Journal of cardiovascular computed tomography
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J Cardiovasc Comput Tomogr · Jul 2011
Direct chest area measurement: A potential anthropometric replacement for BMI to inform cardiac CT dose parameters?
Significant dose reductions for coronary CT angiography (CTA) can be achieved with reduced tube potential (kV); however, the potential effect on image quality is unknown. ⋯ Patients' chest area and BMI classes were frequently discordant, potentially leading to overdosing or underdosing when using BMI to select tube potential.
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J Cardiovasc Comput Tomogr · May 2011
Multicenter StudyComparative diagnostic yield and 3-month outcomes of "triple rule-out" and standard protocol coronary CT angiography in the evaluation of acute chest pain.
"Triple rule-out" CT angiography simultaneously evaluates coronary artery disease, pulmonary embolism, and aortic dissection in a single imaging examination. However, the clinical outcomes of this approach are unknown. ⋯ Among patients with acute chest pain, a triple rule-out approach resulted in higher radiation exposure compared with cardiac CT, but was not associated with improved diagnostic yield, reduced clinical events, or diminished downstream resource use.
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J Cardiovasc Comput Tomogr · Jan 2011
Case ReportsGuidewire embolization and right ventricular perforation visualized by cardiac CT.
A 60-year-old physician with a history of septic arthritis presented with chest pain. Initial studies including an electrocardiogram, chest x-ray, and transthoracic echocardiogram were non-diagnostic. Cardiac CT demonstrated perforation of the right ventricle from a retained wire stylus. Our case highlights the clinical utility of CT in diagnosing migration of devices through the cardiac chambers, evaluating for associated sequelae, including hemopericardium and other perforated structures, and defining the complete course of the device, thereby facilitating safe extraction.
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J Cardiovasc Comput Tomogr · Nov 2010
ReviewAortic valve stenosis: CT contributions to diagnosis and therapy.
As populations in Western civilizations are aging, the prevalence of degenerative aortic valve stenosis is increasing. CT imaging provides information on aortic valve pathology in many ways: In nonenhanced scans, aortic valve calcification can be quantified accurately, which helps to understand the pathogenesis and progression of aortic sclerosis and stenosis. After contrast injection, CT allows excellent visualization of aortic valve structure and, through measurement of the aortic valve area, is capable to serve as a "backup method" for the assessment of aortic valve stenosis, especially if other imaging methods are difficult to interpret. ⋯ In fact, the ability to provide superbly accurate anatomic imaging of the aortic valve and entire aortic root makes CT a uniquely useful tool for the planning of transcatheter aortic valve implantation. Hence, CT imaging spans a wide range of applications in aortic valve disease, from basic research to diagnosis and treatment planning. This review aims to summarize the current state of the art concerning imaging of the aortic valve by CT and the potential clinical applications.
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A number of congenital anomalies of the aortic arch complex can occur, ranging from asymptomatic normal variations in arch vessel branch pattern to symptomatic vascular rings, stenoses, and arch interruptions with a frequency ranging from 0.5% to 3.0%. A right aortic arch is present in 0.1% of the population and can occur in isolation or be associated with congenital heart disease. Patients may present at any age with signs and symptoms of airway or esophageal compression, heart failure, or abnormal chest imaging studies. This pictorial essay will show the computed tomography and appearances of congenital variations of the right aortic arch and use Edwards' hypothetical embryonic double aortic arch model to explain the cause of some of these variants.