The use of carbon dioxide angiography for renal sympathetic denervation: a technical report.

Objective: Hypertension is the leading attributable cause of cardiovascular mortality worldwide. Patients with hypertension have multiple comorbidities including high rates of concomitant renal disease. Current pharmacological approaches are inadequate in the treatment of resistant hypertension.

Computed tomography and magnetic resonance imaging evaluation of pericardial disease.

Pericardial diseases are commonly encountered in clinical practice and may present as an isolated process or in association with various systemic conditions. Traditionally transthoracic echocardiography (TTE) has been the method of choice for the evaluation of suspected pericardial disease but increasingly computed tomography (CT) and magnetic resonance imaging (MRI) are also being used as part of a rational multi-modality imaging approach tailored to the specific clinical scenario. This paper reviews the role of CT and MRI across the spectrum of pericardial diseases.

The prevalence and significance of thoracic findings in patients undergoing extended coverage computed tomography for assessment of abdominal aortic aneurysms.

Objective: Many major vascular centres, including ours, incorporate coverage of the thoracic aorta in CT scans evaluating abdominal aortic aneurysms (AAAs) (extended coverage contrast-enhanced CT (EC-CECT) scan]. We sought to determine the prevalence of thoracic pathology in a large consecutive series of patients with AAA undergoing EC-CECT.

Methods: All patients who underwent EC-CECT for AAA between April 2013 and 2014 were identified from our radiology information system.

Spontaneous spinal epidural haematoma mimicking acute coronary syndrome.

Spontaneous spinal epidural hematoma (SSEH) is an acute neurological emergency which carries significant morbidity unless diagnosed and treated in a timely fashion. Some cases of SSEH are idiopathic but there is a well-recognised association with deranged coagulation and abnormalities of clotting. In recent years there has been increasing availability of novel anti-platelet agents, often prescribed in the setting of suspected acute coronary syndromes (ACS) and following percutaneous coronary interventions and these agents also present an increased risk of SSEH.

MRI assessment of cardiac tumours: part 2, spectrum of appearances of histologically malignant lesions and tumour mimics.

Cardiac magnetic resonance imaging (MRI) is the reference standard technique for assessment and characterization of a suspected cardiac tumour. It provides an unrestricted field of view, high temporal resolution and non-invasive tissue characterization based on multi-parametric assessment of the chemical micro-environment. Sarcomas account for around 95% of all primary malignant cardiac tumours with lymphoma, and primary pericardial mesothelioma making up most of the remainder of cases.

MRI assessment of cardiac tumours: part 1, multiparametric imaging protocols and spectrum of appearances of histologically benign lesions.

Cardiac magnetic resonance imaging (MRI) is the reference standard technique for assessment and characterization of a suspected cardiac tumour. It provides an unrestricted field of view, high temporal resolution and non-invasive tissue characterization based on multi-parametric assessment of the chemical micro-environment. MRI exploits differences in hydrogen proton density in conjunction with T1 and T2 relaxation properties of different tissues to help differentiation normal from abnormal and benign from malignant lesions.

Radiology training in United Kingdom: current status.

Clinical radiology has always been one of the most competitive specialties in UK. Due to the increasing demand for radiology services the number of training posts in the UK has been increased. Clinical radiology training takes 5 years and requires completion of the Fellowship of Royal College of Radiologists (FRCR) exams, adequate evidence to demonstrate completion of the curriculum and successful appraisals.

Multidetector CT angiography characterisation of Type 4 dual left anterior descending coronary artery.

Duplication of the left anterior descending (LAD) coronary artery is a rare anomaly (incidence 1%) characterized by a short LAD that terminates high in the anterior interventricular groove and a long LAD that has a proximal course outside the anterior interventricular groove and returns to the groove in its distal course. The Type 4 variant of this anomaly is extremely rare whereby a long LAD arises from the right coronary sinus with a short LAD arising from the left mainstem. We present a case of Type 4 dual LAD which was characterised with multi-detector computed tomography (CT).

Multidetector CT assessment of partial anomalous pulmonary venous return in association with sinus venosus type atrial septal defect.

Sinus venosus defects account for 15% of all atrial septal defects. They are frequently associated with partial anomalous pulmonary venous drainage of the right superior pulmonary vein into the superior vena cava (SVC). These defects require surgical correction and accurate pre-operative imaging assessment is critical.

The role of magnetic resonance imaging in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common inheritable cardiac disorder, with an estimated prevalence of 1:500 in the general population. Most cases of HCM are phenotypically expressed in adolescence or early adulthood but age-related penetrance with certain phenotypes is increasingly recognized. Clinical manifestations of HCM are usually the result of systolic and/or diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, arrhythmias and sudden cardiac death (SCD).

A comparative analysis of ECG-gated steady state free precession magnetic resonance imaging versus transthoracic echocardiography for evaluation of aortic root dimensions.

Purpose: Accurate and reproducible measurement of aortic root dimensions is essential to inform clinical decision making. Transthoracic echocardiography (TTE) is the first line test for assessment of the aortic root but has potential limitations due to its limited field of view and restricted acoustic windows. Cardiac magnetic resonance imaging (MRI) is considered the "gold standard" technique for assessment of cardiac morphology and recently MRI reference ranges for aortic root dimensions have been published.

Safety of an i.v. β-adrenergic blockade protocol for heart rate optimization before coronary CT angiography.

Objective: The purpose of this study was to assess the safety of heart rate optimization by use of β-adrenergic blockade solely by the i.v. route before coronary CT angiography.

Multi-detector CT angiography of the aortic valve-Part 2: disease specific findings.

The aortic valve and adjacent structures should be routinely evaluated on all thoracic cross-sectional imaging studies. Echocardiography and magnetic resonance imaging (MRI) are the main imaging techniques used for assessment of the aortic valve and related pathology but multi-detector computed tomography (MDCT) can offer valuable complimentary information in some clinical scenarios. MDCT is the definite means of assessing aortic valvular calcification, acute aortic syndrome and for non-invasive assessment of the coronary arteries.

Multi-detector CT angiography of the aortic valve-Part 1: anatomy, technique and systematic approach to interpretation.

The aortic valve and adjacent structures should be routinely evaluated on all thoracic cross-sectional imaging studies. Echocardiography and magnetic resonance imaging (MRI) are the main imaging techniques used for assessment of the aortic valve and related pathology but multi-detector computed tomography (MDCT) can offer valuable complimentary information in some clinical scenarios. Radiologists should be familiar with the indications, advantages and limitations of MDCT for assessment of the aortic valve.

The role of imaging in hypertensive heart disease.

Hypertensive heart disease (HHD) describes a spectrum of target organ response that includes left ventricular hypertrophy, systolic, and diastolic dysfunction. A variety of imaging techniques can be used to assess the various aspects of HHD. Echocardiography has for many years been the main imaging technique in the evaluation of HHD, but there is an increasing role for cardiovascular magnetic resonance (CMR) imaging due to its ability to provide an unrestricted field of view and noninvasive tissue characterization.

Endovascular embolization: review of currently available embolization agents.

Percutaneous vascular embolization is one of the major applications of interventional radiology. A wide variety of embolization agents are currently available for clinical use. The interventional radiologist needs to be up to date with the newer and different types of embolic agents available along with their biopharmaceutical characteristics, strengths, and weaknesses that have been reviewed.

Assessment of right heart dilatation with magnetic resonance imaging and multidetector computed tomography angiography: spectrum of disease findings.

Right heart chamber enlargement can be caused by a diverse and heterogeneous group of conditions with highly varied clinical symptoms and signs. An appreciation of the pathophysiology, causes, and imaging features of right heart enlargement is paramount in recognizing and potentially ameliorating the development of right heart dysfunction or adverse cardiac events. Chest x-ray and transthoracic echocardiography have traditionally been, and still are, the mainstay in initial evaluation of right heart dilatation; however, recent advances in both multidetector computed tomography and cardiovascular magnetic resonance imaging now permit a comprehensive assessment of the causes and consequences of right heart dilatation.

A comparative analysis of noncontrast flow-spoiled versus contrast-enhanced magnetic resonance angiography for evaluation of peripheral arterial disease.

Purpose: This feasibility study aimed to obtain initial data to assess the performance of a novel noncontrast spoiled magnetic resonance (MR) angiography technique (fresh-blood imaging [FBI]) compared to gadolinium-enhanced MR (Gd-MR) angiography for evaluation of the aorto-iliac and lower extremity arteries.

Materials And Methods: Thirteen patients with suspected lower extremity arterial disease that had undergone Gd-MR angiography and FBI at the same session were randomly included in the study. FBI was performed using an ECG-gated ow-spoiled T2-weighted half-Fourier fast spin-echo sequence.

Aortic intramural haematoma: pathogenesis, clinical features and imaging evaluation.

Intramural haematoma (IMH) is a localised haemorrhage within the aortic wall. Imaging plays a central role in diagnosing IMH, differentiating it from aortic dissection (AD) and assessing for complications. Imaging is also important for prognostication and to help guide clinical decision making as a number of imaging characteristics have been correlated with increased mortality rates including location, mural thickness and aortic diameter.

Evaluation of the aortic root with MRI and MDCT angiography: spectrum of disease findings.

Objective: This article reviews the spectrum of disease processes that may involve the aortic root with particular emphasis on the role of cardiovascular MRI and MDCT angiography in their assessment. Key MRI and MDCT imaging findings are discussed and illustrated.

Conclusion: Radiologists should be aware of the spectrum of disease processes that may involve the aortic root and their appearances at MRI and MDCT angiography.