Subject(s)
Cardiac Resynchronization Therapy/adverse effects , Heart Injuries/diagnostic imaging , Heart Injuries/etiology , Magnetic Resonance Imaging/methods , Multidetector Computed Tomography/methods , Child , Electrocardiography/methods , Heart Injuries/diagnosis , Humans , Male , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
Since the introduction of the 64-generation scanners, the accuracy and robustness of the diagnosis of coronary artery disease has progressed. The main advantage of cardiac CT is the exclusion of coronary artery disease by its excellent negative predictive value. Currently, cardiac CT applications extend thanks to innovations both in terms of technological development systems scanner or stents implanted. This is a literature review of stent evaluation with cardiac CT.
Subject(s)
Cardiac Imaging Techniques , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/surgery , Stents , Tomography, X-Ray Computed , HumansABSTRACT
The objective of this study was to propose diagnostic reference levels (DRLs) for coronary computed tomography angiography (CCTA), in the context of a large variability in patient radiation dose, and the lack of European recommendations. Volume Computed Tomography Dose Index (CTDIvol) and dose-length product (DLP) were collected from 460 CCTAs performed over a 3-month period at eight French hospitals. CCTAs (â¼50 per centre) were performed using the routine protocols of the centres, and 64- to 320-detector CT scanners. ECG gating was prospective (n = 199) or retrospective (n = 261). The large gap in dose between these two modes required to propose specific DRLs: 26 and 44 mGy for CTDIvol, and 370 and 970 mGy cm for DLP, respectively. This study confirms the large variability in patient doses during CCTA and underlines the need for the optimisation of cardiac acquisition protocols. Availability of national DRLs should be mandatory in this setting.
Subject(s)
Coronary Angiography/statistics & numerical data , Coronary Angiography/standards , Radiometry/statistics & numerical data , Radiometry/standards , Tomography, X-Ray Computed/statistics & numerical data , Tomography, X-Ray Computed/standards , Radiation Dosage , Reference Values , Surveys and QuestionnairesABSTRACT
The purpose of the study was to assess whether a strategy based on a MDCT performed routinely before CA can reduce the radiation dose during the CA, without increased global exposure in patients who need imaging of CABG. A total of 147 consecutive patients were included. The radiation dose during CA (KAP 12.1 vs 22.0 Gy/cm(2), P<.01) and the volume of iodinated contrast (155 vs 200 mL, P<.02) were reduced when preceded by a MDCT. Patients' cumulative exposures were not different in the 2 strategies (5.0 vs 5.1 mSv, P=.76). MDCT performed in first line is a valuable strategy for the assessment of CABG.
Subject(s)
Coronary Artery Bypass , Graft Occlusion, Vascular/diagnostic imaging , Multidetector Computed Tomography , Aged , Angina Pectoris/diagnostic imaging , Contrast Media , Female , France , Humans , Male , Middle Aged , Myocardial Ischemia/diagnostic imaging , Prospective Studies , Radiation Dosage , Sensitivity and SpecificityABSTRACT
Since the introduction of the 64-generation scanners, the accuracy and robustness of the diagnosis of coronary artery disease has progressed. The main advantage of cardiac CT is the exclusion of coronary artery disease by its excellent negative predictive value. Currently, cardiac CT applications extend thanks to innovations both in terms of technological development systems scanner or stents implanted, that the evolution of surgical procedures such as TAVI.
Subject(s)
Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Tomography, X-Ray Computed/methods , Angioplasty, Balloon, Coronary , Coronary Artery Disease/therapy , Equipment Failure , Humans , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional , Sensitivity and Specificity , StentsABSTRACT
We report the case of a man presenting with a Pierre Marie-Bamberger syndrome. This paraneoplastic syndrome revealed an undifferentiated intracardiac sarcoma. This case emphasizes the need for multimodality imaging to characterize intracardiac tumor.
Subject(s)
Heart Neoplasms/diagnosis , Multimodal Imaging , Sarcoma/diagnosis , Adult , Contrast Media , Echocardiography, Transesophageal , Fluorodeoxyglucose F18 , Gadolinium DTPA , Humans , Magnetic Resonance Imaging, Cine , Male , Osteoarthropathy, Secondary Hypertrophic/etiology , Paraneoplastic Syndromes/diagnosis , Positron-Emission Tomography , RadiopharmaceuticalsABSTRACT
Patients with cardiac implantable electronic devices are usually excluded from MRI examinations due to contraindication for MRI. The MRI-conditional pacemaker system may allow the benefits of MRI (system 1.5T) to be more accessible to pacemaker patients. A 62-year-old man was admitted with acute coronary syndrome and atrial fibrillation. A conventional angiography showed normal coronaries. A cardiac cardioversion revealed a significant sinus node dysfunction and a magnetic resonance imaging (MRI) compatible dual chamber system was implanted. At 6-week follow-up, a cardiac MRI revealed a typical anterior myocardial infarction with diagnostic quality images despite pacemaker. This is one of the first reports of cardiovascular MRI in a patient with MRI-conditional pacing system.
Subject(s)
Magnetic Resonance Imaging, Cine , Myocardial Infarction/diagnosis , Pacemaker, Artificial , Coronary Vessels/pathology , Embolism/complications , Humans , Male , Middle AgedABSTRACT
The field of cardiovascular MRI has evolved rapidly over the past decade, feeding new applications across a broad spectrum of clinical and research areas. Advances in magnet hardware technology, and key developments such as segmented k-space acquisitions, advanced motion encoding techniques, ultra-rapid perfusion imaging and delayed myocardial enhancement imaging have all contributed to a revolution in how patients with ischemic and non-ischemic heart disease are diagnosed and treated. Actually, cardiac MRI is a widely accepted method as the "gold standard" for detection and characterization of many forms of cardiac diseases. The aim of this review is to present an overview of cardiac MRI technology, advances in clinical applications, and future directions.
Subject(s)
Cardiovascular Diseases/diagnosis , Magnetic Resonance Imaging, Cine/methods , Blood Flow Velocity/physiology , Contraindications , Contrast Media , Coronary Circulation/physiology , Forecasting , Gadolinium DTPA , Humans , Magnetic Resonance Imaging, Cine/trends , Myocardium/pathology , Necrosis , Stroke Volume/physiologySubject(s)
Cardiology/organization & administration , Public Health/standards , Angioplasty, Balloon, Coronary/methods , Biomedical Research/organization & administration , Cardiology/economics , Cardiology/standards , Congresses as Topic , France , Guidelines as Topic , Humans , Myocardial Infarction/diagnosis , Myocardial Infarction/therapy , Practice Guidelines as Topic , Societies, MedicalABSTRACT
Since the introduction of Multi-slice computed tomography (CT), cardiac CT has been the increasingly used as a noninvasive modality for the diagnosis of coronary disease. Despite its potential benefits and promising clinical results, it has suffered from high doses of radiation associated with a risk of radiation-induced cancers. This has raised serious concerns in clinical practice. A number of strategies were then implemented to reduce the radiation dose associated with cardiac CT. The aim of this review is not to compare doses of different CT systems available on the market but to present an overview of different approaches to dose reduction and future directions.