ABSTRACT
<p><b>BACKGROUND</b>Myocarditis is a common, potentially life-threatening disease that presents a wide rang of symptoms in children, as an important underlying etiology of other myocardial diseases such as dilated and arrhythmogenic right ventricular cardiomyopathy. The incidence of nonfatal myocarditis is probably greater than that of the one actually diagnosed, which is the result of the challenges of establishing the diagnosis in standard clinical settings. Currently, no single clinical or imaging finding confirms the diagnosis of myocarditis with absolute certainty. Historically, clinical exam, electrocardiogram (ECG), serology and echocardiography had an unsatisfactory diagnostic accuracy in myocarditis. Endomyocardial biopsy remains as a widely accepted standard, but may not be suitable for every patient, especially for those with less severe disease. Our aim was to find the changes in cardiovascular magnetic resonance (CMR) imaging of children with myocarditis diagnosed by clinical criteria.</p><p><b>METHODS</b>We studied 25 children (18 male, 7 female; aged from 5-17 years) with diagnosed myocarditis by clinical criteria. CMR included function analyses, T2-weighted imaging, T1-weighted imaging before and after i.v. gadolinium injection (early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE)).</p><p><b>RESULTS</b>The T2 ratio was elevated in 21 children (84%, 11 in anterolateral (44%), 5 in inferolateral (20%), and 5 in septum (20%)), EGE was present in 9 children (36%, 3 in anterolateral (12%), 4 in inferolateral (20%), and 2 in septum (8%)), and LGE was present in 5 children (20%, 2 in anterolateral (8%), 1 in inferolateral (4%), 1 in septum (4%), and 1 in midwall of left ventricular (LV) wall). In 9 children (36%), two (or more) out of three sequences (T2, EGE, LGE) were abnormal.</p><p><b>CONCLUSIONS</b>The CMR findings in children with clinically diagnosed myocarditis vary within the groups, including regional or global myocardial signal increase in T2-weighted images, EGE and LGE in T1-weighted images. The T2 ratio elevation is the most common CMR finding. Children with mild cardiac symptoms may also appear serious myocardial injuries.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Magnetic Resonance Imaging , Methods , Myocarditis , Pathology , Myocardium , PathologyABSTRACT
ObjectiveTo assess the performance of dual-source CT (DSCT) for left atrial volume and function evaluation and compare this performance to that of cardiac cine MR ( CMR ),which was considered as the standard reference technique.Methods Forty-nine patients referred for CT coronary angiography were enrolled in this study.DSCT data sets and FIESTA cines of the vertical long axis covering the left atrium and the short axis covering the left ventricle were obtained on the same day without additional medicine.All images were analyzed to obtain left atrial volume at different time and its function values.All the parameters were corrected by body surface area.Inter-modality agreement was tested through linear regression and Bland-Altman analyses.Repeated measurements were performed to determine inter-observer variation.ResultsThe indexed measurements of DSCT and CMR were (47.4 ± 11.1 ) and (46.2 ± 9.7 )ml/m2 for LAVmax,( 22.2 ± 6.9) and ( 21.3 ± 5.8 ) ml/m2 for LAVmin,( 34.8 ± 8.8 ) and ( 33.6 ± 7.8 )ml/m2 for LAVp,(24.0 ±5.7)and(21.5 ±5.0) ml/m2 for LARV,(11.6 ±3.9)and(10.9 ±3.9) ml/m2 for LAPV,(12.4 ±3.9)and(10.7 ±3.6) ml/m2 for LAAV,(22.6 ±8.4)and(21.0 ±6.4) ml/m2 for LACV,(52.8 ± 7.4) ％ and ( 54.5 ± 6.3 ) ％ for LAEF,respectively.The correlation coefficients between DSCT and CMR measurements for LAVmax,LAVmin,LAVp,LARV,LAPV,LAAV,LACV and LAEF were 0.89,0.90,0.90,0.80,0.82,0.80,0.76 and 0.78,respectively.However,DSCT slightly overestimated LAVmax,LAVmin,LAVp,LARV,LAPV,LAAV and LACV,and the deviation was 1.2,0.9,1.1,0.3,0.1,0.2 and 0.4 ml/m2,respectively.Compared with CMR,DSCT slightly underestimated LAEF of about 0.6％.Interobserver variation was lower in DSCT examination than CMR for the measurements of left atrial function.ConclusionDSCT provided accurateand reproducible measurements of left atrial volume and function.
ABSTRACT
To explore diagnostic acuity of helical CT colonscopic examination, simulated polyps were reproduced in 10 pig colons and 6 human colons obtained from colon resection. Helical CT colonoscopic scanning with different parameters was performed. The images were evaluated with Nav, Axial+MPR, SSD+Raysum. The diagnostic sensitivity of each method for the detection of simulated colonic polyps were assessed. The results indicated that the image quality of CT colonoscopy was improved with the decrease in collimation and pitch. The optimal angle of the colon lumen to the gantry was 90?. CT colonoscopy was superior to other imaging methods. Therefore, the performance of CTVC has a close relationship with the scanning parameters. The optimal scanning parameters were 5mm collimation, 1 5 pitch, and filling the colon with air. The combination of CTVC with other imaging methods would contribute to improving the diagnostic accuracy for the detection of colonic polyps.
ABSTRACT
0.05). The interobserver variability in DSCT measurements was lower than in RT-3DE measurements in indexed left atrial volume and function. Conclusion DSCT can provide not only the information of coronary artery,but also highly reliable measurements of left atrial phasic volume and function at the same time.