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Clinical Applications of CT Myocardial Perfusion Imaging
Cheng Xu,Yan Yi,Yining Wang 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.4
With the continuous development of CT technology, myocardial CT perfusion imaging (CTP) has exhibited great advantages and been shown to have incremental value over coronary CT angiography, providing functional evaluation of coronary artery disease (CAD). Comprehensive assessment of CAD using cardiac CT has become feasible. This article introduces the preliminary clinical experience and advances with CTP and briefly reviews the feasibility verification, diagnostic performance, clinical strategy optimization and prognostic evaluation of CTP.
Joon-Won Kang,Wooil Kim,최상일 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.3
The severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-2) pandemic still makes a significant burden on healthcare systems, including radiology departments. Considering important role of cardiovascular imaging in modern healthcare, and the specific value of cardiopulmonary radiology in COVID-19 patients, organization and imaging programs require to be modified during the pandemic. The uninterrupted availability of cardiovascular radiology imaging is, particularly during the current pandemic period, essential for the initial evaluation and follow-up of patients with suspected or known cardiovascular diseases for avoiding unnecessary complications. Suspected or established COVID-19 patients may also have concomitant cardiovascular symptoms and require further imaging. This review summarized the statements by the European Society of Cardiovascular Radiology, North American Society of Cardiovascular Imaging, Society of Cardiovascular Computed Tomography, and Society of Cardiovascular Magnetic Resonance for providing information on measures for guidelines of safety and recommendations for cardiovascular imaging during the pandemic.
Low Iodine Dose is Related with Overestimation of Extracellular Volume Derived from Cardiac CT
Hiroaki Arakawa,Nobuo Tomizawa,Shengpu Chou,Satoshi Matsuoka,Kodai Yamamoto,Shinichi Inoh,Takeshi Nojo,Kanako Kunishima Kumamaru,Shinichiro Fujimoto,Sunao Nakamura 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.2
Objective: To assess the relationship between the amount of injected contrast medium and the extracellular volume (ECV) value during cardiac CT and to propose a minimum amount of contrast medium necessary to correctly calculate ECV. Materials and Methods: A total of 95 patients who underwent comprehensive cardiac CT were included. Patients first underwent myocardial CT perfusion (CTP) with a contrast medium dose determined by the body weight (<70 kg: 50 mL; 70–89 kg: 55 mL; ≥90 kg: 60 mL). Coronary CT angiography (CTA) scan followed with a contrast medium dose of 0.8×body weight (kg). We defined the ECV value calculated after CTP as ECVCTP, and we used the ECV value calculated after the CTA exam as the reference standard (ECVref). We calculated the difference in ECV values (ECVdiff) as ECVCTP-ECVref. Results: The injected iodine doses during CTP and the entire exam were 284±50 and 559± 69 mg iodine/kg, respectively. There was a weak but significant negative relationship (R2 =0.07, p=0.01) between the injected iodine dose during CTP and ECVdiff. The ECVdiff of patients who received an injected iodine dose of <285 mg iodine/kg during CTP was significantly higher (2.7±4.1 vs. 0.8±3.4%, p=0.02) than that of the remaining patients. Conclusion: ECV derived from cardiac CT might be overestimated when a small amount of contrast medium is injected. Inj
Acute Right Intracardiac Thrombus-in-Transit Complicated by Submassive Pulmonary Embolism
Raja Shariff Raja Ezman,Badrul Zaman Nazurah,Mohamad Razi Adli Azam,Najme Khir Rizmy,Kasim Sazzli 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.1
A 61-year-old female presented with symptoms suggestive of congestive cardiac failure that was confirmed on transthoracic echocardiography (TTE) with the absence of an intracardiac thrombus. In the hospital, she suffered episodes of syncope, prompting further investigations. Repeat TTE revealed an acute mobile right atrial thrombus, and CT imaging of the pulmonary artery confirmed the presence of a massive pulmonary embolism (PE). Despite a low pulmonary embolism severity index (PESI) score, the patient underwent surgical pulmonary embolectomy. The prevalence of right-sided thrombi ranges between 4–18% in the presence of acute PE, and right-sided thrombi will almost always lead to PE. Our case highlights the limitation of the PESI score and emphasizes urgent management for the presence of a thrombus-in-transit, despite a low PESI score.
Yang Fan,Wu Qian,Yan Yan,Zhang Zhang,Li Dong 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.4
Primary pericardial liposarcomas are extremely rare. We presented a case of a 69-year-old man who presented with exertional dyspnea for more than one week. A pericardial mass was detected by echocardiography and then further investigated by computed tomography and cardiac magnetic resonance imaging. The tumor was resected completely, and the histopathological result was confirmed to be a well-differentiated liposarcoma.
Tsai I-Chen,Goo Hyun Woo,Latiff Haifa Abdul,Goo Seon Young,Park Sang Joon 아시아심장혈관영상의학회 2022 Cardiovascular Imaging Asia Vol.6 No.3
Due to COVID-19, onsite medical conferences were converted to virtual or hybrid formats, which have been widely accepted and successful. However, hands-on training and workshops among groups studying congenital heart disease imaging were hardly available due to their unique features requiring a high degree of interactivity. Virtual conferences are speculated to remain after the pandemic to enrich sharing ideas, concepts, and clinical experiences. Additionally, strategies utilizing augmented reality, virtual reality, and the metaverse may help reduce barriers in conducting hands-on workshops. This review illustrates various academic activities during past onsite small group conferences, suggests tips and tricks for virtual conferences, and introduces currently available innovative platforms, including the personal three-dimensional display program, hologram, and metaverse for medical education and conferences.
Rupinder Buttar,Khosa Gurveer Singh,Baibhav Bipul 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.4
A 63-year-old male with past medical history of bicuspid aortic valve and ascending aortic aneurysm was referred to cardiology for aortic valve replacement (AVR) and aneurysm repair. Transthoracic echocardiogram (TTE) showed bicuspid aortic valve with severe aortic valve stenosis. Patient underwent transesophageal echocardiogram which showed an incidental finding of double orifice mitral valve (DOMV) with fusion of A/P cusps along anterolateral commissure not noted on previous TTE. Patient underwent AVR with bioprosthetic aortic valve along with resection and replacement of the ascending aortic aneurysm. No intervention was performed for the asymptomatic DOMV. DOMV is a rare congenital cardiac abnormality, easily missed on routine TTE. It warrants need for careful evaluation of mitral valve apparatus in patients with other congenital cardiac abnormalities known to be associated with DOMV.
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.
Polycythemia Vera Presenting as Left Ventricular Pseudoaneurysm: The Role of Multimodality Imaging
Mansour Mohamad Jihad,Haddoul Ahmad,Ohanian Antranik,El Haj Sleiman Ahmad,Osman Raed,Adhami Atika 아시아심장혈관영상의학회 2019 Cardiovascular Imaging Asia Vol.3 No.2
The association of left ventricular pseudoaneurysm (LVPA) formation to polycythemia vera (PV) is unknown and, to our knowledge, has never been reported. We describe the case of a 58- year-old man with PV who was admitted for acute dyspnea following an inferior myocardial infarction that occurred seven weeks prior to presentation. Multimodality imaging disclosed the presence of an LVPA. The patient refused surgical treatment and was readmitted three months later with acute decompensation. Follow-up imaging revealed increased LVPA. Review of the literature however showed no report of PV presenting as an LVPA that worsened in a follow-up admission. This rare association prompted a definitive diagnosis. In this case, multimodality imaging was crucial to establishing a definitive diagnosis and guiding therapy.