Asunto(s)
Terapia de Resincronización Cardíaca/efectos adversos , Lesiones Cardíacas/diagnóstico por imagen , Lesiones Cardíacas/etiología , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada Multidetector/métodos , Niño , Electrocardiografía/métodos , Lesiones Cardíacas/diagnóstico , Humanos , Masculino , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
Since the introduction of the 64-generation scanners, the accuracy and robustness of the diagnosis of coronary artery disease has progressed. The main advantage of cardiac CT is the exclusion of coronary artery disease by its excellent negative predictive value. Currently, cardiac CT applications extend thanks to innovations both in terms of technological development systems scanner or stents implanted. This is a literature review of stent evaluation with cardiac CT.
Asunto(s)
Técnicas de Imagen Cardíaca , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Stents , Tomografía Computarizada por Rayos X , HumanosRESUMEN
The objective of this study was to propose diagnostic reference levels (DRLs) for coronary computed tomography angiography (CCTA), in the context of a large variability in patient radiation dose, and the lack of European recommendations. Volume Computed Tomography Dose Index (CTDIvol) and dose-length product (DLP) were collected from 460 CCTAs performed over a 3-month period at eight French hospitals. CCTAs (â¼50 per centre) were performed using the routine protocols of the centres, and 64- to 320-detector CT scanners. ECG gating was prospective (n = 199) or retrospective (n = 261). The large gap in dose between these two modes required to propose specific DRLs: 26 and 44 mGy for CTDIvol, and 370 and 970 mGy cm for DLP, respectively. This study confirms the large variability in patient doses during CCTA and underlines the need for the optimisation of cardiac acquisition protocols. Availability of national DRLs should be mandatory in this setting.
Asunto(s)
Angiografía Coronaria/estadística & datos numéricos , Angiografía Coronaria/normas , Radiometría/estadística & datos numéricos , Radiometría/normas , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Tomografía Computarizada por Rayos X/normas , Dosis de Radiación , Valores de Referencia , Encuestas y CuestionariosRESUMEN
Since the introduction of the 64-generation scanners, the accuracy and robustness of the diagnosis of coronary artery disease has progressed. The main advantage of cardiac CT is the exclusion of coronary artery disease by its excellent negative predictive value. Currently, cardiac CT applications extend thanks to innovations both in terms of technological development systems scanner or stents implanted, that the evolution of surgical procedures such as TAVI.
Asunto(s)
Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Angioplastia Coronaria con Balón , Enfermedad de la Arteria Coronaria/terapia , Falla de Equipo , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional , Sensibilidad y Especificidad , StentsRESUMEN
The purpose of the study was to assess whether a strategy based on a MDCT performed routinely before CA can reduce the radiation dose during the CA, without increased global exposure in patients who need imaging of CABG. A total of 147 consecutive patients were included. The radiation dose during CA (KAP 12.1 vs 22.0 Gy/cm(2), P<.01) and the volume of iodinated contrast (155 vs 200 mL, P<.02) were reduced when preceded by a MDCT. Patients' cumulative exposures were not different in the 2 strategies (5.0 vs 5.1 mSv, P=.76). MDCT performed in first line is a valuable strategy for the assessment of CABG.
Asunto(s)
Puente de Arteria Coronaria , Oclusión de Injerto Vascular/diagnóstico por imagen , Tomografía Computarizada Multidetector , Anciano , Angina de Pecho/diagnóstico por imagen , Medios de Contraste , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico por imagen , Estudios Prospectivos , Dosis de Radiación , Sensibilidad y EspecificidadRESUMEN
We report the case of a man presenting with a Pierre Marie-Bamberger syndrome. This paraneoplastic syndrome revealed an undifferentiated intracardiac sarcoma. This case emphasizes the need for multimodality imaging to characterize intracardiac tumor.
Asunto(s)
Neoplasias Cardíacas/diagnóstico , Imagen Multimodal , Sarcoma/diagnóstico , Adulto , Medios de Contraste , Ecocardiografía Transesofágica , Fluorodesoxiglucosa F18 , Gadolinio DTPA , Humanos , Imagen por Resonancia Cinemagnética , Masculino , Osteoartropatía Hipertrófica Secundaria/etiología , Síndromes Paraneoplásicos/diagnóstico , Tomografía de Emisión de Positrones , RadiofármacosRESUMEN
Patients with cardiac implantable electronic devices are usually excluded from MRI examinations due to contraindication for MRI. The MRI-conditional pacemaker system may allow the benefits of MRI (system 1.5T) to be more accessible to pacemaker patients. A 62-year-old man was admitted with acute coronary syndrome and atrial fibrillation. A conventional angiography showed normal coronaries. A cardiac cardioversion revealed a significant sinus node dysfunction and a magnetic resonance imaging (MRI) compatible dual chamber system was implanted. At 6-week follow-up, a cardiac MRI revealed a typical anterior myocardial infarction with diagnostic quality images despite pacemaker. This is one of the first reports of cardiovascular MRI in a patient with MRI-conditional pacing system.
Asunto(s)
Imagen por Resonancia Cinemagnética , Infarto del Miocardio/diagnóstico , Marcapaso Artificial , Vasos Coronarios/patología , Embolia/complicaciones , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The field of cardiovascular MRI has evolved rapidly over the past decade, feeding new applications across a broad spectrum of clinical and research areas. Advances in magnet hardware technology, and key developments such as segmented k-space acquisitions, advanced motion encoding techniques, ultra-rapid perfusion imaging and delayed myocardial enhancement imaging have all contributed to a revolution in how patients with ischemic and non-ischemic heart disease are diagnosed and treated. Actually, cardiac MRI is a widely accepted method as the "gold standard" for detection and characterization of many forms of cardiac diseases. The aim of this review is to present an overview of cardiac MRI technology, advances in clinical applications, and future directions.
Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Imagen por Resonancia Cinemagnética/métodos , Velocidad del Flujo Sanguíneo/fisiología , Contraindicaciones , Medios de Contraste , Circulación Coronaria/fisiología , Predicción , Gadolinio DTPA , Humanos , Imagen por Resonancia Cinemagnética/tendencias , Miocardio/patología , Necrosis , Volumen Sistólico/fisiologíaAsunto(s)
Cardiología/organización & administración , Salud Pública/normas , Angioplastia Coronaria con Balón/métodos , Investigación Biomédica/organización & administración , Cardiología/economía , Cardiología/normas , Congresos como Asunto , Francia , Guías como Asunto , Humanos , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/terapia , Guías de Práctica Clínica como Asunto , Sociedades MédicasRESUMEN
Since the introduction of Multi-slice computed tomography (CT), cardiac CT has been the increasingly used as a noninvasive modality for the diagnosis of coronary disease. Despite its potential benefits and promising clinical results, it has suffered from high doses of radiation associated with a risk of radiation-induced cancers. This has raised serious concerns in clinical practice. A number of strategies were then implemented to reduce the radiation dose associated with cardiac CT. The aim of this review is not to compare doses of different CT systems available on the market but to present an overview of different approaches to dose reduction and future directions.