Establishment of diagnostic reference levels in cardiac CT in France: a need for patient dose optimisation.

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 (∼50 per centre) were performed using the routine protocols of the centres, and 64- to 320-detector CT scanners.

Cardiac diffusion-weighted MR imaging in recent, subacute, and chronic myocardial infarction: a pilot study.

Purpose: To investigate the clinical feasibility of diffusion-weighted imaging (DWI) to detect recent myocardial infarction (MI) and to differentiate it from subacute and chronic MI, with late-gadolinium enhancement (LGE) sequence as reference. Furthermore, to measure variation of the myocardial apparent diffusion coefficient (ADC) according to the age of MI.

Materials And Methods: Seventy-four MI patients were separated in 3 groups.

Dilated cardiomyopathy in patients with mutations in anoctamin 5.

Background: Homozygous mutations in ANO5, a gene encoding anoctamin 5, a putative calcium-activated chloride channel, have recently been reported in patients with adult-onset myopathies or isolated high-CK levels. Cardiomyopathy has not previously been reported in these populations despite a proven expression of anoctamin 5 in the cardiac muscle.

Methods: Patients presenting for the management of high-CK levels or overt myopathy with proven ANO5 mutations were prospectively investigated between June 2010 and March 2012 in Pitié Salpêtrière Hospital, according to a standardised protocol.

Intracoronary autologous mononucleated bone marrow cell infusion for acute myocardial infarction: results of the randomized multicenter BONAMI trial.

Aims: Intracoronary administration of autologous bone marrow cells (BMCs) leads to a modest improvement in cardiac function, but the effect on myocardial viability is unknown. The aim of this randomized multicentre study was to evaluate the effect of BMC therapy on myocardial viability in patients with decreased left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI) and to identify predictive factors for improvement of myocardial viability.

Methods And Results: One hundred and one patients with AMI and successful reperfusion, LVEF ≤45%, and decreased myocardial viability (resting Tl201-SPECT) were randomized to either a control group (n = 49) or a BMC group (n = 52).

[Contrast enhanced MR angiography: evolving towards whole-body real time acquisitions].

MRA includes all techniques used to depict vessels with MR. Gadolinium contrast injection combined with gradient echo sequences is the technique of choice for vascular imaging. Technical advances now allow faster acquisitions.

Cardiac magnetic resonance imaging in systemic sclerosis: a cross-sectional observational study of 52 patients.

Objectives: To assess the prevalence and patterns of cardiac abnormalities as detected by cardiac magnetic resonance imaging (MRI) in systemic sclerosis (SSc).

Methods: Fifty-two consecutive patients with SSc underwent cardiac MRI to determine morphological, functional, perfusion at rest and delayed enhancement abnormalities.

Results: At least one abnormality on cardiac MRI was observed in 39/52 patients (75%).

[Intravascular lymphoma revealed by generalized arborescent telangiectasia and repeated venous thrombosis].

Background: Intravascular lymphoma is a rare form of non-Hodgkin's lymphoma characterized by proliferation of lymphoid cells within the lumen of small veins, small arteries and capillaries.

Case Report: A 79-year-old man presented with repeated superficial venous thrombosis of the lower limbs associated with diffuse telangiectasia of the trunk, upper arms and thighs but with normal epidermis. Screening for thrombophilia and neoplasm were negative.

Diagnosis, imaging, and treatment of an unusual cardiac hydatid cyst.

Echinococcosis is endemic in sheep- and cattle-raising areas in Europe, especially in Southern and Central Europe. In France, most cases originated from immigrants from countries where echinococcosis is endemic. Extremely rare native cases have been reported during the last few years in France, especially those concerning isolated cardiac hydatid cyst.

Fibromuscular dysplasia of the main renal arteries: comparison of contrast-enhanced MR angiography with digital subtraction angiography.

Purpose: To retrospectively evaluate the sensitivity and specificity of contrast material-enhanced magnetic resonance (MR) angiography by using digital subtraction angiography as the reference standard in patients with hypertension and renal artery fibromuscular dysplasia (FMD).

Materials And Methods: Institutional review board approval was obtained, with waiver of informed consent. The results of renal contrast-enhanced MR angiography were retrospectively analyzed in 25 patients with hypertension (24 women, one man; mean age, 48 years +/- 19 [standard deviation]; age range, 18-72 years) who had FMD diagnosed on the basis of clinical and angiographic features.

Multislice computed tomographic angiography versus digital subtraction angiography in the follow-up of nitinol stents in the superficial femoral artery.

Purpose: To compare quantitative and qualitative parameters obtained from digital subtraction angiography (DSA) with multislice computed tomographic angiography (MSCTA) in the follow-up of superficial femoral artery (SFA) stents.

Methods: Thirteen patients who had SMART stents implanted in the SFA were examined systematically with DSA and MSCTA (16-row scanner) at 6 months. Quantitative analysis and morphological assessment were performed on DSA images by an independent core laboratory, while the MSCTA images were analyzed by 2 radiologists in consensus.

Results of endovascular repair of the thoracic aorta with the Talent Thoracic stent graft: the Talent Thoracic Retrospective Registry.

Background: Endovascular treatment of thoracic aortic diseases demonstrated low perioperative morbidity and mortality when compared with conventional open repair. Long-term effectiveness of this minimally invasive technique remains to be proven. The Talent Thoracic Retrospective Registry was designed to evaluate the impact of this therapy on patients treated in 7 major European referral centers over an 8-year period.

Midterm results of aortic diameter outcomes after thoracic stent-graft implantation for aortic dissection: a multicenter study.

Purpose: To evaluate aortic diameter outcomes after stent-graft implantation for aortic dissection in the descending thoracic aorta.

Methods: Fifty patients with type A dissection after ascending aortic surgery (n = 10), type B dissection (n = 34), or intramural hematoma (n = 6) underwent stent-graft repair in 3 centers. Thrombosis and aortic diameter were analyzed by computed tomographic angiography at different levels of the aorta before stent-graft implantation, at discharge, and at follow-up.

Momentarily stuck in the foramen ovale.

An 80-year-old woman was admitted for a diagnosis of severe pulmonary embolism. A large serpentine thrombus stuck in a patent foramen ovale (PFO) completely resolved without the patient experiencing any manifestation. The right renal artery was the final destination.

False aneurysm formation following cutting balloon angioplasty in the renal artery of a child.

Purpose: To report the fortuitous discovery of a false aneurysm 7 years after cutting balloon angioplasty for severe renal artery fibromuscular dysplasia in a child.

Case Report: A 3-year-old girl with neurofibromatosis was referred to our institution because of high blood pressure (220/160 mmHg). Computed tomography identified coarctation of the aorta and severe bilateral renal artery stenoses.

Observations from multidetector CT imaging of different types of renal artery stents.

Purpose: To present an optimized protocol for acquisition and reconstruction of multidetector computed tomographic angiographic (CTA) images of the stents most commonly used in renal arteries.

Technique: CTA was performed on a 16-detector row CT scanner using 0.75-mm collimation.

Imaging of aortic dissection by helical computed tomography (CT).

Aortic dissection is the most frequent cause of aortic emergency, and its outcome is still frequently fatal. The management of this pathology has changed with the development of endovascular means. Nowadays, imaging modalities are helpful in management decision-making by providing information such as identification of entry tears along the aorta and involvement of the visceral branches of the abdominal aorta.

[Imaging of the renal arteries: when, how and why?].

The objectives of this course are both: to describe acquisition, injection and reconstruction parameters of volumic images for renal arteries examination and specific signs; to discuss the role of the different images in the diagnosis and in the therapeutic management. Ultrasound is one of the best imaging for the analysis of renal arteries in the detection of stenosis even if the sensitivity is less (around 85%)compared to CT Angiography (95%) and MR Angiography (90%). Because of this advantage and of 3D evaluation, CTA and MRA are sometimes in the first line for renal artery evaluation and can assess morphology before angioplasty.

Relationship of intimal flap position to endovascular treatment of malperfusion syndromes in aortic dissection.

Purpose: To propose a classification system based on the position and extension of the intimal flap to assist in the endovascular repair of aortic dissection complicated by a malperfusion syndrome.

Methods: Forty-one patients (34 men; mean age 58 years, range 22-78) with 19 type A and 22 type B dissections complicated by a malperfusion syndrome were treated with stenting, fenestration, or both for the peripheral ischemia. A retrospective review of the preprocedural imaging studies (computed tomographic angiography and arteriography) was performed to determine and categorize the position of the aortic intimal flap.

Multicenter trial of the Jostent balloon-expandable stent-graft in renal and iliac artery lesions.

Purpose: To report the results of a multicenter feasibility study of the Jostent balloon-expandable stent-graft in the treatment of renal and iliac artery lesions.

Methods: Twenty-three patients (17 men; mean age 62 years, range 38-80) with lesions in the renal (n=12) or iliac arteries (n=12) were enrolled in 6 centers over a 1-year period. Preprocedural computed tomography (CT) and angiography were performed in all patients.