Primary neuroendocrine tumour of the left ventricle.

Neuroendocrine tumours are rare neoplasms typically arising in the gastrointestinal tract that may result in carcinoid syndrome and/or acquired valvular dysfunction. Herein, we present a unique case of a 68-year-old asymptomatic woman with a primary left ventricular neuroendocrine tumour.

Echocardiography fails to detect left ventricular noncompaction in a cohort of patients with noncompaction on cardiac magnetic resonance imaging.

Background: Left ventricular noncompaction (LVNC) is a rare disorder characterized by increased left ventricular trabeculation, deep intertrabecular recesses, and a thin compacted myocardial layer with associated clinical sequelae. Cardiac imaging with echocardiogram and cardiac magnetic resonance (CMRI) can detect variable myocardial morphology including excessive trabeculations. Multiple CMRI and echocardiographic criteria have been offered that attempt to identify LVNC morphology.

The global cardiovascular magnetic resonance registry (GCMR) of the society for cardiovascular magnetic resonance (SCMR): its goals, rationale, data infrastructure, and current developments.

Background: With multifaceted imaging capabilities, cardiovascular magnetic resonance (CMR) is playing a progressively increasing role in the management of various cardiac conditions. A global registry that harmonizes data from international centers, with participation policies that aim to be open and inclusive of all CMR programs, can support future evidence-based growth in CMR.

Methods: The Global CMR Registry (GCMR) was established in 2013 under the auspices of the Society for Cardiovascular Magnetic Resonance (SCMR).

Efficacy of Noncontrast Computed Tomography of the Abdomen and Pelvis for Evaluating Nontraumatic Acute Abdominal Pain in the Emergency Department.

Background: Computed tomography (CT) clarity has significantly improved since it became widely available in the early 1980s, making the utility and benefit of contrast material for image quality of the abdomen and pelvis uncertain, and so far, minimally studied.

Objectives: This study sought to assess the efficacy of a noncontrast CT scan of the abdomen and pelvis by evaluating patients presenting to the emergency department (ED) with acute nontraumatic abdominal pain by following them for 7 days and observing for signs and symptoms of clinically significant acute emergent pathology.

Methods: We enrolled, and for 7 days followed, a prospective observational convenience sample of patients who received a noncontrast CT scan of the abdomen and pelvis in the ED for acute nontraumatic abdominal pain.

To breathe or not to breathe: a review of artificial airway placement and related complications.

Artificial airway devices are commonly used to provide adequate ventilation and/or oxygenation in multiple clinical settings, both emergent and nonemergent. These frequently used devices include laryngeal mask airway, esophageal-tracheal combitube, endotracheal tube, and tracheostomy tube and are associated with various acute and late complications. Clinically, this may vary from mild discomfort to a potentially life-threatening situation.

Aspiration-related lung diseases.

Aspiration is a common but underrecognized clinicopathologic entity, with varied radiographic manifestations. Aspiration represents a spectrum of diseases, including diffuse aspiration bronchiolitis, aspiration pneumonitis, airway obstruction by foreign body, exogenous lipoid pneumonia, interstitial fibrosis, and aspiration pneumonia with or without lung abscess formation. Many patients who aspirate do not present with disease, suggesting that pathophysiology is related to a variety of factors, including decreased levels of consciousness, dysphagia, impaired mucociliary clearance, composition of aspirate, and impaired host defenses.

Reconstruction of pulmonary venous conduit with CorMatrix in lung transplant.

Anomalous pulmonary vein anatomy is infrequently encountered during reconstructive lung surgery, especially lung transplantation. Complications of pulmonary venous anastomosis carry high morbidity and mortality. We report a case of anomalous pulmonary vein reconstruction with a decellularized porcine small intestinal submucosa-derived extracellular matrix during bilateral lung transplantation in an 18-year-old woman with cystic fibrosis.

Myocarditis: diagnosis and treatment.

Myocarditis is a condition that can have a very wide clinical spectrum ranging from asymptomatic forms to fatal disease, but mostly presenting as new onset heart failure with reduced left ventricular ejection fraction, with or without viral syndrome. This condition is an important cause of sudden cardiac death in young patients. High risk features include second and third degree atrioventricular block or malignant arrhythmias.

Unrepaired tetralogy of fallot with major aortopulmonary collateral arteries in an adult patient.

Tetralogy of Fallot is characterized by a ventricular septal defect, a large, overriding aorta, subpulmonic stenosis, and right ventricular hypertrophy. These lesions can be associated with abnormal development of the pulmonary vasculature. This can include peripheral pulmonic stenosis, discontinuous pulmonary arteries, anomalous pulmonary venous return, and the development of aortopulmonary collateral vessels.

Gerbode ventricular septal defect diagnosed using cardiac CTA imaging.

This report describes the ability of computed tomography angiography (CTA) imaging of the heart to visualize an acquired shunt between the left ventricular outflow tract (LVOT) and the right atrium (RA) (Gerbode defect). Previously, transesophageal echocardiography (TEE) has been the mainstay of diagnosis. To the best of our knowledge, the use of cardiac CTA imaging to visualize and diagnose this disorder has not been previously reported.

Delayed levorotation of the heart in traumatic pericardial rupture.

Traumatic pericardial rupture, with complicating cardiac herniation, is an extremely uncommon condition with a high mortality rate. We are reporting our experience with a case of blunt trauma to the chest, secondary to high-impact motor vehicle collision. The preoperative diagnosis of ascending aortic transection was made on subsequent imaging studies for which surgical repair was elected.

Risk stratification for therapeutic management and prognosis.

In coronary artery disease (CAD), cardiac magnetic resonance (CMR) imaging can integrate several types of pulse-sequence examinations (eg, myocardial perfusion, cine wall motion, T2-weighted imaging for myocardial edema, late gadolinium enhancement, and CMR angiography) that can provide anatomic, functional, and physiologic information about the heart in a single imaging session. Because of this ability to interrogate myocardial physiology using different pulse sequence techniques within a single CMR session, this technique has been recognized increasingly in many centers as the test of choice for assessing patients who present with cardiomyopathy of undetermined cause. This article first reviews the current evidence supporting the prognosticating role of CMR in assessing CAD and then discusses CMR applications and prognostication in many non-coronary cardiac conditions.

ACR appropriateness criteria on recurrent symptoms following lower-extremity angioplasty.

Lower-extremity arteriopathy patients can be managed nonsurgically, but there is no standard algorithm for follow-up. The authors present a consensus on appropriate postangioplasty studies in the setting of claudication or a threatened limb. Physical examination with measurements of the ankle-brachial index should be the first step in patients with recurrent symptoms.

Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography.

Purpose: To evaluate the relationship between the phase window width and image quality in prospectively ECG-gated 320-detector row coronary CTA, and to evaluate the relationship between heart rate and the number of cardiac phases with diagnostic quality images.

Methods: Thirty-six phases (60-95% R-R, 1% increments) were reconstructed in 41 consecutive prospectively gated single R-R 320 x 0.5 mm detector row coronary CTA patients.

Interdepartmental conflict management and negotiation in cardiovascular imaging.

Although the relationship between cardiologists and radiologists has a thorny history, advanced cardiac imaging technology and the promise of cardiac computed tomography are forcing both specialties back to the negotiation table. These discussions represent an opportunity for better communication, collaboration, and resource allocation. The authors address the aspects of interdepartmental conflict management and negotiation through their radiology department's ongoing efforts to provide high-quality advanced noninvasive cardiovascular imaging services at a large academic institution.

Initial evaluation of coronary images from 320-detector row computed tomography.

Purpose: To evaluate image quality and contrast opacification from coronary images acquired from 320-detector row computed tomography (CT). Patient dose is estimated for prospective and retrospective ECG-gating; initial correlation between 320-slice CT and coronary catheterization is illustrated.

Methods: Retrospective image evaluation from forty consecutive patients included subjective assessment of image quality and contrast opacification (80 ml iopamidol 370 mg I/ml followed by 40 ml saline).

Evaluation of posterior tibial pathology: comparison of sonography and MR imaging.

Objective: To compare the results of sonographic (US) and magnetic resonance (MR) imaging in detecting pathology of the posterior tibial tendon (PTT) in patients with PTT dysfunction.

Design: Twenty-two ankles that were clinically suspected by the orthopedic surgeon to have PTT dysfunction were evaluated with US (10 MHz linear-array transducer) and 1.5 T MR examinations within the same day.

Plain radiography of the lumbosacral spine in Marfan syndrome.

Background Context: Marfan syndrome is a connective tissue disorder that results from a defect in the production of fibrillin. These patients tend to have several osseous anomalies of the lumbosacral spine.

Purpose: This study examines the effectiveness of plain radiographic findings in predicting Marfan syndrome.

Septic arthritis of the hip following cortisone injection: case report and review of the literature.

Septic arthritis of the hip is a serious medical condition that can result in permanent joint dysfunction. This is a case of a 65-year-old woman who underwent therapeutic intraarticular steroid/lidocaine injection for hip pain and subsequently developed septic arthritis. It is critical that radiologists performing these procedures maintain a high index of suspicion in symptomatic patients following intraarticular injections to prevent destruction of the joint.

The etiology of adolescent idiopathic scoliosis.

The etiology of adolescent idiopathic scoliosis (AIS), the most common form of scoliosis, is unclear. Researchers with divergent perspectives have tried to better define this etiology. Genetics, growth hormone secretion, connective tissue structure, muscle structure, vestibular dysfunction, melatonin secretion, and platelet microstructure are major areas of focus.

Dural ectasia and back pain: review of the literature and case report.

Dural ectasia is defined as a ballooning of the dural sac which is more common in patients with connective tissue disorders such as the Marfan syndrome. Several studies have shown that dural ectasia may be associated with such conditions as back pain, headaches, radiculopathies, or incontinence. We present a case of a 52 year old woman with Marfan syndrome who presented with a significantly large anterior sacral meningocele without having associated symptoms.

Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments.

The cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome) is marked by slow, insidious progression and a high incidence of dural ectasia in the lumbosacral spine. A high index of suspicion for this problem must be maintained when evaluating the patient with ankylosing spondylitis with a history of incontinence and neurologic deficit on examination. There has been disagreement in the literature as to whether surgical treatment is warranted for this condition.

Dural ectasia and conventional radiography in the Marfan lumbosacral spine.

Objective: To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.

Design And Patients: Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.

The lumbar interpediculate distance is widened in adults with the Marfan syndrome: data from 32 cases.

32 patients with Marfan syndrome, diagnosed with DePaepe's criteria, volunteered for this study. All patients underwent standard anteroposterior radiographs of the lumbar spine. Interpediculate distances (IPD) at each level were compared to those of previously established norms.

Dural ectasia in the Marfan syndrome: MR and CT findings and criteria.

Purpose: To create criteria for detecting dural ectasia on MR or CT images in adult Marfan patients.

Methods: Images were analyzed using a workstation. Parameters that predicted dural ectasia were included in our criteria.