CT Angiography of the Heart and Aorta in TIA and Ischaemic Stroke: Cardioembolic Risk Sources and Clinical Implications.

Background: Cardiac emboli are important causes of (recurrent) ischaemic stroke. Aorta atherosclerosis might also be associated with an increased risk of stroke recurrence. This study aimed to evaluate the yield and clinical implications of CT-angiography (CTA) of the heart and aorta in the diagnostic workup of transient ischaemic attack (TIA) or ischaemic stroke.

Magnetic Resonance Direct Thrombus Imaging (MRDTI) Can Distinguish Between Old and New Thrombosis in the Abdominal Aorta: a Case Report.

Unlabelled: A 43-year-old man complaining of abdominal angina for several months showed a large suprarenal aneurysm of the abdominal aorta with extensive circumferential wall thrombosis, complete occlusion of the right renal artery and a critically stenosed left renal artery on CT angiography. He suffered from severe hypertension and renal failure. A percutaneous transluminal angioplasty (PTA) was planned.

Automatic quantitative analysis of pulmonary vascular morphology in CT images.

Purpose: Vascular remodeling is a significant pathological feature of various pulmonary diseases, which may be assessed by quantitative computed tomography (CT) imaging. The purpose of this study was therefore to develop and validate an automatic method for quantifying pulmonary vascular morphology in CT images.

Methods: The proposed method consists of pulmonary vessel extraction and quantification.

Relation of Fontan Baffle Stroke Volume to Fontan Failure and Lower Exercise Capacity in Patients With an Atriopulmonary Fontan.

Fontan failure remains a significant problem, especially in patients with an atriopulmonary Fontan. Fontan baffle volume change during the cardiac cycle (Fontan baffle stroke volume) may affect outcomes in Fontan circulation. Assuming that increased Fontan baffle stroke volume is associated with increased energy loss in the baffle, we hypothesized that higher baffle stroke volume is associated with worse exercise capacity and increased incidence of Fontan failure.

Pulmonary Vascular Morphology Associated With Gas Exchange in Systemic Sclerosis Without Lung Fibrosis.

Purpose: Gas exchange in systemic sclerosis (SSc) is known to be affected by fibrotic changes in the pulmonary parenchyma. However, SSc patients without detectable fibrosis can still have impaired gas transfer. We aim to investigate whether pulmonary vascular changes could partly explain a reduction in gas transfer of SSc patients without fibrosis.

Four-dimensional flow magnetic resonance imaging-derived blood flow energetics of the inferior vena cava-to-extracardiac conduit junction in Fontan patients.

Objectives: In patients with the Fontan circulation, systemic venous return flows passively towards the lungs. Because of the absence of the subpulmonary ventricle, favourable blood flow patterns with minimal energy loss are clinically relevant. The region where the inferior vena cava, the hepatic veins and the extracardiac conduit join (IVC-conduit junction) is a potential source of increased energy loss.

Impact of computed tomography myocardial perfusion following computed tomography coronary angiography on downstream referral for invasive coronary angiography, revascularization and, outcome at 12 months.

Aims: The aim of this study was to assess the impact of adding stress computed tomography (CT) myocardial perfusion (CTP) to coronary CT angiography (CTA) on downstream referral for invasive coronary angiography (ICA), revascularization, and outcome in patients presenting with new-onset chest pain.

Methods And Results: Three hundred and eighty-four patients were referred for cardiac CT. Patients with lesions ≥50% stenosis underwent subsequently stress CTP.

Biplane versus short-axis measures of the left atrium and ventricle in patients with systolic dysfunction assessed by magnetic resonance.

Purpose: This study aims to investigate if the time saving biplane method can be an alternative to short-axis measurements for left atrium (LA) and left ventricle (LV) in cardiac magnetic resonance of patients with extensive LV remodeling.

Materials And Methods: In 45 patients with coronary artery disease and systolic LV dysfunction [ejection fraction (EF)<50%], LA and LV end-diastolic volume, end-systolic volume, stroke volume, and EF were measured by the biplane area length and by the short-axis volume method.

Results: No statistical differences between the biplane area length and short-axis volume were found for the LA end-systolic or the LV end-diastolic volumes.

Therapeutic and diagnostic outcomes of a standardised, comprehensive care pathway for patients with systemic sclerosis.

Objectives: To determine the outcomes, including number of medical interventions and initiation of immunosuppressive treatment of a standardised, comprehensive, diagnostic care pathway for patients with systemic sclerosis (SSc). Patient characteristics associated with need for medical interventions and with need for immunosuppressive treatment were determined.

Methods: Data were routinely gathered in connection with a 2-day care pathway combining multidisciplinary care and complete diagnostic work-up of organ involvement in SSc.

The influence of clinical and acquisition parameters on the interpretability of adenosine stress myocardial computed tomography perfusion.

Aims: The interpretation of adenosine stress myocardial computed tomography perfusion (CTP) is often hampered by image artefacts caused by cardiac motion, beam hardening, and cone beam. The aim of the present analysis was to assess the influence of the heart-rate response during adenosine infusion, patient characteristics, and medication use on the interpretability of stress myocardial CTP examinations.

Methods And Results: Interpretability of stress myocardial CTP examinations was evaluated in 120 patients who underwent sequentially coronary CTA and adenosine stress myocardial CTP (320-row CT scanner, temporal resolution 175 ms) and scored as follows: excellent = absence of any artefact (n = 27, 22%); good = presence of artefacts that do not interfere with the study interpretability (n = 56, 47%); fair = artefacts that do interfere with interpretability (n = 35, 29%); poor = uninterpretable study due to artefacts (n = 2, 2%).

Liver Fat Assessed With CT Relates to MRI Markers of Incipient Brain Injury in Middle-Aged to Elderly Overweight Persons.

Objective: Obesity has been related to structural brain abnormalities. Increasing evidence suggests that accumulation of fat in the liver is an important determinant of cardiometabolic complications of obesity. The purpose of this study was to investigate the association between CT-assessed liver-to-spleen attenuation ratio as a measure of liver steatosis and MRI-assessed brain tissue integrity in middle-aged to elderly persons.

Relation between quantitative coronary CTA and myocardial ischemia by adenosine stress myocardial CT perfusion.

Background: Coronary-computed tomography angiography (CTA) has limited accuracy to predict myocardial ischemia. Besides luminal area stenosis, other coronary plaque morphology and composition parameters may help to assess ischemia. With the integration of coronary CTA and adenosine stress CT myocardial perfusion (CTP), reliable information regarding coronary anatomy and function can be derived in one procedure.

Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus.

Aspirin use for primary prevention in patients at high risk with diabetes mellitus (DM) is often recommended under the assumption that most patients with DM have coronary artery disease (CAD). However, not all patients may have CAD. The present study evaluated, in 425 patients at high risk with DM (without chest pain syndrome or a history of cardiac disease), the prevalence of CAD on coronary computed tomography angiography (CTA).

Impact of pulmonary fibrosis and elevated pulmonary pressures on right ventricular function in patients with systemic sclerosis.

Objectives: Right ventricular (RV) dysfunction is of great prognostic value in patients with SSc. The aim of the present study was to assess in these patients the relationship between pulmonary fibrosis and elevated pulmonary pressure (PHT) with RV function.

Methods: A total of 102 SSc patients who underwent thoracic CT and transthoracic echocardiography were included.

Chest CT examinations in patients presenting with acute chest pain: a pictorial review.

Acute chest pain (ACP) is one of the most common presenting symptoms at the emergency department. The differential diagnosis is vast. To exclude life-threatening causes, radiologists encounter an increasing amount of thoracic computed tomography (CT) examinations including CT angiography of the heart and great vessels.

Altered left ventricular vortex ring formation by 4-dimensional flow magnetic resonance imaging after repair of atrioventricular septal defects.

Objectives: During normal left ventricular (LV) filling, a vortex ring structure is formed distal to the left atrioventricular valve (LAVV). Vortex structures contribute to efficient flow organization. We aimed to investigate whether LAVV abnormality in patients with a corrected atrioventricular septal defect (AVSD) has an impact on vortex ring formation.

Reliability of diagnosing incidental pulmonary embolism in cancer patients.

Background: With the routine use of advanced multi-slice CT scanners, pulmonary embolism (PE) is increasingly detected as an incidental finding among cancer patients. Although this generally leads to therapeutic interventions, the accuracy of diagnosing PE on routinely performed contrast enhanced CT scans is unknown.

Methods: Consecutive cancer patients diagnosed with incidental PE were eligible for inclusion.

Disturbed Intracardiac Flow Organization After Atrioventricular Septal Defect Correction as Assessed With 4D Flow Magnetic Resonance Imaging and Quantitative Particle Tracing.

Objectives: Four-dimensional (3 spatial directions and time) velocity-encoded flow magnetic resonance imaging with quantitative particle tracing analysis allows assessment of left ventricular (LV) blood flow organization. Corrected atrioventricular septal defect (AVSD) patients have an abnormal left atrioventricular valve shape. We aimed to analyze flow organization in corrected AVSD patients and healthy controls.

Prognostic value of coronary computed tomography angiography in diabetic patients without chest pain syndrome.

Aims: Diabetic patients with coronary artery disease (CAD) are often free of chest pain syndrome. A useful modality for non-invasive assessment of CAD is coronary computed tomography angiography (CTA). However, the prognostic value of CAD on coronary CTA in diabetic patients without chest pain syndrome is relatively unknown.

The role of computed tomography in the diagnosis of acute and chronic pulmonary embolism.

Pulmonary embolism (PE) is a potentially life threatening condition requiring adequate diagnosis and treatment. Computed tomography pulmonary angiography (CTPA) is excellent for including and excluding PE, therefore CT is the first-choice diagnostic imaging technique in patients suspected of having acute PE. Due to its wide availability and low invasiveness, CTPA tends to be overused.

Thromboembolic resolution assessed by CT pulmonary angiography after treatment for acute pulmonary embolism.

The systematic assessment of residual thromboembolic obstruction after treatment for acute pulmonary embolism (PE) has been understudied. This assessment is of potential clinical importance, should clinically suspected recurrent PE occur, or as tool for risk stratification of cardiopulmonary complications or recurrent venous thromboembolism (VTE). This study aimed to assess the rate of PE resolution and its implications for clinical outcome.

Right ventricular cardiomyopathy meeting the arrhythmogenic right ventricular dysplasia revised criteria? Don't forget sarcoidosis!

A 53-year-old woman was referred for ventricular fibrillation with resuscitation. A CT-angiography showed signs of a right ventricular enlargement without obvious cause. A cardiac MRI demonstrated a dilated and hypokinetic right ventricle with extensive late gadolinium enhancement.

Genetically determined prospect to become long-lived is associated with less abdominal fat and in particular less abdominal visceral fat in men.

Purpose: familial longevity is marked by an exceptionally healthy metabolic profile and low prevalence of cardiometabolic disease observed already at middle age. We aim to investigate whether regional body fat distribution, which has previously shown to be associated with cardiometabolic risk, is different in offspring of long-lived siblings compared with controls.

Methods: our institutional review board approved the study, and all participants (n = 344, average age in years 65.