Haverkamp, Matthias Rief
CONTEXT: Congenital coronary anomalies, including anomalous origin, distribution, intercoronary communications, and coronary fistulae occur at a rate of approximately 1% in the general population and are the most incidental findings. CASE REPORT: A 49-year-old male patient presented to the emergency department with exercise-induced dyspnea and atypical angina pectoris. Coronary angiography (CAG) and contrast-enhanced 320-slice multidetector cardiac computed tomography with subsequent three-dimensional reconstructions revealed a single coronary artery (SCA) arising from the right sinus of Valsalva with a proximal branch giving rise to the left anterior descending coronary artery...
February 2016: North American Journal of Medical Sciences
Bedia Kara, Alaaddin Nayman, Ibrahim Guler, Enes Elvin Gul, Mustafa Koplay, Yahya Paksoy
BACKGROUND: The purpose of this study was to compare the left ventricular parameters obtained from multi-detector row computed tomography (MDCT) studies with two-dimensional echocardiography (2DE), and magnetic resonance imaging (MRI), which is accepted as the gold standard in the evaluation of left ventricular functions. The study also aimed to evaluate whether or not there is a relationship between the MR-Argus and CMR tools software programs which are used in post-process calculations of data obtained by MRI...
2016: Polish Journal of Radiology
C Sorensen, P Gach, H Pico, N Hugues, A Dabadie, C Desvignes, B Bourlière, A Aschero, N Colavolpe, P Petit, G Gorincour
The different factors involved in the choice of the best cardiovascular imaging examination for pediatric patients are justification, radiation protection, sedation, resolutions (spatial and contrast), morphology or function, intervention and contrast enhancement. Computed tomography is preferable for all coronary artery conditions, any arterial or venous abnormalities in newborns and infants and in the preoperative assessment for tetralogy of Fallot. Magnetic resonance imaging is used for any tumoral or functional assessment, cardiomyopathy or arrhythmia or if the child's participation and/or size of the structures being examined allows using this technique...
May 2016: Diagnostic and Interventional Imaging
Matthew C Henn, Brian P Cupps, Julia Kar, Kevin Kulshrestha, Danielle Koerner, Alan C Braverman, Michael K Pasque
OBJECTIVE: When significant coronary lesions are identified by angiography, regional left ventricular (LV) contractile function often plays a role in determining candidacy for revascularization. To improve on current subjective and nonquantitative metrics of regional LV function, we tested a z-score "normalization" of regional strain information quantified from clinically acquired high-resolution LV geometric datasets. METHODS: Test subjects (n = 120) underwent cardiac MRI with multiple 3-dimensional strain parameters calculated from tissue tag-plane displacement data...
July 2015: Journal of Thoracic and Cardiovascular Surgery
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