Case 318: Adult Polyglucosan Body Disease.

A 72-year-old man sought care for a cognitive deterioration over the past 5 years. There was a documented decline in his performance on the Mini-Mental State Examination (30 of 30 in 2016, 23 of 30 in 2021), with mainly episodic memory impairment. A more detailed history revealed a gait problem, paresthesia in both feet, and nocturnal urinary frequency.

Case 318.

A 72-year-old man sought care for a cognitive deterioration over the past 5 years. There was a documented decline in his performance on the Mini-Mental State Examination (30 of 30 in 2016, 23 of 30 in 2021), with mainly episodic memory impairment. A more detailed history revealed a gait problem, paresthesia in both feet, and nocturnal urinary frequency.

Aortocaval Fistula: A Rare Complication of an Infrarenal Aortic Aneurysm.

Aortocaval fistula is a rare complication of infrarenal aortic aneurysms.

BSR 2020 Annual Meeting: Program.

Different times call for different measures. The COVID-19 pandemic has forced us to search for alternative methods to provide an annual meeting which is equally interesting and has quality. For the Belgian Society of Radiology (BSR) 2020 Annual Meeting, the sections on Abdominal Imaging, Thoracic Imaging and the Young Radiologist Section (YRS) joined forces to organize a meeting which is quite different from the ones we have organised in the past.

Clinical impact of CT coronary angiography without exclusion of small coronary artery segments: a real-world and long-term study.

Objectives: CT coronary angiography (CTCA) has become a valuable diagnostic test in the workup of patients with possible coronary artery disease (CAD). Because of inherent limitations in spatial resolution, epicardial vessels with a small diameter, in general less than 1.5-2 mm, have so far been excluded in studies assessing clinical utility of CTCA.

Value of Relative Myocardial Perfusion at MRI for Fractional Flow Reserve-Defined Ischemia: A Pilot Study.

Correcting the perfusion in areas distal to coronary stenosis (risk) according to that of normal (remote) areas defines the relative myocardial perfusion index, which is similar to the fractional flow reserve (FFR) concept. The aim of this study was to assess the value of relative myocardial perfusion by MRI in predicting lesion-specific inducible ischemia as defined by FFR. Forty-six patients (33 men and 13 women; mean [± SD] age, 61 ± 9 years) who underwent adenosine perfusion MRI and FFR measurement distal to 49 coronary artery stenoses during coronary angiography were retrospectively evaluated.

Belgian Radiology Research in Full Power!

In Belgium, there has always been a strong tradition to foster radiology and imaging research. The former Royal Belgian Society of Radiology (RBSR-KBVR-SRBR)-after the merger with the Consilium and NUR, now the Belgian Society of Radiology (BSR-BVR-SBR)-has persistently been one of the driving forces of support to individuals who wanted to innovate and put Belgian radiology research at the forefront.

Image quality in coronary CT angiography: challenges and technical solutions.

Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations.

Coronary Computed Tomography Angiography: Patient-related factors determining image quality using a second-generation 320-slice CT scanner.

Purpose: To investigate the diagnostic confidence of Coronary Computed Tomography Angiography (CCTA) and the effect of patient-related factors on CCTA image quality using a second-generation 320-slice scanner.

Methods And Results: 200 consecutive patients (mean age 60±12years; 109 men) prospectively underwent CCTA. The mean body mass index (BMI) was 27.

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses.

Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity.

On the inappropriateness of noninvasive multidetector computed tomography coronary angiography to trigger coronary revascularization: a comparison with invasive angiography.

Objectives: Our purpose was to evaluate the appropriateness of multidetector computed tomography angiography (MDCTA) as an anatomical standard for decision making in patients with known or suspected coronary artery disease.

Background: Although correlative studies between MDCTA and coronary angiography (CA) show good agreement, MDCTA visualizes plaque burden and calcifications well before luminal dimensions are encroached.

Methods: Pressure-derived fractional flow reserve (FFR) was obtained in 81 patients (116 vessels) who underwent both CA and MDCTA.

Head-to-head comparison of coronary plaque evaluation between multislice computed tomography and intravascular ultrasound radiofrequency data analysis.

Objectives: The purpose of this study was to perform a head-to-head comparison of plaque observations with multislice computed tomography (MSCT) to virtual histology intravascular ultrasound (VH IVUS).

Background: The VH IVUS allows in vivo coronary plaque characterization with high spatial resolution. Noninvasively, plaques may be evaluated with MSCT, but limited data are available.

Type 2 diabetes is associated with more advanced coronary atherosclerosis on multislice computed tomography and virtual histology intravascular ultrasound.

Background: Data on coronary plaque observations on multi-slice computed tomography (MSCT) in patients with type 2 diabetes are scarce.

Methods And Results: In total, 60 patients (19 with diabetes) underwent 64-slice MSCT, followed by conventional coronary angiography with intravascular ultrasound (IVUS). Non-invasively, the extent of coronary atherosclerosis and 3 plaque types (non-calcified, calcified, mixed) were visually evaluated on MSCT.

Characterisation of the "vulnerable" coronary plaque by multi-detector computed tomography: a correlative study with intravascular ultrasound-derived radiofrequency analysis of plaque composition.

Aims: To assess plaque characteristics by multi-detector computed tomography angiography in patients with known coronary artery disease and to compare these findings with those obtained with intravascular ultrasound-derived radiofrequency analysis of plaque composition.

Methods And Results: By computed tomography, lesions were classified on the basis of Hounsfield Units as non-calcified, calcified, or mixed. By intravascular ultrasound-derived radiofrequency analysis, plaques were classified according to the relative composition of components with specific backscatter characteristics (necrotic core, fibrous, fibro-fatty, calcium).

Evaluation of plaque characteristics in acute coronary syndromes: non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis.

Aims: Atherosclerotic plaque characteristics play an important role in the development of coronary events. We investigated coronary plaque characteristics on multi-slice computed tomography (MSCT) and virtual histology intravascular ultrasound (VH IVUS) in patients with acute coronary syndromes (ACS) and stable coronary artery disease (CAD).

Methods And Results: Fifty patients (25 with ACS, 25 with stable CAD) underwent 64-slice MSCT followed by VH IVUS in 48 (96%) patients.

Multidetector computed tomography angiography for assessment of in-stent restenosis: meta-analysis of diagnostic performance.

Background: Multi-detector computed tomography angiography (MDCTA)of the coronary arteries after stenting has been evaluated in multiple studies.The purpose of this study was to perform a structured review and meta-analysis of the diagnostic performance of MDCTA for the detection of in-stent restenosis in the coronary arteries.

Methods: A Pubmed and manual search of the literature on in-stent restenosis (ISR) detected on MDCTA compared with conventional coronary angiography (CA) was performed.

Effects of sublingual nitroglycerin on coronary lumen diameter and number of visualized septal branches on 64-MDCT angiography.

Objective: This article describes the influence of sublingual nitroglycerin spray on the lumen diameter, number of side branches visualized, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of the coronary arteries with MDCT angiography.

Subjects And Methods: Forty-two patients were prospectively included in this study: 21 were examined without sublingual nitroglycerin (group A), and 21 were examined after the administration of sublingual nitroglycerin (group B). CT angiography was performed using a 64-MDCT scanner.

Detection of non-ST-elevation myocardial infarction and unstable angina in the acute setting: meta-analysis of diagnostic performance of multi-detector computed tomographic angiography.

Background: Multi-detector computed tomography angiography (MDCTA) has been increasingly used in the evaluation of the coronary arteries. The purpose of this study was to review the literature on the diagnostic performance of MDCTA in the acute setting, for the detection of non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP).

Methods: A Pubmed and manual search of the literature published between January 2000 and June 2007 was performed.

Diagnostic performance of multidetector CT angiography for assessment of coronary artery disease: meta-analysis.

Purpose: To review the literature on the diagnostic performance of multidetector computed tomographic (CT) angiography for assessment of symptomatic coronary artery disease, with conventional coronary angiography as the reference standard.

Materials And Methods: A PubMed and manual search of the literature published between January 1998 and May 2006 on use of multidetector CT angiography compared with coronary angiography in patients with symptomatic coronary artery disease was performed. Summary estimates of diagnostic odds ratio, sensitivity, and specificity were calculated.

What does the clinical cardiologist need from noninvasive cardiac imaging: is it time to adjust practices to meet evolving demands?

With the recent emergence of multidetector computed tomography angiography, coronary anatomy can now be assessed noninvasively. Until this advancement, functional noninvasive imaging used to serve as a gatekeeper that governed access to invasive diagnosis by coronary angiography and subsequent therapy. In the current era the threshold for access to coronary anatomy will be lowered.

A simple method to estimate cardiac function during routine multi-row detector CT exams.

Cardiac dysfunction may be suggested at computed tomography (CT) exams by the presence of morphological abnormalities such as cardiac enlargement and thickening of the pulmonary interlobular septa. However, these morphological signs are non specific. We evaluated whether right-to-left cardiac transit time of contrast during single-level timing scans could predict the cardiac output and ejection fraction.

Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging.

Objectives: The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography.

Background: Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown.

Methods: A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI.