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Background: A free-floating thrombus (FFT) is often considered to be a risk factor for pulmonary embolism (PE), despite adequate anticoagulation therapy, in patients with proximal deep venous thrombosis. Methods: Ninety-five patients underwent prospective assessment according to the presence (FFT group [n=62]) or absence (occlusive thrombus group [n=28]) of an FFT. On day 1, color venous duplex scanning, venography (reference method), perfusion lung scanning, and, if results of the lung scan were abnormal, pulmonary angiography were performed. On day 10 (range, days 9-11), the lung scan was repeated, as well as pulmonary angiography if the lung scan demonstrated impairment. A 3-month clinical follow-up visit was scheduled. Five patients were retrospectively excluded from analysis for uncertain diagnosis of FFT. Patients were treated with intravenous unfractionated heparin sodium adjusted for activated partial thromboplastin time (n=1) or subcutaneous lowmolecular-weight heparin (n=89) (nadroparin calcium, 225 Institut Choay factor Xa inhibitory units per kilogram for 12 hours). Warfarin sodium therapy was initiated on day 3 (range, days 2-4). Results: Both groups were well-matched according to age, sex, risk factors, and delay from onset of symptoms to treatment. Positive and negative predictive values of color venous duplex scanning for the diagnosis of an FFT were 91% and 55%, respectively. On admission, PE prevalence was 64% in the FFT group (40 of 62 patients) and 50% in the occlusive thrombus group (14 of 28 patients) ( P =.19). Two patients were excluded on follow-up analysis (range, days 9-11) for preventive vena cava filtering (due to major bleeding in 1 and cholecystectomy in the other); the recurrent rate of PE was 3.3% in the FFT group (2 of 61 patients) and 3.7% in the occlusive thrombus group (1 of 27 patients). No symptomatic recurrent PE occurred between day 10 (range, days 9-11) and 3 months. Four patients died of evolutive neoplasm after hospital discharge. Conclusions: No higher risk for PE was observed in patients with free-floating proximal deep venous thrombosis; anticoagulant therapy should prevent recurrent PE in such patients. Arch Intern Med. 1997;157:305-308

Strawberry hemangiomas are the most common congenital vascular malformation seen in infants. Usually, they appear as a raised bright or purplish red lobulated tumor with well-defined borders and capillaries protruding from its surface. They are not present at birth. They develop during the first weeks of life, grow rapidly during the first 6 months, remain stationary for awhile, and then undergo complete or partial involution and resolution without treatment. Usually, these hemangiomas are solitary or in small number1 and are not associated with congenital anomalies. We report a case of strawberry hemangiomas that is unusual because of the multiplicity and extension associated with laryngeal hemangioma and coarctation with right aortic arch.

Background T2and T1-mapping are novel CMR techniques allowing objective tissue characterization. These techniques have been shown to be superior to dark blood imaging in NSTEMI patients in detecting ischaemic area at risk and acute oedema. These methods have not been assessed in Tako-Tsubo cardiomyopathy (TC).The aim of the study was to assess myocardial involvement using T2and T1mapping in Tako-Tsubo cardiomyopathy (TC).

ObjectivesWe sought to evaluate whether transient myocardial systolic impairment in stress cardiomyopathy is associated with myocardial edema.BackgroundThe mechanisms of stress cardiomyopathy are still debated. T2 mapping in cardiac MRI (CMR) examination allows quantification of myocardial edema. The aim of the study was to detect and quantify transient myocardial edema in systolic dysfunctional myocardial segments in this setting.MethodsWe conducted a retrospective study of 6 patients presenting confirmed stress cardiomyopathy. CMR results of patients were compared with results of 11 healthy volunteers (control group). All examinations were performed in acute phase: left ventricle long axis T2 mapping sequence and dynamic sequences in the 3 axis of heart and delayed enhancement (DE) sequences 10 minutes after 0.2mmol/kg body weight of Gd-DTPA. A second CMR was performed in 4 patients after a delay >2 months.ResultsNo abnormal DE was observed. All systolic dysfunction recovered on follow-up. In acute phase, apical systolic dysfunction was observed in all patients. Mean T2 values of hypo- or akinetic segments were significantly higher than those of normokinetic segments (88.7±22.7ms vs. 55.4±7.7ms; p

Methods A prospective CMR T1 mapping study of 37 patients with severe AS before and six months after aortic valve replacement (AVR) was conducted. CMR at 1.5 T, including T1 mapping using a modified Look-Locker inversion recovery sequence (before and 15 minutes after the administration of 0.2 mmol/kg of Gadoteric acid), was carried out. Global T1 values, ECV, ICV have been measured before and six months after surgery.