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Coronary Cameral Fistula and Anomalous Right Coronary Artery: A Case Report
Ng Pan Pan,Chow Boris Chun Kei,Cheung Stephen Chi Wai,Ng Ming-Yen 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.1
Coronary artery anomalies are uncommon with variable clinical significance. We present a case of 49-year-old gentleman with atypical chest pain, who was found to have single left coronary artery, anomalous right coronary artery with pre-pulmonic course, as well as coronary- cameral fistula on coronary computed tomography angiogram (CCTA). CCTA demonstrated no significant coronary artery stenosis to suggest ischemic heart disease nor ventricular dysfunction to suggest significant hemodynamic consequence secondary to the coronary anomalies.
Haemangioma in Left Atrial Appendage: Common Pathology in Uncommon Location
Ng Pan Pan,Chow Boris Chun Kei,Chiang Jeanie Betsy,Lee Jonan Chun-yin 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.1
Cardiac haemangiomas are rare primary cardiac tumours. Patient are often asymptomatic but life-threatening complications can occur owing to tumor location. We present an asymptomatic 50-year-old lady who had incidental finding of a left atrial appendage (LAA) mass on computer tomography. Cardiac magnetic resonance imaging showed a T2-weighted hyperintense, hypervascular intraluminal LAA tumour. The signal characteristics of the cardiac tumor followed that of hepatic haemangiomas, which were inadvertently included in the same image plane, suggesting the diagnosis of cardiac haemangioma.
Wan Fiona Fong-ying,Yeung Catherine Ming-mun,Yam Pak-ki,Ng Pan Pan,Chow Boris Chun Kei,Chiang Jeanie Betsy,Lee Jonan Chun-yin,Cheung Kenneth Kai-yat,Ng Ming-yen 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.3
Objective:Splenic switch-off (SSO) sign has been utilized as a surrogate marker of adequate stress but can only be assessed after first-pass perfusion imaging. A study previously reported that drop in T1spleen ≥30 ms during adenosine infusion predicts presence of SSO, but this finding has not been externally validated. This study aimed to prospectively validate whether drop in T1spleen ≥30 ms is a reliable marker of SSO and hence adequate stress, and to assess reproducibility of T1spleen measurements. Materials and Methods: Data of fifty consecutive patients undergoing stress cardiac magnetic resonance were prospectively collected. Native T1-maps were acquired at rest and at 2.5 min after adenosine infusion in short axis slices, followed by perfusion images at 3 min. To measure T1spleen pre- and post-adenosine infusion, regions of interest were manually placed to include most splenic tissue. Adenosine stress adequacy was evaluated by visual SSO assessment and semi-quantitative splenic perfusion analysis. Results:A significant association was found between a drop in T1spleen of ≥30 ms and SSO response (p<0.001). There was excellent correlation between SSO response and semiquantitative perfusion change in spleen (rho=0.847, p<0.001). Inter-observer and intra-observer agreement for measurement of ΔT1spleen values were excellent, with intra-class correlation coefficients of 0.987 and 0.995, respectively. By receiver-operating characteristic analysis, the optimal cut-off value of ΔT1spleen for predicting presence of SSO was -28 ms, with area under the curve=0.76 (p=0.002). Conclusion:Splenic T1-mapping is accurate and reproducible for predicting SSO, potentially allowing optimization of adenosine dosage for adequate stress.