Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging.

Conventional coronary angiography is the gold standard for the diagnosis of coronary artery anomalies. Coronary anomalies are relatively rare findings in patients undergoing conventional coronary angiography for suspected obstructive coronary artery disease. Recently, the increasing performance of diagnostic techniques, such as electron beam tomography (EBT), magnetic resonance (MR) and, more recently, multislice computed tomography (MSCT), has enabled their application to cardiac imaging.

Is calcium the key for the assessment of progression/regression of coronary artery disease?

Coronary calcium scoring has become a common test for cardiovascular risk stratification.

Characterization of benign hepatic tumors arising in fatty liver with SonoVue and pulse inversion US.

Background: We describe the spectrum of contrast-enhancement patterns of benign hepatic tumors arising in fatty liver on contrast-enhanced ultrasound (US).

Methods: Sixteen patients (12 women and four men) with 27 benign hepatic tumors (17 hemangiomas, eight focal nodular hyperplasias, and two hepatocellular adenomas) arising in fatty liver underwent baseline and pulse inversion US after administration of SonoVue. Two experienced radiologists evaluated baseline echogenicity and dynamic enhancement pattern of each lesion in comparison with adjacent liver parenchyma.

Noninvasive detection of subclinical coronary atherosclerosis coupled with assessment of changes in plaque characteristics using novel invasive imaging modalities: the Integrated Biomarker and Imaging Study (IBIS).

Objectives: Our purpose was to assess noninvasive imaging in detection of subclinical atherosclerosis and to examine novel invasive modalities to describe prevalence and temporal changes in putative characteristics of "high-risk" plaques.

Background: Conventional coronary imaging cannot identify "high-risk" lesions.

Methods: Conventional (quantitative angiography and intravascular ultrasound [IVUS]) and novel imaging (IVUS-based palpography and gray scale echogenicity) were performed at baseline and 6 months later in 67 patients with diverse clinical presentations.

Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing.

Objective: The objective of our study was to compare diagnostic accuracy of MDCT coronary angiography in a population of patients with mild heart rhythm irregularities before and after editing the ECG.

Subjects And Methods: Thirty-eight patients who underwent MDCT coronary angiography and conventional coronary angiography were enrolled in the study. The inclusion criterion was the presence of mild heart rhythm irregularities (i.

Prediction of left ventricular function after drug-eluting stent implantation for chronic total coronary occlusions.

Objectives: We studied the effect of drug-eluting stent implantation for chronic total coronary occlusion (CTO) on left ventricular volumes and function and assessed the predictive value of magnetic resonance imaging (MRI) performed before revascularization.

Background: The effect of recanalization of CTO on long-term left ventricular function and the value of myocardial viability assessment with MRI is incompletely understood.

Methods: Twenty-seven patients underwent contrast-enhanced MRI before and five months after successful drug-eluting stent implantation for CTO.

High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400.

Objective: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration.

Material And Methods: Forty consecutive patients (29 male, 11 female; mean age, 61+/-11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s.

Non-invasive evaluation of coronary calcium.

With the increasing diffusion of 4-row,16-row and 64-row multislice computed tomography scanners, widespread coronary calcium scoring has become possible in Europe. This relatively easy-to-perform test has a high sensitivity and low specificity for the detection of significant coronary artery stenosis, and may have an important role in the risk stratification for future coronary artery events in selected groups of patients, such as those immediately at risk. This study reviews the techniques available for coronary calcium scoring (electron beam tomography and multislice computed tomography) with their respective protocols, as well as their advantages and disadvantages.

Effects of primary angioplasty for acute myocardial infarction on early and late infarct size and left ventricular wall characteristics.

Unlabelled: The effects of reperfusion on early and late infarct size and left ventricular wall characteristics were studied by performing cine-magnetic resonance imaging, first-pass perfusion, and delayed enhancement imaging in 22 patients at five days and five months after successful primary angioplasty for first acute myocardial infarction. Infarct size, end-diastolic wall thickness, and segmental wall thickening were quantified, and the extent of microvascular obstruction (MO) was evaluated qualitatively. Infarct size decreased by 31%.

Intravenous contrast material administration in multislice computed tomography coronary angiography.

Rationale And Objectives: to compare contrast material (CM) administration protocols in non-invasive coronary angiography (CA) using a 16-row multislice CT (16-MSCT).

Methods: 45 patients undergoing CA with 16-MSCT were divided into three CM protocols: group 1 (140 ml@4ml/s), group 2 (140 ml = 60 ml@5ml/s + 80 ml@3ml/s), and group 3 (100 ml@4ml/s). The attenuation at the origin of the coronary vessels was assessed.

Chronic pseudoaneurysm of the left ventricle.

We present a case of a 55-year-old men who suffered a silent myocardial infarction four years earlier and presented with exertional dyspnoea. Cardiac magnetic resonance imaging (CMR) and Multislice computed tomography (MSCT) was performed and revealed a giant pseudoaneursym of the lateral wall of the left ventricle with the presence of a thrombus in the lateral wall of the pseudoaneursym. We present this case since excellent non-invasive evaluation of the pseudoaneursym was feasible using state-of-the-art imaging modalities.

Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris.

Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as > or = 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA).

High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography.

Background: The diagnostic performance of the latest 64-slice CT scanner, with increased temporal (165 ms) and spatial (0.4 mm3) resolution, to detect significant stenoses in the clinically relevant coronary tree is unknown.

Methods And Results: We studied 52 patients (34 men; mean age, 59.

Influence of increasing convolution kernel filtering on plaque imaging with multislice CT using an ex-vivo model of coronary angiography.

Purpose: To assess the variability in attenuation of coronary plaques with multislice CT-angiography (MSCT-CA) in an ex-vivo model with varying convolution kernels.

Materials And Methods: MSCT-CA (Sensation 16, Siemens) was performed in three ex-vivo left coronary arteries after instillation of contrast material solution (Iomeprol 400 mgI/ml, dilution: 1/80). The specimens were placed in oil to simulate epicardial fat.

Non-invasive coronary angiography with 64-slice computed tomography.

Multislice computed tomography is a rapidly emerging technique for the non-invasive visualization of coronary arteries. Over the past 5 years several scanner generation were introduced with a progressive improvement in the diagnostic accuracy in the detection of coronary artery stenosis in selected patients populations. The introduction of 64-slice technology has further improved the diagnostic performance.

Sixteen-detector row CT angiography of carotid arteries: comparison of different volumes of contrast material with and without a bolus chaser.

Purpose: To prospectively compare different volumes of intravenously administered contrast material with and without a bolus chaser at 16-detector row computed tomographic (CT) angiography of the carotid arteries.

Materials And Methods: Institutional Review Board approval and informed consent were obtained. Seventy-five consecutive patients (44 men, 31 women; mean age, 63 years; range, 22-85 years) were allocated to one of three protocols: group 1, 80 mL of contrast material; group 2, 80 mL of contrast material followed by 40 mL of saline; and group 3, 60 mL of contrast material followed by 40 mL of saline.

Usefulness of multislice computed tomographic coronary angiography to assess in-stent restenosis.

Fifty-one patients (42 men; 60 +/- 12 years of age) who had previous stent implantation underwent multislice computed tomographic coronary angiography. All coronary branches > or = 2.0 mm were independently evaluated by 2 observers and screened for in-stent restenosis (> or = 50%) and occlusion.

Impact of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in multislice computed tomography coronary angiography.

Purpose: To assess the effect of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in the detection of significant coronary artery stenosis using 16-row multislice computed tomography (MSCT).

Materials And Methods: One hundred patients (88 males; 59+/-11 years) with suspected coronary artery disease who had undergone conventional coronary angiography (CA) and MSCT-CA were retrospectively enrolled for the study. Patients underwent a MSCT-CA, with the following protocol: collimation 16x0.

Introduction to coronary imaging with 64-slice computed tomography.

The aim of this article is to illustrate the main technical improvements in the last generation of 64-row CT scanners and the possible applications in coronary angiography. In particular, we describe the new physical components (X-ray tube-detectors system) and the general scan and reconstruction parameters. We then define the scan protocols for coronary angiography with the new generation of 64-row CT scanners to enable radiologists to perform a CT study on the basis of the diagnostic possibilities.

Pitfalls and feasibility of a protocol of virtual colonography designed for the screening of colo-rectal pre-cancerous lesions.

Purpose: To evaluate the pitfalls occurring during the virtual colonoscopy examination performed with a protocol designed for screening purposes.

Materials And Methods: 40 patients underwent a spiral CT for virtual colonoscopic evaluation with the following parameters: collimation 3 mm, feed 6 mm.rot(-1), pitch 2 and increment 1 mm in supine position.

Multislice CT coronary angiography: how to do it and what is the current clinical performance?

The introduction of multislice computed tomography (MSCT) has allowed non-invasive coronary angiography. Although widely applied, extensive information on technical details of the technique is lacking. This survey offers detailed information on patient preparation, data acquisition, reconstruction and interpretation.