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Coronary Artery Disease Assessment via On-Site CT Fractional Flow Reserve in Patients Undergoing Transcatheter Aortic Valve Replacement. 通过现场 CT 分数血流储备评估接受经导管主动脉瓣置换术患者的冠状动脉疾病。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.230096
Alexandra Steyer, Valentina O Puntmann, Eike Nagel, David M Leistner, Vitali Koch, Mariuca Vasa-Nicotera, Parveen Kumar, Christian Booz, Thomas J Vogl, Silvia Mas-Peiro, Simon S Martin

Purpose To examine the clinical feasibility of workstation-based CT fractional flow reserve (CT-FFR) for coronary artery disease (CAD) evaluation during preprocedural planning in patients undergoing transcatheter aortic valve replacement (TAVR). Materials and Methods In this retrospective single-center study, 434 patients scheduled for TAVR between 2018 and 2020 were screened for study inclusion; a relevant proportion of patients (35.0% [152 of 434]) was not suitable for evaluation due to insufficient imaging properties. A total of 112 patients (mean age, 82.1 years ± 6.7 [SD]; 58 [52%] men) were included in the study. Invasive angiography findings, coronary CT angiography results, and Agatston score were acquired and compared with on-site CT-FFR computation for evaluation of CAD and prediction of major adverse cardiovascular events (MACE) within a 24-month follow-up. Results Hemodynamic relevant CAD, as suggested by CT-FFR of 0.80 or less, was found in 41 of 70 (59%) patients with stenosis of 50% or more. MACE occurred in 23 of 112 (20.5%) patients, from which 14 of 23 had stenoses with CT-FFR of 0.80 or less (hazard ratio [HR], 3.33; 95% CI: 1.56, 7.10; P = .002). CT-FFR remained a significant predictor of MACE after inclusion in a multivariable model with relevant covariables (HR, 2.89; 95% CI: 1.22, 6.86; P = .02). An Agatston score of 1000 Agatston units or more (HR, 2.25; 95% CI: 0.98, 5.21; P = .06) and stenoses of 50% or more determined via invasive angiography (HR, 0.94; 95% CI: 0.41, 2.17; P = .88) were not significant predictors of MACE. Conclusion Compared with conventional CAD markers, CT-FFR better predicted adverse outcomes after TAVR. A relevant portion of the screened cohort, however, was not suitable for CT-based CAD evaluation. Keywords: CT, Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR), Cardiac, Coronary Arteries, Outcomes Analysis © RSNA, 2024 See also the commentary by Weir-McCall and Pugliese in this issue.

目的 探讨在接受经导管主动脉瓣置换术(TAVR)的患者进行术前规划时,基于工作站的 CT 分数血流储备(CT-FFR)用于冠状动脉疾病(CAD)评估的临床可行性。材料与方法 在这项回顾性单中心研究中,筛选了 2018 年至 2020 年期间计划接受 TAVR 的 434 例患者作为研究对象;由于成像特性不足,有一定比例的患者(35.0% [434 例中的 152 例])不适合接受评估。共有 112 名患者(平均年龄 82.1 岁 ± 6.7 [SD];男性 58 [52%])被纳入研究。研究人员获取了有创血管造影结果、冠状动脉 CT 血管造影结果和 Agatston 评分,并将其与现场 CT-FFR 计算结果进行比较,以评估 CAD 和预测 24 个月随访期间的主要不良心血管事件 (MACE)。结果 在 70 名血管狭窄程度达到或超过 50%的患者中,有 41 人(59%)发现了血流动力学相关的 CAD(CT-FFR 为 0.80 或更低)。112名患者中有23名(20.5%)发生了MACE,其中14名患者的血管狭窄程度为CT-FFR 0.80或以下(危险比[HR],3.33;95% CI:1.56,7.10;P = .002)。在纳入包含相关协变量的多变量模型后,CT-FFR仍是MACE的重要预测因素(HR,2.89;95% CI:1.22,6.86;P = .02)。Agatston评分达到或超过1000 Agatston单位(HR,2.25;95% CI:0.98,5.21;P = .06)以及通过有创血管造影确定的血管狭窄达到或超过50%(HR,0.94;95% CI:0.41,2.17;P = .88)并不能显著预测MACE。结论 与传统的 CAD 标志物相比,CT-FFR 更能预测 TAVR 后的不良预后。然而,在接受筛查的人群中,有相当一部分人不适合进行基于 CT 的 CAD 评估。关键词CT、经导管主动脉瓣植入/置换术(TAVI/TAVR)、心脏、冠状动脉、结果分析 © RSNA, 2024 另请参阅本期 Weir-McCall 和 Pugliese 的评论。
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引用次数: 0
Associations between 3D-based Left Atrial Volumetric and Blood Flow Parameters in a Single-Site Cohort of the Multi-Ethnic Study of Atherosclerosis. 多种族动脉粥样硬化研究单点队列中基于三维的左心房容积参数和血流参数之间的关联。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.230148
Maurice Pradella, Justin J Baraboo, Anthony Maroun, Sophia Z Liu, Amanda L DiCarlo, Stanley H Chu, Julia M Hwang, Mitchell A Collins, Rod Passman, Susan R Heckbert, Philip Greenland, Michael Markl

Purpose To investigate associations between left atrial volume (LAV) and function with impaired three-dimensional hemodynamics from four-dimensional flow MRI. Materials and Methods A subcohort of participants from the Multi-Ethnic Study of Atherosclerosis from Northwestern University underwent prospective 1.5-T cardiac MRI including whole-heart four-dimensional flow and short-axis cine imaging between 2019 and 2020. Four-dimensional flow MRI analysis included manual three-dimensional segmentations of the LA and LA appendage (LAA), which were used to quantify LA and LAA peak velocity and blood stasis (% voxels < 0.1 m/sec). Short-axis cine data were used to delineate LA contours on all cardiac time points, and the resulting three-dimensional-based LAVs were extracted for calculation of LA emptying fractions (LAEFtotal, LAEFactive, LAEFpassive). Stepwise multivariable linear models were calculated for each flow parameter (LA stasis, LA peak velocity, LAA stasis, LAA peak velocity) to determine associations with LAV and LAEF. Results This study included 158 participants (mean age, 73 years ± 7 [SD]; 83 [52.5%] female and 75 [47.4%] male participants). In multivariable models, a 1-unit increase of LAEFtotal was associated with decreased LA stasis (β coefficient, -0.47%; P < .001), while increased LAEFactive was associated with increased LA peak velocity (β coefficient, 0.21 cm/sec; P < .001). Furthermore, increased minimum LAV indexed was most associated with impaired LAA flow (higher LAA stasis [β coefficient, 0.65%; P < .001] and lower LAA peak velocity [β coefficient, -0.35 cm/sec; P < .001]). Conclusion Higher minimum LAV and reduced LA function were associated with impaired flow characteristics in the LA and LAA. LAV assessment might therefore be a surrogate measure for LA and LAA flow abnormalities. Keywords: Atherosclerosis, Left Atrial Volume, Left Atrial Blood Flow, 4D Flow MRI Supplemental material is available for this article. © RSNA, 2024.

目的 研究左心房容积(LAV)和功能与四维血流 MRI 中受损的三维血流动力学之间的关联。材料与方法 美国西北大学多种族动脉粥样硬化研究(Multi-Ethnic Study of Atherosclerosis)亚群参与者在 2019 年至 2020 年期间接受了前瞻性 1.5 T 心脏 MRI 检查,包括全心四维血流和短轴电影成像。四维血流 MRI 分析包括 LA 和 LA 附肢 (LAA) 的手动三维分割,用于量化 LA 和 LAA 峰值速度和血液淤滞(< 0.1 米/秒的体素百分比)。短轴电影数据用于勾勒所有心脏时间点的 LA 轮廓,并提取由此产生的基于三维的 LAV,用于计算 LA 排空分数(LAEFtotal、LAEFactive、LAEFpassive)。针对每个血流参数(LA淤积、LA峰值速度、LAA淤积、LAA峰值速度)计算逐步多变量线性模型,以确定与LAV和LAEF的关系。结果 本研究共纳入 158 名参与者(平均年龄为 73 岁 ± 7 [SD];女性 83 [52.5%],男性 75 [47.4%])。在多变量模型中,LAEFtotal 增加 1 个单位与 LA 淤血减少有关(β 系数,-0.47%;P < .001),而 LAEFactive 增加与 LA 峰值速度增加有关(β 系数,0.21 厘米/秒;P < .001)。此外,最小 LAV 指数增加与 LAA 血流受损关系最大(更高的 LAA 淤积率 [β系数,0.65%;P < .001] 和更低的 LAA 峰值速度 [β系数,-0.35 厘米/秒;P < .001])。结论 LAV最小值升高和LA功能减退与LA和LAA血流特征受损有关。因此,LAV评估可能是衡量LA和LAA血流异常的替代指标。关键词动脉粥样硬化 左心房容积 左心房血流 四维血流 MRI 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Multi-Energy Low-Kiloelectron Volt versus Single-Energy Low-Kilovolt Images for Endoleak Detection at CT Angiography of the Aorta. 在主动脉 CT 血管造影中,多能量低千伏与单能量低千伏图像在内膜渗漏检测中的对比。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.230217
Anna Landsmann, Thomas Sartoretti, Victor Mergen, Lisa Jungblut, Matthias Eberhard, Adrian Kobe, Hatem Alkadhi, André Euler

Purpose To compare image quality, diagnostic performance, and conspicuity between single-energy and multi-energy images for endoleak detection at CT angiography (CTA) after endovascular aortic repair (EVAR). Materials and Methods In this single-center prospective randomized controlled trial, individuals undergoing CTA after EVAR between August 2020 and May 2022 were allocated to imaging using either low-kilovolt single-energy images (SEI; 80 kV, group A) or low-kiloelectron volt virtual monoenergetic images (VMI) at 40 and 50 keV from multi-energy CT (80/Sn150 kV, group B). Scan protocols were dose matched (volume CT dose index: mean, 4.5 mGy ± 1.8 [SD] vs 4.7 mGy ± 1.3, P = .41). Contrast-to-noise ratio (CNR) was measured. Two expert radiologists established the reference standard for the presence of endoleaks. Detection and conspicuity of endoleaks and subjective image quality were assessed by two different blinded radiologists. Interreader agreement was calculated. Nonparametric statistical tests were used. Results A total of 125 participants (mean age, 76 years ± 8; 103 men) were allocated to groups A (n = 64) and B (n = 61). CNR was significantly lower for 40-keV VMI (mean, 19.1; P = .048) and 50-keV VMI (mean, 16.8; P < .001) as compared with SEI (mean, 22.2). In total, 45 endoleaks were present (A: 23 vs B: 22). Sensitivity for endoleak detection was higher for SEI (82.6%, 19 of 23; P = .88) and 50-keV VMI (81.8%, 18 of 22; P = .90) as compared with 40-keV VMI (77.3%, 17 of 22). Specificity was comparable among groups (SEI: 92.7%, 38 of 41; both VMI energies: 92.3%, 35 of 38; P = .99), with an interreader agreement of 1. Conspicuity of endoleaks was comparable between SEI (median, 2.99) and VMI (both energies: median, 2.87; P = .04). Overall subjective image quality was rated significantly higher for SEI (median, 4 [IQR, 4-4) as compared with 40 and 50 keV (both energies: median, 4 [IQR, 3-4]; P < .001). Conclusion SEI demonstrated higher image quality and comparable diagnostic accuracy as compared with 50-keV VMI for endoleak detection at CTA after EVAR. Keywords: Aneurysms, CT, CT Angiography, Vascular, Aorta, Technology Assessment, Multidetector CT, Abdominal Aortic Aneurysms, Endoleaks, Perigraft Leak Supplemental material is available for this article. © RSNA, 2024.

目的 比较单能量和多能量图像在血管内主动脉修复术(EVAR)后 CT 血管造影(CTA)中用于内漏检测的图像质量、诊断性能和清晰度。材料与方法 在这项单中心前瞻性随机对照试验中,2020 年 8 月至 2022 年 5 月期间接受 EVAR 后 CTA 的患者被分配到使用低千伏单能图像(SEI;80 千伏,A 组)或多能 CT(80/Sn150 千伏,B 组)40 和 50 千伏的低千伏虚拟单能图像(VMI)进行成像。扫描方案剂量匹配(容积 CT 剂量指数:平均值 4.5 mGy ± 1.8 [SD] vs 4.7 mGy ± 1.3,P = .41)。测量对比度与噪声比(CNR)。两位放射科专家确定了是否存在内漏的参考标准。由两名不同的盲人放射科医生对内膜漏的检测和明显程度以及主观图像质量进行评估。计算读片者之间的一致性。采用非参数统计检验。结果 共有 125 名参与者(平均年龄 76 岁 ± 8 岁;103 名男性)被分配到 A 组(64 人)和 B 组(61 人)。与 SEI(平均值为 22.2)相比,40-keV VMI(平均值为 19.1;P = .048)和 50-keV VMI(平均值为 16.8;P < .001)的 CNR 明显较低。共有 45 个内漏(A:23 个;B:22 个)。与 40-keV VMI(77.3%,22 人中有 17 人)相比,SEI(82.6%,23 人中有 19 人;P = .88)和 50-keV VMI(81.8%,22 人中有 18 人;P = .90)的内漏检测灵敏度更高。各组的特异性相当(SEI:92.7%,41 组中的 38 组;两种 VMI 能量:92.3%,38 组中的 35 组;P = .99),读片者之间的一致性为 1。SEI(中位数,2.99)和 VMI(两种能量:中位数,2.87;P = .04)的内漏明显度相当。与 40 和 50 keV(两种能量:中位数均为 4 [IQR,3-4];P < .001)相比,SEI 的整体主观图像质量评分明显更高(中位数为 4 [IQR,4-4])。结论 SEI 与 50-keV VMI 相比,在 EVAR 后的 CTA 内漏检测中显示出更高的图像质量和相当的诊断准确性。关键词动脉瘤、CT、CT 血管造影、血管、主动脉、技术评估、多载体 CT、腹主动脉瘤、内漏、移植物周围漏 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Time to Go with the Flow in Coronary Artery Disease in TAVR? TAVR 中的冠状动脉疾病该顺其自然了吗?
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.240078
Jonathan R Weir-McCall, Francesca Pugliese
{"title":"Time to Go with the Flow in Coronary Artery Disease in TAVR?","authors":"Jonathan R Weir-McCall, Francesca Pugliese","doi":"10.1148/ryct.240078","DOIUrl":"10.1148/ryct.240078","url":null,"abstract":"","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"6 2","pages":"e240078"},"PeriodicalIF":7.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11056746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy. 吸烟对冠状动脉容积-心肌质量比的影响:一项 ADVANCE 注册子研究。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.220197
Kenneth R Holmes, Gaurav S Gulsin, Timothy A Fairbairn, Lynne Hurwitz-Koweek, Hitoshi Matsuo, Bjarne L Nørgaard, Jesper M Jensen, Niels-Peter Rønnow Sand, Koen Nieman, Jeroen J Bax, Gianluca Pontone, Kavitha M Chinnaiyan, Mark G Rabbat, Tetsuya Amano, Tomohiro Kawasaki, Takashi Akasaka, Hironori Kitabata, Campbell Rogers, Manesh R Patel, Geoffrey W Payne, Jonathon A Leipsic, Stephanie L Sellers

Purpose To examine the relationship between smoking status and coronary volume-to-myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm3 ± 934.0 [SD]; never-smokers, 2967.6 mm3 ± 978.0; P = .002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; P = .02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm3/g ± 7.9; former smokers, 24.9 mm3/g ± 7.1; never-smokers, 25.8 mm3/g ± 7.4; P < .001 [unadjusted] and P = .002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; P = .009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; P = .02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; P < .001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; P < .001) were independent predictors of low V/M. Conclusion Both current and former smoking status were independently associated with low V/M. Keywords: CT Angiography, Cardiac, Heart, Ischemia/Infarction Clinical trial registration no. NCT02499679 Supplemental material is available for this article. © RSNA, 2024.

目的 研究接受 CT 分形血流储备(CT-FFR)分析的冠状动脉疾病(CAD)患者中吸烟状态与冠状动脉体积-心肌质量比(V/M)之间的关系。材料与方法 在这项二次分析中,纳入了从 2015 年 7 月 15 日至 2017 年 10 月 20 日期间因疑似 CAD 而接受 ADVANCE 登记评估的参与者,这些参与者在冠状动脉 CT 血管造影(CCTA)中被发现冠状动脉狭窄达到或超过 30%,如果他们已知吸烟状态并接受了 CT-FFR 和 V/M 分析。对 CCTA 图像进行分割,以计算冠状动脉容积和心肌质量。比较不同吸烟组的 V/M,并确定低 V/M 的预测因素。结果 分析样本包括 503 名当前吸烟者、1060 名曾经吸烟者和 1311 名从不吸烟者(2874 名参与者;1906 名男性参与者)。在对人口统计学和临床因素进行调整后,曾经吸烟者的冠状动脉容积大于从不吸烟者(曾经吸烟者,3021.7 mm3 ± 934.0 [SD]; 从不吸烟者,2967.6 mm3 ± 978.0; P = .002),而现在吸烟者的心肌质量大于从不吸烟者(现在吸烟者,127.8 g ± 32.9; 从不吸烟者,118.0 g ± 32.5; P = .02)。然而,当前吸烟者和曾经吸烟者的 V/M 值均低于从不吸烟者(当前吸烟者,24.1 mm3/g ± 7.9;曾经吸烟者,24.9 mm3/g ± 7.1;从不吸烟者,25.8 mm3/g ± 7.4;P < .001 [未调整] 和 P = .002 [未调整])。当前吸烟状态(几率比 [OR],0.74 [95% CI:0.59, 0.93];P = .009)、曾经吸烟状态(OR,0.81 [95% CI:0.68, 0.97];P = .02)、狭窄程度达到或超过 50%(OR,0.62 [95% CI:0.52, 0.74];P < .001)和糖尿病(OR,0.67 [95% CI:0.56, 0.82];P < .001)是低 V/M 的独立预测因素。结论 目前和以前的吸烟状况都与低V/M独立相关。关键词CT血管造影 心脏 心脏缺血/梗死 临床试验注册号本文有补充材料。© RSNA, 2024.
{"title":"Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy.","authors":"Kenneth R Holmes, Gaurav S Gulsin, Timothy A Fairbairn, Lynne Hurwitz-Koweek, Hitoshi Matsuo, Bjarne L Nørgaard, Jesper M Jensen, Niels-Peter Rønnow Sand, Koen Nieman, Jeroen J Bax, Gianluca Pontone, Kavitha M Chinnaiyan, Mark G Rabbat, Tetsuya Amano, Tomohiro Kawasaki, Takashi Akasaka, Hironori Kitabata, Campbell Rogers, Manesh R Patel, Geoffrey W Payne, Jonathon A Leipsic, Stephanie L Sellers","doi":"10.1148/ryct.220197","DOIUrl":"10.1148/ryct.220197","url":null,"abstract":"<p><p>Purpose To examine the relationship between smoking status and coronary volume-to-myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm<sup>3</sup> ± 934.0 [SD]; never-smokers, 2967.6 mm<sup>3</sup> ± 978.0; <i>P</i> = .002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; <i>P</i> = .02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm<sup>3</sup>/g ± 7.9; former smokers, 24.9 mm<sup>3</sup>/g ± 7.1; never-smokers, 25.8 mm<sup>3</sup>/g ± 7.4; <i>P</i> < .001 [unadjusted] and <i>P</i> = .002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; <i>P</i> = .009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; <i>P</i> = .02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; <i>P</i> < .001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; <i>P</i> < .001) were independent predictors of low V/M. Conclusion Both current and former smoking status were independently associated with low V/M. <b>Keywords:</b> CT Angiography, Cardiac, Heart, Ischemia/Infarction Clinical trial registration no. NCT02499679 <i>Supplemental material is available for this article</i>. © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"6 2","pages":"e220197"},"PeriodicalIF":7.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11056751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of Impaired Left Ventricular Mitral Filling from 4D Flow Cardiac MRI and Prognosis of Hypertrophic Cardiomyopathy. 四维流式心脏磁共振成像显示左心室二尖瓣充盈受损与肥厚型心肌病预后的关系
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.230198
Hichem Sakhi, Gilles Soulat, Damian Craiem, Umit Gencer, Jérôme Lamy, Valentina Stipechi, Tania Puscas, Jean-Sébastien Hulot, Albert Hagege, Elie Mousseaux

Purpose To investigate whether the peak early filling rate normalized to the filling volume (PEFR/FV) estimated from four-dimensional (4D) flow cardiac MRI may be used to assess impaired left ventricular (LV) filling and predict clinical outcomes in individuals with hypertrophic cardiomyopathy (HCM). Materials and Methods Cardiac MRI with a 4D flow sequence and late gadolinium enhancement (LGE), as well as echocardiography, was performed in 88 individuals: 44 participants with HCM from a French prospective registry (ClinicalTrials.gov; NCT01091480) and 44 healthy volunteers matched for age and sex. In participants with HCM, a composite primary end point was assessed at follow-up, including unexplained syncope, new-onset atrial fibrillation, hospitalization for congestive heart failure, ischemic stroke, sustained ventricular arrhythmia, septal reduction therapy, and cardiac death. A Cox proportional hazard model was used to analyze associations with the primary end point. Results PEFR/FV was significantly lower in the HCM group (mean age, 51.8 years ± 18.5 [SD]; 29 male participants) compared with healthy volunteers (mean, 3.35 sec-1 ± 0.99 [0.90-5.20] vs 4.42 sec-1 ± 1.68 [2.74-11.86]; P < .001) and correlated with both B-type natriuretic peptide (BNP) level (r = -0.31; P < .001) and the ratio of pulsed Doppler early transmitral inflow to Doppler tissue imaging annulus velocities (E/E'; r = -0.54; P < .001). At a median follow-up of 2.3 years (IQR, 1.7-3.3 years), the primary end point occurred in 14 (32%) participants. A PEFR/FV of 2.61 sec-1 or less was significantly associated with occurrence of the primary end point (hazard ratio, 9.46 [95% CI: 2.61, 45.17; P < .001] to 15.21 [95% CI: 3.51, 80.22; P < .001]), independently of age, BNP level, E/E', LGE extent, and LV and left atrial strain according to successive bivariate models. Conclusion In HCM, LV filling evaluated with 4D flow cardiac MRI correlated with Doppler and biologic indexes of diastolic dysfunction and predicted clinical outcomes. Keywords: Diastolic Function, Left Ventricular Filling, Hypertrophic Cardiomyopathy, Cardiac MRI, 4D Flow Sequence Clinical trial registration no. NCT01091480 Supplemental material is available for this article. © RSNA, 2024.

目的 研究通过四维(4D)血流心脏磁共振成像估算的早期充盈峰值率与充盈容积(PEFR/FV)的归一化值是否可用于评估肥厚型心肌病(HCM)患者左心室(LV)充盈受损的情况并预测临床预后。材料和方法 对 88 名患者进行了 4D 血流序列和晚期钆增强 (LGE) 心脏 MRI 以及超声心动图检查:44 名 HCM 患者来自法国前瞻性登记处(ClinicalTrials.gov; NCT01091480),44 名健康志愿者年龄和性别匹配。在 HCM 患者中,随访评估了一个复合主要终点,包括不明原因晕厥、新发心房颤动、充血性心力衰竭住院、缺血性中风、持续室性心律失常、室间隔减容治疗和心源性死亡。采用 Cox 比例危险模型分析与主要终点的关系。结果 与健康志愿者相比,HCM 组(平均年龄 51.8 岁 ± 18.5 [SD];29 名男性参与者)的 PEFR/FV 明显较低(平均值 3.35 sec-1 ± 0.99 [0.90-5.20] vs 4.42 sec-1 ± 1.68 [2.74-11.86];P < .001),并与 B 型钠尿肽(BNP)水平(r = -0.31;P < .001)和脉冲多普勒早期透射瓣流入量与多普勒组织成像瓣环速度之比(E/E';r = -0.54;P < .001)相关。在中位随访 2.3 年(IQR,1.7-3.3 年)时,14 名参与者(32%)出现了主要终点。根据连续的双变量模型,PEFR/FV 为 2.61 sec-1 或更低与主要终点的发生显著相关(危险比为 9.46 [95% CI: 2.61, 45.17; P < .001] 至 15.21 [95% CI: 3.51, 80.22; P < .001]),与年龄、BNP 水平、E/E'、LGE 程度以及左心室和左心房应变无关。结论 在 HCM 中,用四维血流心脏 MRI 评估的左心室充盈度与舒张功能障碍的多普勒和生物学指标相关,并可预测临床预后。关键词: 舒张功能 左心室舒张功能 左心室充盈 肥厚型心肌病 心脏核磁共振成像 四维血流序列 临床试验注册号本文有补充材料。© RSNA, 2024.
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引用次数: 0
Radiology: Cardiothoracic Imaging Highlights 2023. 放射学:2023 年心胸影像亮点。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.240020
Gilberto J Aquino, Domenico Mastrodicasa, Samer Alabed, Shady Abohashem, Lingyi Wen, Ritu R Gill, Dianna M E Bardo, Suhny Abbara, Kate Hanneman

Radiology: Cardiothoracic Imaging publishes novel research and technical developments in cardiac, thoracic, and vascular imaging. The journal published many innovative studies during 2023 and achieved an impact factor for the first time since its inaugural issue in 2019, with an impact factor of 7.0. The current review article, led by the Radiology: Cardiothoracic Imaging trainee editorial board, highlights the most impactful articles published in the journal between November 2022 and October 2023. The review encompasses various aspects of coronary CT, photon-counting detector CT, PET/MRI, cardiac MRI, congenital heart disease, vascular imaging, thoracic imaging, artificial intelligence, and health services research. Key highlights include the potential for photon-counting detector CT to reduce contrast media volumes, utility of combined PET/MRI in the evaluation of cardiac sarcoidosis, the prognostic value of left atrial late gadolinium enhancement at MRI in predicting incident atrial fibrillation, the utility of an artificial intelligence tool to optimize detection of incidental pulmonary embolism, and standardization of medical terminology for cardiac CT. Ongoing research and future directions include evaluation of novel PET tracers for assessment of myocardial fibrosis, deployment of AI tools in clinical cardiovascular imaging workflows, and growing awareness of the need to improve environmental sustainability in imaging. Keywords: Coronary CT, Photon-counting Detector CT, PET/MRI, Cardiac MRI, Congenital Heart Disease, Vascular Imaging, Thoracic Imaging, Artificial Intelligence, Health Services Research © RSNA, 2024.

放射学Cardiothoracic Imaging》刊登心脏、胸部和血管成像领域的新研究和技术发展。该期刊在 2023 年期间发表了许多创新性研究,自 2019 年创刊以来首次实现了影响因子,影响因子为 7.0。本期综述文章由《放射学》领衔撰写:心胸影像》见习编委会牵头撰写的本期评论文章,重点介绍了2022年11月至2023年10月期间该杂志发表的最具影响力的文章。综述涵盖了冠状动脉 CT、光子计数探测器 CT、PET/MRI、心脏 MRI、先天性心脏病、血管成像、胸部成像、人工智能和医疗服务研究的各个方面。主要亮点包括光子计数探测器 CT 减少造影剂用量的潜力、联合 PET/MRI 在评估心脏肉样瘤病中的实用性、磁共振成像中左心房晚期钆增强在预测心房颤动事件中的预后价值、人工智能工具在优化偶然肺栓塞检测中的实用性以及心脏 CT 医学术语的标准化。正在进行的研究和未来发展方向包括评估用于评估心肌纤维化的新型 PET 示踪剂、在临床心血管成像工作流程中部署人工智能工具,以及提高成像中环境可持续性的意识。关键词冠状动脉 CT、光子计数探测器 CT、PET/MRI、心脏 MRI、先天性心脏病、血管成像、胸部成像、人工智能、健康服务研究 © RSNA, 2024.
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引用次数: 0
Multimodality Imaging Features of Immunoglobulin G4-related Vessel Involvement. 免疫球蛋白 G4 相关血管受累的多模态成像特征
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-01 DOI: 10.1148/ryct.230105
Aileen O'Shea, Rory K Crotty, Mangun Kaur Randhawa, George Oliveira, Cory A Perugino, John H Stone, Mukesh G Harisinghani, Zachary S Wallace, Sandeep S Hedgire

Immunoglobulin 4 (IgG4)-related disease is a chronic immune-mediated fibroinflammatory disorder. Involvement of the vascular system, including large- and medium-sized vessels, is increasingly recognized. The varied appearances of vascular involvement reflect the sequela of chronic inflammation and fibrosis and can include aortitis and periaortitis with resultant complications such as aneurysm formation and dissection. A diagnosis of IgG4-related large vessel involvement should be considered when there is known or suspected IgG4-related disease elsewhere. Other organs that are typically affected in IgG4-related disease include the lacrimal and salivary glands, thyroid, pancreas, biliary tree, lungs, kidneys, and meninges. Diagnosis typically requires careful correlation with clinical, imaging, serum, and pathologic findings. Patients may be managed with corticosteroid therapy or the anti-CD20 monoclonal antibody, rituximab, if needed. The varied clinical presentations and imaging features of large vessel involvement are discussed herein. Keywords: Vascular, Inflammation, Aorta, IgG4-related Vessel Involvement © RSNA, 2024.

免疫球蛋白 4(IgG4)相关疾病是一种由免疫介导的慢性纤维炎症性疾病。越来越多的人认识到该病会累及血管系统,包括大血管和中血管。血管受累的表现多种多样,反映了慢性炎症和纤维化的后遗症,可包括主动脉炎和主动脉周围炎,并可导致动脉瘤形成和夹层等并发症。当已知或怀疑其他部位有 IgG4 相关疾病时,应考虑 IgG4 相关大血管受累的诊断。IgG4 相关疾病通常累及的其他器官包括泪腺和唾液腺、甲状腺、胰腺、胆道、肺、肾和脑膜。诊断通常需要与临床、影像学、血清和病理学检查结果仔细对照。必要时,患者可接受皮质类固醇治疗或抗CD20单克隆抗体利妥昔单抗治疗。本文讨论了大血管受累的不同临床表现和影像学特征。关键词血管 炎症 主动脉 IgG4 相关血管受累 © RSNA, 2024.
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引用次数: 0
Erratum for: Echocardiography versus Cardiac MRI for Measurement of Left Ventricular Ejection Fraction in Individuals with Cancer and Suspected Cardiotoxicity. 勘误超声心动图与心脏磁共振成像在测量癌症患者左心室射血分数和疑似心脏毒性方面的对比。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-01 DOI: 10.1148/ryct.249003
Muhummad Sohaib Nazir, Joseph Okafor, Theodore Murphy, Maria Sol Andres, Sivatharshini Ramalingham, Stuart D Rosen, Amedeo Chiribiri, Sven Plein, Sanjay Prasad, Raad Mohiaddin, Dudley J Pennell, A John Baksi, Rajdeep Khattar, Alexander R Lyon
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引用次数: 0
Erratum for: Coronary Calcium Association with All-Cause Mortality in Suspected Acute Aortic Syndrome. 勘误:疑似急性主动脉综合征患者冠状动脉钙与全因死亡率的关系。
IF 7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-01 DOI: 10.1148/ryct.249002
Arosh S Perera Molligoda Arachchige
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引用次数: 0
期刊
Radiology. Cardiothoracic imaging
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