The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Dec 2013
Comparative StudyDetermination of cardiac output with dynamic contrast-enhanced computed tomography.
Cardiac output (CO) is an important diagnostic and prognostic factor in the haemodynamic evaluation of patients. The gold standard for CO measurement, thermodilution, requires an invasive right-heart catheterisation (RHC). In this pilot study we aimed to determine the accuracy of non-invasive CO determination from dynamic contrast-enhanced computed tomography (CT) compared to thermodilution. ⋯ The average effective dose for the dynamic investigation was 1.2 ± 0.7 mSv. CO determined with dynamic contrast-enhanced CT in the main pulmonary artery reliably predicts the values obtained by thermodilution during RHC. This non-invasive technique might provide an alternative for repeated invasive right-heart catheter investigations in the follow-up of pulmonary arterial hypertension patients.
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Int J Cardiovasc Imaging · Oct 2013
Comparative StudyComparison of high-resolution MRI with CT angiography and digital subtraction angiography for the evaluation of middle cerebral artery atherosclerotic steno-occlusive disease.
Intracranial atherosclerotic disease is increasingly recognized as a major stroke subtype worldwide. Current diagnostic evaluation of atherosclerotic disease of the middle cerebral artery (MCA) relies on detection of stenoses with luminographic imaging studies that do not directly visualize plaque unlike high-resolution MRI. This retrospective study seeks to evaluate the accuracy of high-resolution MRI vessel wall imaging, computed tomographic angiography (CTA) and digital subtraction angiography (DSA) in measuring the degree of stenosis within the MCA. 28 recently symptomatic patients with MCA territory symptoms underwent preliminary imaging with CTA followed by high-resolution MRI at 3-Tesla and definitive imaging with DSA for detection of M1 territory steno-occlusive lesions. ⋯ MRI-derived values correlated better with DSA (Spearman R = 0.68, p < 0.01) than CTA MIP and VR (Spearman R = 0.45, 0.22; p = 0.02, 0.24, respectively). High-resolution MRI of the MCA is capable of accurately measuring the degree of stenosis and is more sensitive than CTA in a sample of high-risk, symptomatic patients. This study, combined with previous reports, supports the potential of morphological MRI to measure intracranial atherosclerotic plaque non-invasively.
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Int J Cardiovasc Imaging · Oct 2013
Comparative StudyCoronary CT angiography using the second-generation 320-detector row CT: assessment of image quality and radiation dose in various heart rates compared with the first-generation scanner.
To assess the image quality and radiation dose reduction in various heart rates in coronary CT angiography using the second-generation 320-detector row CT compared with the first-generation CT. Ninety-six patients were retrospectively included. The first 48 patients underwent coronary CT angiography with the first-generation 320-detector row CT, while the last 48 patients underwent with the second-generation CT. ⋯ The overall radiation dose reduced by 24 % (3.3 vs 2.5 mSv, respectively, p = 0.03), and the reduction was substantial in patients with higher heart rate (66- to 75-bpm, 4.3 vs 2.2 mSv, respectively, p = 0.009; >75 bpm, 8.2 vs 3.7 mSv, respectively, p = 0.005). The second-generation 320-detector row CT could maintain the image quality while reducing the radiation dose in coronary CT angiography. The dose reduction was larger in patients with higher heart rate.
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Int J Cardiovasc Imaging · Aug 2013
Case ReportsA new intracavitary lesion at echocardiography and MR: a case of mistaken identity.
Atrial myxomas often show contrast enhancement following administration of intravenous gadolinium, whereas thrombus appears as a hypointense structure, typically without any contrast enhancement. This case report presents a diagnostic challenge involving a recently developed left atrial mass in which echocardiography and cardiac MRI provided discordant results. While the morphological characteristics of the new left atrial lesion were suggestive of myxoma, the signal characteristics and behavior following intravenous gadolinium at MR, and, in particular, the rapid interval appearance of the lesion, prompted consideration for left atrial thrombus. Subsequent intra-operative and histopathologic evaluation proved the mass to be a left atrial myxoma.
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Int J Cardiovasc Imaging · Jun 2013
Randomized Controlled Trial Multicenter StudyA randomized, double-blind, placebo-controlled, phase II dose-finding study of the short acting β1-blocker, landiolol hydrochloride, in patients with suspected ischemic cardiac disease.
The purpose of this study was to compare the safety and efficacy of the short-acting β1-receptor blocker, landiolol hydrochloride (0.06 and 0.125-mg/kg), to placebo during coronary computed tomography angiography (CTA) in a phase 2 dose-finding study. A total of 183 patients suspected of having ischemic cardiac disease and scheduled to undergo an invasive coronary angiography were randomized to groups treated with landiolol hydrochloride (0.06 or 0.125-mg/kg) or placebo. The heart rate, safety, and the performance of coronary diagnosis using landiolol hydrochloride were evaluated in a multicenter, double-blind, randomized, parallel study. ⋯ The proportion of correctly classified patients was significantly higher in the 0.125-mg/kg landiolol hydrochloride group than in the placebo group (73.6 vs. 50.0 %). Landiolol hydrochloride at doses of 0.06 and 0.125-mg/kg significantly decreased the heart rate compared with a placebo. The present findings suggest that landiolol hydrochloride is safe and useful at a dose of 0.125-mg/kg to improve coronary diagnostic performance during coronary CTA.