RESUMEN
The assessment of patients presenting with symptoms of myocardial ischaemia remains one of the most common and challenging clinical scenarios faced by physicians. Current imaging modalities are capable of three-dimensional, functional and anatomical views of the heart and as such offer a unique contribution to understanding and managing the pathology involved. Evidence has accumulated that visual anatomical coronary evaluation does not adequately predict haemodynamic relevance and should be complemented by physiological evaluation, highlighting the importance of functional assessment. Technical advances in CT technology over the past decade have progressively moved cardiac CT imaging into the clinical workflow. In addition to anatomical evaluation, cardiac CT is capable of providing myocardial perfusion parameters. A variety of CT techniques can be used to assess the myocardial perfusion. The single energy first-pass CT and dual energy first-pass CT allow static assessment of myocardial blood pool. Dynamic cardiac CT imaging allows quantification of myocardial perfusion through time-resolved attenuation data. CT-based myocardial perfusion imaging (MPI) is showing promising diagnostic accuracy compared with the current reference modalities. The aim of this review is to present currently available myocardial perfusion techniques with a focus on CT imaging in light of recent clinical investigations. This article provides a comprehensive overview of currently available CT approaches of static and dynamic MPI and presents the results of corresponding clinical trials.
Asunto(s)
Angiografía Coronaria/métodos , Isquemia Miocárdica/diagnóstico por imagen , Imagen de Perfusión Miocárdica/métodos , Tomografía Computarizada por Rayos X/métodos , Circulación Coronaria , Humanos , Isquemia Miocárdica/fisiopatología , Reproducibilidad de los ResultadosRESUMEN
A 48-year-old woman presented with cough and chest pain. A chest radiograph and CT scans showed bilateral lung masses containing massive venous varices. A core biopsy specimen revealed benign metastasising leiomyoma with strong expression of progesterone receptors. A review of her medical history revealed a hysterectomy 11 years earlier. The lung masses showed significant reduction in size after induction of artificial menopause, although the pulmonary varices persisted.
Asunto(s)
Leiomioma/irrigación sanguínea , Neoplasias Pulmonares/irrigación sanguínea , Neoplasias Uterinas , Várices/diagnóstico por imagen , Dolor en el Pecho/etiología , Femenino , Humanos , Histerectomía , Leiomioma/terapia , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/terapia , Persona de Mediana Edad , Tomografía por Rayos X , Neoplasias Uterinas/cirugía , Várices/terapiaRESUMEN
Drug-induced lung diseases are a frequent cause of morbidity. Diffuse pulmonary haemorrhage is an uncommon complication of drug therapy, and is a potentially life-threatening situation. We report the high-resolution CT and clinical findings of a 32-year-old man with diffuse pulmonary haemorrhage induced by ketorolac tromethamine.