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Incremental Prognostic Value of Cardiac MRI Feature Tracking and T1 Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy. 心律失常性右室心肌病的心脏磁共振成像特征追踪和 T1 映射的增量预后价值
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.230430
Guanyu Lu, Liqi Cao, Weitao Ye, Xiaoyu Wei, Jiajun Xie, Zhicheng Du, Xinyue Zhang, Xinyi Luo, Jiehao Ou, Qianhuan Zhang, Yang Liu, Yuelong Yang, Hui Liu

Purpose To explore the role of cardiac MRI feature tracking (FT) and T1 mapping in predicting sustained ventricular arrhythmias (VA) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and to investigate their possible incremental value beyond ARVC risk score. Materials and Methods The retrospective study analyzed 91 patients with ARVC (median age, 36 years [IQR, 27-50 years]; 60 male, 31 female) who underwent cardiac MRI examinations between November 2010 and March 2022. The primary end point was the first occurrence of sustained VA after cardiac MRI to first VA, with censoring of patients who were alive without VA at last follow-up. Cox regression analysis was performed to assess the association between variables and time to sustained VA. Time-dependent receiver operating characteristic (ROC) analysis was performed to determine the incremental value of cardiac MRI FT and T1 mapping. Results During a median follow-up of 55.0 months (IQR, 37.0-76.0 months), 36 of 91 (40%) patients experienced sustained VA. A 1% worsening in left ventricular global longitudinal peak strain (GLS), 1% worsening in right ventricular GLS, and a 1% increase in extracellular volume fraction (ECV) were associated with increased risk of sustained VA, with hazard ratios of 1.14 (95% CI: 1.06, 1.23; P = .001), 1.09 (95% CI: 1.02, 1.16; P = .02), and 1.13 (95% CI: 1.08, 1.18; P < .001), respectively, after adjustment for ARVC risk score. Adding both biventricular GLS and ECV to ARVC risk score showed significant incremental value for predicting sustained VA (area under the ROC curve: 0.73 vs 0.65; P < .001). Conclusion Cardiac MRI-derived biventricular GLS and ECV provided independent and incremental value for predicting sustained VA beyond ARVC risk score alone in patients with ARVC. Keywords: Cardiovascular MRI, Feature Tracking, T1 Mapping, Arrhythmogenic Right Ventricular Cardiomyopathy, Sustained Ventricular Arrhythmias Supplemental material is available for this article Published under a CC BY 4.0 license.

目的 探讨心脏磁共振成像特征追踪(FT)和 T1 映射在预测致心律失常性右室心肌病(ARVC)患者持续性室性心律失常(VA)中的作用,并研究其在 ARVC 风险评分之外可能的增量价值。材料与方法 该回顾性研究分析了 2010 年 11 月至 2022 年 3 月期间接受心脏磁共振成像检查的 91 例 ARVC 患者(中位年龄 36 岁 [IQR,27-50 岁];男性 60 例,女性 31 例)。主要终点是心脏磁共振成像后首次出现持续VA至首次VA,并对最后一次随访时未出现VA的存活患者进行普查。采用 Cox 回归分析评估变量与持续 VA 时间之间的关系。进行了时间依赖性接收器操作特征(ROC)分析,以确定心脏 MRI FT 和 T1 图谱的增量价值。结果 在中位随访 55.0 个月(IQR,37.0-76.0 个月)期间,91 例患者中有 36 例(40%)出现持续 VA。左心室整体纵向峰值应变(GLS)恶化 1%、右心室 GLS 恶化 1%、细胞外容积分数(ECV)增加 1%,均与持续 VA 风险增加有关,危险比为 1.调整 ARVC 风险评分后,危险比分别为 1.14 (95% CI: 1.06, 1.23; P = .001)、1.09 (95% CI: 1.02, 1.16; P = .02) 和 1.13 (95% CI: 1.08, 1.18; P < .001)。在 ARVC 风险评分的基础上增加双心室 GLS 和 ECV 可显著提高持续 VA 的预测价值(ROC 曲线下面积:0.73 vs 0.65;P < .001)。结论 在预测 ARVC 患者的持续 VA 方面,心脏 MRI 导出的双心室 GLS 和 ECV 可提供独立的增量价值,而不仅仅是 ARVC 风险评分。关键词心血管 MRI 特征追踪 T1 Mapping 致心律失常性右室心肌病 持续性室性心律失常 本文有补充材料,采用 CC BY 4.0 许可发布。
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引用次数: 0
Atypical Presentation of Tertiary Syphilis. 三期梅毒的非典型表现
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.230373
Paul Cholley, Julien Stievenart, Damien Fayard, Lucie Cassagnes

Syphilis is a sexually transmitted infection characterized by multiple stages. Cardiovascular involvement is a manifestation of tertiary syphilis, occurring between 10 and 40 years after the primary infection. The authors present a case of atypical presentation of tertiary syphilis in a 49-year-old male patient who was admitted to the hospital with bilateral transient loss of vision. Contrast-enhanced CT imaging revealed thoracic aortitis with carotid occlusion, coronary artery stenosis, ischemic stroke, myocardial infarction, and multiple intracardiac thrombi. A postmortem autopsy revealed positive laboratory results for syphilis, which was corroborated by medical autopsy findings of syphilitic aortitis. Keywords: CT-Angiography, Aorta, Cardiac, Vascular, Tertiary Syphilis © RSNA, 2024.

梅毒是一种性传播感染,分为多个阶段。心血管受累是三期梅毒的一种表现,发生在原发感染后的 10 至 40 年间。作者介绍了一例表现不典型的三期梅毒病例,患者为 49 岁男性,因双侧一过性失明入院。对比增强 CT 成像显示胸主动脉炎伴颈动脉闭塞、冠状动脉狭窄、缺血性中风、心肌梗死和多发性心内血栓。尸体解剖显示梅毒化验结果呈阳性,梅毒性大动脉炎的医学验尸结果也证实了这一点。关键词CT-血管造影 主动脉 心脏 血管 三级梅毒 © RSNA, 2024.
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引用次数: 0
Severe Quadricuspid Pulmonary Valve Stenosis Presenting as Scrotal Edema. 严重四尖瓣肺动脉瓣狭窄表现为阴囊水肿
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.240239
Dan Liu, Zhao Li, Hongwei Zhang, Zihao Li
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引用次数: 0
Collateral Circulation in Coarctation. 共动脉侧支循环
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.240250
Niraj Nirmal Pandey, Sreelal Thazhathu Veettil, Sanjeev Kumar
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引用次数: 0
Clinically Relevant Extracardiac Findings at Cardiac Imaging: Insights from the European MR/CT Registry. 心脏成像中与临床相关的心外发现:来自欧洲 MR/CT 登记处的启示。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.240117
Lukas J Moser, Matthias Gutberlet, Rozemarijn Vliegenthart, Marco Francone, Ricardo P J Budde, Rodrigo Salgado, Maja Hrabak Paar, Maja Pirnat, Christian Loewe, Konstantin Nikolaou, Michelle C Williams, Giuseppe Muscogiuri, Luigi Natale, Robin F Gohmann, Christian Lücke, Matthias Eberhard, Hatem Alkadhi

Purpose To determine the prevalence of clinically relevant extracardiac findings at cardiac CT and MRI examinations from a multicenter, multinational MR/CT registry and the relationship of prevalence with examination indications and patient characteristics. Materials and Methods This was a retrospective analysis of data from the European Society of Cardiovascular Radiology MR/CT Registry. Data from 208 506 cardiac CT examinations (median patient age, 66 years [IQR, 55-77]; 121 617 [58.33%] male patients) and 228 462 cardiac MRI examinations (median patient age, 57 years [IQR, 42-69]; 145 792 [63.81%] male patients) entered into the registry between January 2011 and November 2023 were analyzed. Clinically relevant extracardiac findings were defined as findings requiring follow-up examinations or influencing clinical management. The association of examination indication and patient characteristics, including age, with prevalence of extracardiac findings was evaluated using incidence rate ratios (IRRs) derived from multivariable Poisson regression models. Results The prevalence of clinically relevant extracardiac findings was 3.28% (6832 of 208 506) at cardiac CT and 1.50% (3421 of 228 462) at cardiac MRI examinations. Extracardiac findings were more common at CT examinations performed for transcatheter aortic valve replacement (IRR, 2.07; P < .001) and structural heart disease (IRR, 1.44; P < .001) compared with CT performed for coronary artery disease (IRR, 1; reference). Extracardiac findings were more common at MRI examinations performed for myocarditis (IRR, 1.36; P < .001) and structural heart disease (IRR, 1.16; P < .001) than for coronary artery disease. Older patient age was also significantly associated with higher prevalence of extracardiac findings, with an IRR for both CT and MRI examinations of 1.02 (P < .001). Conclusion Data from the multicenter, multinational MR/CT registry indicate that clinically relevant extracardiac findings are present at cardiovascular CT and MRI examinations, and the prevalence of these findings is associated with examination indication and patient age. Keywords: Cardiac Imaging Techniques, Incidental Findings, MRI, CT Angiography, CT, Heart Disease Supplemental material is available for this article. © RSNA, 2024.

目的 通过一项多中心、跨国 MR/CT 注册研究确定心脏 CT 和 MRI 检查中临床相关心外检查结果的发生率,以及发生率与检查适应症和患者特征之间的关系。材料和方法 这是对欧洲心血管放射学会 MR/CT 登记数据的回顾性分析。分析了 2011 年 1 月至 2023 年 11 月期间登记的 208 506 例心脏 CT 检查(患者年龄中位数为 66 岁 [IQR,55-77];121 617 例 [58.33%] 男性患者)和 228 462 例心脏 MRI 检查(患者年龄中位数为 57 岁 [IQR,42-69];145 792 例 [63.81%] 男性患者)的数据。与临床相关的心外检查结果被定义为需要进行随访检查或影响临床治疗的结果。使用多变量泊松回归模型得出的发病率比(IRRs)评估了检查指征和患者特征(包括年龄)与心外检查结果发生率的关系。结果 在心脏 CT 和心脏 MRI 检查中,临床相关心外检查结果的发生率分别为 3.28%(208 506 例中的 6832 例)和 1.50%(228 462 例中的 3421 例)。经导管主动脉瓣置换术(IRR,2.07;P <.001)和结构性心脏病(IRR,1.44;P <.001)与冠状动脉疾病(IRR,1;参考)的 CT 检查相比,心外检查结果更常见。与冠状动脉疾病相比,心肌炎(IRR,1.36;P<.001)和结构性心脏病(IRR,1.16;P<.001)的核磁共振检查更常见心外检查结果。患者年龄越大,心外检查结果的发生率也越高,CT 和 MRI 检查的 IRR 均为 1.02(P < .001)。结论 来自多中心、跨国 MR/CT 登记处的数据表明,心血管 CT 和 MRI 检查中存在临床相关的心外检查结果,这些结果的发生率与检查适应症和患者年龄有关。关键词心脏成像技术、意外发现、核磁共振成像、CT 血管造影、CT、心脏病 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Low-Dose Whole-Chest Dynamic CT for the Assessment of Large Airway Collapsibility in Patients with Suspected Tracheobronchial Instability. 低剂量全胸动态 CT 用于评估疑似气管支气管不稳患者的大气管塌陷度。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.240041
Arved Bischoff, Oliver Weinheimer, Anja Dutschke, Roman Rubtsov, Hans-Ulrich Kauczor, Daniela Gompelmann, Ralf Eberhardt, Franziska Trudzinski, Claus P Heussel, Felix J F Herth, Mattias Heinrich, Fenja Falta, Mark O Wielpütz

Purpose To quantify tracheal collapsibility using low-dose four-dimensional (4D) CT and to compare visual and quantitative 4D CT-based assessments with assessments from paired inspiratory-expiratory CT, bronchoscopy, and spirometry. Materials and Methods The authors retrospectively analyzed 4D CT examinations (January 2016-December 2022) during shallow respiration in 52 patients (mean age, 66 years ± 12 [SD]; 27 female, 25 male), including 32 patients with chronic obstructive pulmonary disease (mean forced expiratory volume in 1 second percentage predicted [FEV1%], 50% ± 27), with suspected tracheal collapse. Paired CT data were available for 27 patients and bronchoscopy data for 46 patients. Images were reviewed by two radiologists in consensus, classifying patients into three groups: 50% or greater tracheal collapsibility, less than 50% collapsibility, or fixed stenosis. Changes in minimal tracheal lumen area, tracheal volume, and lung volume from inspiration to expiration were quantified using YACTA software. Tracheal collapsibility between groups was compared employing one-way analysis of variance (ANOVA). For related samples within one group, ANOVA with repeated measures was used. Spearman rank order correlation coefficient was calculated for collapsibility versus pulmonary function tests. Results At 4D CT, 25 of 52 (48%) patients had tracheal collapsibility of 50% or greater, 20 of 52 (38%) less than 50%, and seven of 52 (13%) had fixed stenosis. Visual assessment of 4D CT detected more patients with collapsibility of 50% or greater than paired CT, and concordance was 41% (P < .001). 4D CT helped identify more patients with tracheal collapsibility of 50% or greater than did bronchoscopy, and concordance was 74% (P = .39). Mean collapsibility of tracheal lumen area and volume at 4D CT were higher for 50% or greater visually assessed collapsibility (area: 53% ± 9 and lumen: 52% ± 10) compared with the less than 50% group (27% ± 9 and 26% ± 6, respectively) (P < .001), whereas both tracheal area and volume were stable for the fixed stenosis group (area: 16% ± 12 and lumen: 21% ± 11). Collapsibility of tracheal lumen area and volume did not correlate with FEV1% (rs = -0.002 to 0.01, P = .99-.96). Conclusion The study demonstrated that 4D CT is feasible and potentially more sensitive than paired CT for central airway collapse. Expectedly, FEV1% was not correlated with severity of tracheal collapsibility. Keywords: CT-Quantitative, Tracheobronchial Tree, Chronic Obstructive Pulmonary Disease, Imaging Postprocessing, Thorax Supplemental material is available for this article. © RSNA, 2024.

目的 使用低剂量四维 (4D) CT 量化气管塌陷度,并将基于四维 CT 的视觉和定量评估与成对吸气-呼气 CT、支气管镜检查和肺活量测定的评估进行比较。材料与方法 作者回顾性分析了 52 名患者(平均年龄为 66 岁 ± 12 [SD];27 名女性,25 名男性)浅呼吸时的四维 CT 检查结果(2016 年 1 月至 2022 年 12 月),其中包括 32 名慢性阻塞性肺病患者(平均每秒用力呼气容积预测值百分比 [FEV1%],50%±27),疑似气管塌陷。27 名患者获得了配对 CT 数据,46 名患者获得了支气管镜数据。两名放射科医生在达成共识后对图像进行了审查,并将患者分为三组:气管塌陷度大于或等于 50%、塌陷度小于 50%、固定狭窄。使用 YACTA 软件对最小气管腔面积、气管容积和肺容积从吸气到呼气的变化进行量化。采用单因素方差分析(ANOVA)比较组间气管塌陷度。对于同一组内的相关样本,则采用重复测量方差分析。计算塌缩度与肺功能测试的斯皮尔曼秩相关系数。结果 在四维 CT 上,52 名患者中有 25 人(48%)的气管塌陷度大于或等于 50%,52 人中有 20 人(38%)的气管塌陷度小于 50%,52 人中有 7 人(13%)的气管有固定狭窄。与配对 CT 相比,4D CT 的目视评估发现了更多气管塌陷度为 50% 或以上的患者,一致性为 41% (P < .001)。与支气管镜检查相比,四维 CT 能帮助发现更多气管塌陷度为 50% 或以上的患者,一致性为 74% (P = .39)。与低于 50% 组(分别为 27% ± 9 和 26% ± 6)相比,目测塌缩度为 50% 或以上组(面积:53% ± 9,管腔:52% ± 10)的四维 CT 平均塌缩度气管管腔面积和容积更高(P < .001),而固定狭窄组的气管面积和容积均保持稳定(面积:16% ± 12,管腔:21% ± 11)。气管腔面积和容积的塌陷度与 FEV1% 无关(rs = -0.002 至 0.01,P = .99-.96)。结论 该研究表明,四维 CT 是可行的,而且可能比成对 CT 对中心气道塌陷更敏感。预计 FEV1% 与气管塌陷的严重程度无关。关键词CT定量、气管支气管树、慢性阻塞性肺病、成像后处理、胸廓 本文有补充材料。© RSNA, 2024.
{"title":"Low-Dose Whole-Chest Dynamic CT for the Assessment of Large Airway Collapsibility in Patients with Suspected Tracheobronchial Instability.","authors":"Arved Bischoff, Oliver Weinheimer, Anja Dutschke, Roman Rubtsov, Hans-Ulrich Kauczor, Daniela Gompelmann, Ralf Eberhardt, Franziska Trudzinski, Claus P Heussel, Felix J F Herth, Mattias Heinrich, Fenja Falta, Mark O Wielpütz","doi":"10.1148/ryct.240041","DOIUrl":"https://doi.org/10.1148/ryct.240041","url":null,"abstract":"<p><p>Purpose To quantify tracheal collapsibility using low-dose four-dimensional (4D) CT and to compare visual and quantitative 4D CT-based assessments with assessments from paired inspiratory-expiratory CT, bronchoscopy, and spirometry. Materials and Methods The authors retrospectively analyzed 4D CT examinations (January 2016-December 2022) during shallow respiration in 52 patients (mean age, 66 years ± 12 [SD]; 27 female, 25 male), including 32 patients with chronic obstructive pulmonary disease (mean forced expiratory volume in 1 second percentage predicted [FEV<sub>1</sub>%], 50% ± 27), with suspected tracheal collapse. Paired CT data were available for 27 patients and bronchoscopy data for 46 patients. Images were reviewed by two radiologists in consensus, classifying patients into three groups: 50% or greater tracheal collapsibility, less than 50% collapsibility, or fixed stenosis. Changes in minimal tracheal lumen area, tracheal volume, and lung volume from inspiration to expiration were quantified using YACTA software. Tracheal collapsibility between groups was compared employing one-way analysis of variance (ANOVA). For related samples within one group, ANOVA with repeated measures was used. Spearman rank order correlation coefficient was calculated for collapsibility versus pulmonary function tests. Results At 4D CT, 25 of 52 (48%) patients had tracheal collapsibility of 50% or greater, 20 of 52 (38%) less than 50%, and seven of 52 (13%) had fixed stenosis. Visual assessment of 4D CT detected more patients with collapsibility of 50% or greater than paired CT, and concordance was 41% (<i>P</i> < .001). 4D CT helped identify more patients with tracheal collapsibility of 50% or greater than did bronchoscopy, and concordance was 74% (<i>P</i> = .39). Mean collapsibility of tracheal lumen area and volume at 4D CT were higher for 50% or greater visually assessed collapsibility (area: 53% ± 9 and lumen: 52% ± 10) compared with the less than 50% group (27% ± 9 and 26% ± 6, respectively) (<i>P</i> < .001), whereas both tracheal area and volume were stable for the fixed stenosis group (area: 16% ± 12 and lumen: 21% ± 11). Collapsibility of tracheal lumen area and volume did not correlate with FEV<sub>1</sub>% (<i>r</i><sub>s</sub> = -0.002 to 0.01, <i>P</i> = .99-.96). Conclusion The study demonstrated that 4D CT is feasible and potentially more sensitive than paired CT for central airway collapse. Expectedly, FEV<sub>1</sub>% was not correlated with severity of tracheal collapsibility. <b>Keywords:</b> CT-Quantitative, Tracheobronchial Tree, Chronic Obstructive Pulmonary Disease, Imaging Postprocessing, Thorax <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impactful Cardiac CT and MRI Articles from 2023. 2023 年具有影响力的心脏 CT 和 MRI 文章。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.240142
Fionn Coughlan, Sebastian Flynn, Alexander Haenel, Shane Crilly, Jonathon A Leipsic, Jonathan D Dodd

Cardiac imaging is important in diagnosing, treating, and predicting prognosis in patients with cardiovascular disease. Imaging protocols and analysis are consistently evolving, and the implementation of artificial intelligence-based applications is of increasing interest. This review presents recent advancements in noninvasive cardiac imaging, specifically focusing on cardiac CT and MRI, from notable publications across multidisciplinary journals in 2023 of interest to both radiologists and referring clinicians in the field. The discussion encompasses the latest trials of CT fractional flow reserve and the performance of the newest generation of photon-counting detector CT, particularly in coronary stenosis quantification. Additionally, it addresses coronary plaque quantification using artificial intelligence applications and their implications from large patient cohorts, alongside prognostic outcomes, and the value of coronary artery calcification scores. Various aspects of CT trials, such as anatomic planning before revascularization, high-risk plaque features, outcomes, and pericoronary fat index, are evaluated. New insights from cardiac MRI trials for cardiomyopathies, including cardiac amyloidosis, dilated cardiomyopathy, hypertrophic cardiomyopathy, myocarditis, and valvular disease, are also outlined. The review concludes by highlighting impactful societal statements and guidelines. Keywords: CT Angiography, MR Imaging, Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR), Cardiac, Coronary Arteries, Heart, Left Ventricle © RSNA, 2024.

心脏成像对于心血管疾病患者的诊断、治疗和预后预测非常重要。成像方案和分析在不断发展,基于人工智能的应用也越来越受到关注。这篇综述介绍了无创心脏成像的最新进展,尤其侧重于心脏 CT 和 MRI,内容来自 2023 年在多学科期刊上发表的著名论文,放射科医生和该领域的临床医生均对此感兴趣。讨论包括 CT 分数血流储备的最新试验和最新一代光子计数探测器 CT 的性能,尤其是在冠状动脉狭窄量化方面。此外,它还讨论了使用人工智能应用进行冠状动脉斑块量化的情况及其对大型患者群的影响、预后结果以及冠状动脉钙化评分的价值。还评估了 CT 试验的各个方面,如血管再通前的解剖规划、高危斑块特征、预后和冠状动脉周围脂肪指数。此外,还概述了针对心肌病(包括心脏淀粉样变性、扩张型心肌病、肥厚型心肌病、心肌炎和瓣膜病)的心脏磁共振成像试验的新见解。综述最后强调了具有影响力的社会声明和指南。关键词CT 血管造影 MR 成像 经导管主动脉瓣植入/置换术(TAVI/TAVR) 心脏 冠状动脉 心脏 左心室 © RSNA, 2024.
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引用次数: 0
Geometric Changes in Mitral Valve Apparatus during Long-term Cardiac Resynchronization Therapy as Assessed with Cardiac CT. 用心脏 CT 评估长期心脏再同步化疗法期间二尖瓣器械的几何变化
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1148/ryct.230320
Daniel B Fyenbo, Bjarne L Nørgaard, Philipp Blanke, Anders Sommer, Jade Duchscherer, Kelsey Kalk, Mads B Kronborg, Jesper M Jensen, Elliot R McVeigh, Victoria Delgado, Jonathon Leipsic, Jens C Nielsen

Purpose To assess long-term geometric changes of the mitral valve apparatus using cardiac CT in individuals who underwent cardiac resynchronization therapy (CRT). Materials and Methods Participants from a randomized controlled trial with cardiac CT examinations before CRT implantation and at 6 months follow-up (Clinicaltrials.gov identifier NCT01323686) were invited to undergo an additional long-term follow-up cardiac CT examination. The geometry of the mitral valve apparatus, including mitral valve annulus area, A2 leaflet angle, tenting height, and interpapillary muscle distances, were assessed. Geometric changes at the long-term follow-up examination were reported as mean differences (95% CI), and the Pearson correlation test was used to assess correlation between statistically significant geometric changes and left ventricular (LV) volumes and function. Results Thirty participants (mean age, 68 years ± 9 [SD]; 25 male participants) underwent cardiac CT imaging after a median long-term follow-up of 9.0 years (IQR, 8.4-9.4). There were reductions in end-systolic A2 leaflet angle (-4° [95% CI: -7, -2]), end-systolic tenting height (-1 mm [95% CI: -2, -1]), and end-systolic and end-diastolic interpapillary muscle distances (-4 mm [95% CI: -6, -2]) compared with pre-CRT implantation values. The mitral valve annulus area remained unchanged. LV end-diastolic and end-systolic volumes decreased (-68 mL [95% CI: -99, -37] and -67 mL [95% CI: -96, -39], respectively), and LV ejection fraction increased (13% [95% CI: 7, 19]) at the long-term follow-up examination. Changes in interpapillary muscle distances showed moderate to strong correlations with LV volumes (r = 0.42-0.72; P < .05), while A2 leaflet angle and tenting height were not correlated to LV volumes or function. Conclusion Among the various geometric changes in the mitral valve apparatus after long-term CRT, the reduction in interpapillary muscle distances correlated with LV volumes while the reduced A2 leaflet angle and tenting height did not correlate with LV volumes. Keywords: Mitral Valve Apparatus, Cardiac Resynchronization Therapy, Cardiac CT Supplemental material is available for this article. © RSNA, 2024.

目的 使用心脏 CT 评估接受心脏再同步化疗法(CRT)的患者二尖瓣器械的长期几何变化。材料和方法 邀请在 CRT 植入前和随访 6 个月时接受心脏 CT 检查的随机对照试验(Clinicaltrials.gov identifier NCT01323686)参与者接受额外的长期随访心脏 CT 检查。对二尖瓣器械的几何形状进行了评估,包括二尖瓣瓣环面积、A2瓣叶角度、瓣翼高度和瓣间肌距离。长期随访检查的几何变化以平均差(95% CI)的形式报告,并使用皮尔逊相关性检验来评估具有统计学意义的几何变化与左心室(LV)容积和功能之间的相关性。结果 30 名参与者(平均年龄为 68 岁 ± 9 [SD];25 名男性参与者)在中位数为 9.0 年(IQR,8.4-9.4)的长期随访后接受了心脏 CT 成像检查。与CRT植入前的值相比,收缩末期A2瓣叶角度(-4° [95% CI:-7,-2])、收缩末期瓣叶高度(-1 mm [95% CI:-2,-1])以及收缩末期和舒张末期乳头肌间距离(-4 mm [95% CI:-6,-2])均有所下降。二尖瓣瓣环面积保持不变。在长期随访检查中,左心室舒张末期容积和收缩末期容积分别下降(-68 mL [95% CI: -99, -37]和-67 mL [95% CI: -96, -39]),左心室射血分数增加(13% [95% CI: 7, 19])。乳头肌间距离的变化与左心室容积呈中度至高度相关(r = 0.42-0.72; P < .05),而 A2 小叶角度和帐篷高度与左心室容积或功能无关。结论 在长期CRT后二尖瓣器械的各种几何变化中,瓣间肌距离的减少与左心室容积相关,而A2瓣叶角度和瓣翼高度的减少与左心室容积无关。关键词二尖瓣装置 心脏再同步化治疗 心脏CT 本文有补充材料。© RSNA, 2024.
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引用次数: 0
To-and-Fro Flow Equivalent at Dynamic CT Angiography of the Aorta. 主动脉动态 CT 血管造影的前后血流等值。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240062
André Vaz, Kevin Rafael De Paula Morales, Eduardo Kaiser Ururahy Nunes Fonseca
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引用次数: 0
Evaluating the Association between Anomalous Aortic Origin of the Right Coronary Artery from the Left Sinus with Interarterial Course at Coronary CT Angiography and Sudden Cardiac Death. 评估冠状动脉 CT 血管造影术中左侧窦房右冠动脉异常主动脉起源与动脉间走向与心脏性猝死之间的关联。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230407
Bo Mi Gil, Suyon Chang, Kyongmin Sarah Beck, Whal Lee, Hye-Jeong Lee, Ki Seok Choo, Myung Hee Chung, Tae Hoon Kim, Jung Im Jung

Purpose To investigate the association between the anomalous aortic origin of the right coronary artery (R-AAOCA) from the left coronary sinus with interarterial course (IAC) found at coronary CT angiography and sudden cardiac death using a large data set from five university hospitals. Materials and Methods From a total of 89 314 CCTA scans (January 2009 to December 2016) that were retrospectively collected, 316 patients with R-AAOCA from the left sinus with IAC were retrospectively collected. After excluding patients with less than 2 years of follow-up, patients who had already undergone cardiovascular surgery or intervention, and patients with arrhythmia or heart failure before undergoing coronary CT angiography, 224 patients were analyzed. Follow-up was terminated upon the occurrence of major adverse cardiovascular events (MACE). Logistic regression was used to identify clinical and radiologic information as independent predictors of MACE. Results The period prevalence of R-AAOCA from the left sinus with IAC was 0.354%. The mean age was 62.03 years, with a male-to-female ratio of 182:134. During follow-up, 19 of 224 patients (8.5%) experienced MACE, but none had sudden cardiac death. Of these cases, only seven (3.13%) were suspected of being due to R-AAOCA from the left sinus with IAC and all of them had unstable angina. Coronary artery disease was significantly associated with MACE (P < .001), while no significant correlation was observed with radiologic features. Conclusion Sudden cardiac death was not associated with R-AAOCA from the left sinus with IAC found at coronary CT angiography. The occurrence of MACE was low, with coronary artery disease being the sole significant predictor of a patient's prognosis. Keywords: Anomalous Aortic Origin of the Right Coronary Artery, Left Coronary Sinus with Interarterial Course, Coronary CT Angiography, Sudden Cardiac Death Supplemental material is available for this article. © RSNA, 2024.

目的 利用来自五所大学医院的大数据集,研究冠状动脉 CT 血管造影发现的右冠状动脉主动脉起源异常(R-AAOCA)来自左冠状动脉窦并伴有动脉间路径(IAC)与心脏性猝死之间的关联。材料与方法 从回顾性收集的总共 89 314 次 CCTA 扫描(2009 年 1 月至 2016 年 12 月)中,回顾性收集了 316 例左冠状窦 R-AAOCA 伴 IAC 患者。在排除随访时间不足 2 年的患者、已接受心血管手术或介入治疗的患者以及接受冠状动脉 CT 血管造影术前患有心律失常或心力衰竭的患者后,共对 224 名患者进行了分析。一旦发生重大不良心血管事件(MACE),随访即终止。采用逻辑回归法确定临床和放射学信息作为 MACE 的独立预测因素。结果 左窦R-AAOCA合并IAC的时期发病率为0.354%。平均年龄为 62.03 岁,男女比例为 182:134。在随访期间,224 名患者中有 19 人(8.5%)发生了 MACE,但没有人发生心脏性猝死。在这些病例中,只有7例(3.13%)被怀疑是由于左窦R-AAOCA并发IAC所致,而且所有病例都有不稳定型心绞痛。冠状动脉疾病与 MACE 显著相关(P < .001),而与放射学特征无显著相关性。结论 心源性猝死与冠状动脉 CT 血管造影发现的左静脉窦 R-AAOCA 并无关联。MACE 发生率较低,冠状动脉疾病是预测患者预后的唯一重要因素。关键词右冠状动脉异常主动脉起源、左冠状动脉窦动脉间路径、冠状动脉 CT 血管造影、心脏性猝死 本文有补充材料。© RSNA, 2024.
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Radiology. Cardiothoracic imaging
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