Reference range determination for imaging biomarkers: Myocardial T.

Background: Imaging biomarkers, such as the T relaxation time of the myocardium using MRI, can be valuable in cardiac medicine if they are properly validated. Consensus statements recommend that for myocardial T , each investigator should establish a reference range.

Purpose: To describe a statistically valid method for determining and reporting the reference range in each center, which simultaneously minimizes the twin risks of undersampling, leading to a uselessly uncertain range, and oversampling, which exposes volunteers to unnecessary scanning and wastes resources.

Diagnostic accuracy of cardiac magnetic resonance imaging in the detection and characterization of left atrial catheter ablation lesions: a multicenter experience.

Introduction: We tested the hypothesis that cardiovascular magnetic resonance (CMR) imaging can reliably distinguish the presence or absence of left atrial (LA) ablation lesions by blinded analysis of pre- and postablation imaging.

Methods: Consecutive patients at 2 centers undergoing pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation by either wide area circumferential radiofrequency ablation (WACA) or ostial ablation with a cryoballoon underwent CMR late gadolinium enhancement (LGE) imaging pre- and 3 months postablation. Imaging was anonymized for blinded analysis of (1) LGE images, and (2) a 3D fusion image with LGE projected onto a segmented LA surface.

Resolution of Behçet's syndrome associated pulmonary arterial aneurysms with infliximab.

Introduction: We describe the successful treatment of pulmonary arterial aneurysms in Behçet's syndrome using a tumor necrosis factor (TNF) inhibitor.

Methods: A case is reported of Behçet's syndrome complicated by pulmonary arterial aneurysms that responded to anti-TNF therapy. This is accompanied by a literature review of previously published cases.

CT evaluation of pulmonary venous anatomy variation in patients undergoing catheter ablation for atrial fibrillation.

To characterize pulmonary vein (PV) anatomy and the relative position of the PV ostia to the adjacent thoracic vertebral bodies, two readers reviewed 176 computed tomography pulmonary venous studies. PV ostial dimensions were measured and PV ovality assessed. Anatomical variations in PV drainage were noted.

Aortic remodelling in Fabry disease.

Aims: To evaluate thoracic aortic dilation in patients with Fabry disease (FD).

Methods And Results: A cohort of 106 patients with FD (52 males; 54 females) from three European centres were studied. The diameter of the thoracic aorta was assessed at three levels (sinus of Valsalva, ascending aorta, and descending aorta) using echocardiograms and cardiovascular magnetic resonance imaging.

A rare combination of cardiopulmonary anomalies demonstrated on ventilation-perfusion scan.

In this case report we describe an unusual appearance seen on a ventilation-perfusion (V/Q) scan in a woman with pulmonary hypertension. Although the pulmonary hypertension was not caused by pulmonary emboli, the V/Q scan suggested several cardiac anomalies which may lead to pulmonary hypertension. Most of the cardiac anomalies, including right-sided aortic arch and right-to-left shunt, can be deduced from careful examination of the V/Q scan.

Altered myocardial motion pattern in Fabry patients assessed with CMR-tagging.

Progressive left ventricular hypertrophy is the hallmark of cardiac manifestations in patients with Fabry disease. Cardiovascular magnetic resonance with tissue tagging allows detailed assessment of the cardiac motion pattern. The aim was to test the hypothesis that not only Fabry patients with severe left ventricular hypertrophy exhibit changes in myocardial motion, but also Fabry patients with normal left ventricular mass.

Diagnosis of metastatic melanoma to the heart with an intrinsic contrast approach using melanin inversion recovery imaging.

Melanoma not infrequently metastasizes to the heart where it either remains occult or produces a very variable clinical picture. Recognition of metastatic lesions can be difficult on echocardiography because they are frequently intramural rather than intracavity. Magnetic resonance imaging with gadolinium contrast enhancement has previously been reported as the optimum method for identification of cardiac melanoma.

Gradient-enhanced volume rendering: an image processing strategy to facilitate whole small bowel imaging with MRI.

MRI of the small bowel with positive contrast from orally administered contrast agent is a promising non-invasive imaging method. The aim of our study was to introduce small bowel MRI in a display format that clinicians are accustomed to and that maximizes the amount of information visualized on a single image. Twelve healthy volunteers, median age 32 years (range 18-49 years) participated in the study.

Small bowel motility assessment with magnetic resonance imaging.

Purpose: To assess primarily the feasibility of magnetic resonance imaging (MRI) as a tool to monitor small bowel peristaltic motion and secondarily to validate this technique by demonstrating drug-induced motility changes.

Materials And Methods: After a standardized oral preparation of Ispaghula husk (Metamucil) and meglumine gadoterate (Gd-DOTA; Dotarem), 10 volunteers underwent dynamic MRI using a two-dimensional turbofast field echo (TFE) sequence with a slice repetition time of 500 msec. Intraluminal cross-sectional caliber changes over time were assessed allowing quantification of the peristaltic frequencies and amplitudes of the small gut on various regions of interest.