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Thyroid exposure to radiation in brain computed tomography (CT) scan is of great value since it is considered as a vital organ. This study aimed to investigate the absorbed dose of thyroid by various protocols of head CT in patients referring to 64-slice CT scan center and to compare the values with the calculated dose by imaging performance and assessment of CT (ImPACT) method. Also, the values of CT scan dose index (CTDI) were calculated with semiconductor detector. In this cross-sectional study, 120 outpatients including three groups of forty individuals over 40 years old referring to the hospital radiology centers in Tehran for head CT were chosen and 3 thermo-luminescence dosimeter (TLD-GR200) were applied on thyroid gland of each patient. For brain CT, Absorbed and effective doses of thyroid gland were calculated by ImPACT software. In addition, semiconductor detector in head CTDI phantom calculated CTDI for the applied protocols. Mean effective dose of thyroid gland in brain scan group was calculated by TLD and ImPACT software which showed no significant difference (P < 0.001). Mean effective dose of thyroid gland in unidirectional and bi-directional sinus scan by TLD and ImPACT software were different significantly (P < 0.001). Also, the differences between CTDI values shown by brain and sinus scan protocol with semiconductor detector and those CTDI were significant (P < 0.001). The calculated values of absorbed dose and effective doses of thyroid by TLD and ImPACT software were not significantly different. Mean effective dose calculated for thyroid gland in head scans by TLD and ImPACT was less than the annual permissive level for thyroid gland suggested by International Committee on Radiological Protection. In this study, calculated values of thyroid effective dose in brain scan with 64-slice scanner were less than the calculated values in a similar study.

Thyroid exposure to radiation in brain computed tomography (CT) scan is of great value since it is considered as a vital organ. This study aimed to investigate the absorbed dose of thyroid by various protocols of head CT in patients referring to 64-slice CT scan center and to compare the values with the calculated dose by imaging performance and assessment of CT (ImPACT) method. Also, the values of CT scan dose index (CTDI) were calculated with semiconductor detector. In this cross-sectional study, 120 outpatients including three groups of forty individuals over 40 years old referring to the hospital radiology centers in Tehran for head CT were chosen and 3 thermo-luminescence dosimeter (TLD-GR200) were applied on thyroid gland of each patient. For brain CT, Absorbed and effective doses of thyroid gland were calculated by ImPACT software. In addition, semiconductor detector in head CTDI phantom calculated CTDI for the applied protocols. Mean effective dose of thyroid gland in brain scan group was calculated by TLD and ImPACT software which showed no significant difference (P < 0.001). Mean effective dose of thyroid gland in unidirectional and bi-directional sinus scan by TLD and ImPACT software were different significantly (P < 0.001). Also, the differences between CTDI values shown by brain and sinus scan protocol with semiconductor detector and those CTDI were significant (P < 0.001). The calculated values of absorbed dose and effective doses of thyroid by TLD and ImPACT software were not significantly different. Mean effective dose calculated for thyroid gland in head scans by TLD and ImPACT was less than the annual permissive level for thyroid gland suggested by International Committee on Radiological Protection. In this study, calculated values of thyroid effective dose in brain scan with 64-slice scanner were less than the calculated values in a similar study. [ABSTRACT FROM AUTHOR]

In children, myocardial bridge is an inborn coronary anomaly and is usually found in the patients with hypertrophic cardiomyopathy or left ventricular hypertrophy. Myocardial bridges were long thought to be a benign anatomical variant, even in patients with obstructive and non-obstructive hypertrophic cardiomyopathy. However some patients suffer from myocardial infarction, arrhythmia and even sudden cardiac death. In the present report, we describe a 7-year-old girl with the manifestation of recurrent precordial discomfort, and subsequently diagnosed as having an isolated myocardial bridge in the distal segment of left anterior descending coronary artery using 64-slice computed tomography coronary angiography.

A variety of coronary artery disorders, including intramyocardial coronary segments and coronary artery anomalies, can result in sudden cardiac death, especially in young adults. The detection of structural coronary artery abnormalities is important in the management of patients at risk of sudden cardiac death. Coronary artery anomalies occur in about 1% of the population. Congenital absence of left circumflex coronary artery (LCX) is a very rare vascular anomaly, and few cases have been reported in the literature, with a frequency of only 0.003% in all patients who underwent coronary angiography. Although coronary catheterization is the gold standard for the evaluation of coronary arterial patency disease, noninvasive computed tomography (CT) is considered the diagnostic method of choice for the detection and evaluation of coronary artery anomaly. Herein, we report the case of a 17-year-old girl who presented with exertional dyspnea and chest pain and who was studied at our emergency department with the final diagnosis of LCX atresia detected by 64-slice CT. She may be the first case of congenital LCX atresia proved by multislice CT.

Background Patients undergoing transcatheter aortic valve implantation (TAVI) are at increased risk for post-interventional conduction disturbances leading to pacemaker (PM) implantation. We analyzed the association between implantation depth within the left ventricular outflow tract (LVOT), measured by 64-slice computed tomography (CT), and ‘index electrocardiographic (ECG) changes’ (new onset atrioventricular-block grade II or III or left bundle branch block with PR interval prolongation >200 ms). Methods We evaluated patients who underwent TAVI with the Core Valve ® revalving system (Medtronic, Minneapolis, MN, USA) for treatment of severe aortic stenosis at our department. Patients with a prior PM implantation and patients for whom no CT scan was available after 3 months were excluded from analysis. We assessed implantation depth of the prosthesis within the LVOT as possible risk factors for the development of post-interventional ‘index ECG changes’ resulting in PM implantation and compared it with individual patient data as well as echocardiographic and electrocardiographic parameters. Results The final study cohort comprised 53 patients for whom a 64-slice CT scan was available (mean age 81.7 ± 5.1 years, 36% male). Twenty-eight of these finally underwent PM implantation due to ‘index ECG changes’ within the first 48 hours after TAVI. Univariate logistic regression analysis could identify implantation depth of the prosthesis as the only significantly correlated risk factor for PM need in our cohort (OR 1.27, 95% CI: 1.08–1.51, p = 0.004). A cut-off value of 6 mm predicted this need with a sensitivity of 89% and specificity of 40%. Conclusion Implantation depth of the Core Valve ® into the LVOT was associated with post-procedural PM requirement. Thereby, a cut-off value of 6 mm, as measured by 64-slice CT, proved useful to define patients at risk for PM requirement. [ABSTRACT FROM AUTHOR]

Objective : Ectopic fat accumulation is associated with coronary artery disease. Visceral adipose tissue has paracrine and systemic effects and is a source of adipocytokines. It has been implicated in the pathogenesis of coronary atherosclerosis; however, nothing is known about whether increases in epicardial fat have the same effect on coronary atherosclerosis as increases in abdominal visceral fat. Methods : We examined 216 consecutive patients suspected to have coronary artery disease. Individuals with acute coronary syndrome and inadequate computed tomography (CT) imaging were excluded. We enrolled 164 patients (65 ± 10 years old; 70% men; body mass index [BMI], 23.8 ± 3.6 kg/m 2 ). The plasma concentrations of adiponectin, interleukin-6 (IL-6), plasminogen activator inhibitor-1, and vascular endothelial growth factor were measured. The characteristics of coronary plaque, abdominal visceral fat area, and epicardial fat volume (EFV) were determined by 64-slice CT imaging. Results : EFV was greater in subjects with noncalcified plaque than in those with no plaque or with calcified plaque (126 ± 39 mL vs. 98 ± 34 mL and 97 ± 45 mL, respectively; P = 0.010). EFV was significantly correlated with BMI, triglycerides, and the triglyceride/high-density lipoprotein cholesterol ratio ( r = 0.51, 0.19, and 0.20, respectively) but not with plasma levels of adipocytokines. The plasma adiponectin and IL-6 concentration was significantly correlated with abdominal visceral fat area in coronary plaque patients ( r = −0.49 and 0.20). Conclusions : In non-obese Japanese patients, epicardial fat may have unique mechanisms affecting the development of coronary atherosclerosis, which is different from abdominal visceral fat. [ABSTRACT FROM AUTHOR]

Objectives We assessed the hypothesis that the epicardial fat is associated with coronary lipid plaque. Background Epicardial fat volume (EFV) is increased in patients with acute coronary syndrome (ACS), and lipid-rich plaques have been associated with acute coronary events. Methods We enrolled 112 individuals who underwent percutaneous coronary intervention (PCI) (66 with ACS; 46 with stable angina pectoris [SAP]) and classified plaque components using integrated backscatter intravascular ultrasound as calcified, fibrous, or lipid. Possible effects of PCI on plaque data were minimized by assessing 10-mm vessel lengths proximal to the culprit lesions. Total plaque volume and percentage volumes of individual plaque components were calculated. EFV and abdominal visceral fat area were measured using 64-slice computed tomography. Results ACS patients had significantly higher EFV than did SAP patients (118 ± 44 vs.101 ± 41 mL, p = 0.019). In ACS patients, EFV was correlated with total plaque volume and percentage of lipid plaque ( r = 0.27 and 0.31, respectively; p < 0.05). Moreover, an independent interaction between EFV and lipid-rich plaque (odds ratio, 1.04; 95% confidence interval, 1.00–1.07) were revealed. In contrast, in SAP patients, EFV was positively correlated with body mass index and abdominal visceral fat area but not with plaque characteristics. Conclusions EFV was associated with lipid-rich plaque in patients with ACS, whereas no correlation between EFV and coronary plaque profile was apparent in SAP patients. Epicardial fat may have a role in the development of lipid plaque, which contributes to the pathogenesis of ACS. [ABSTRACT FROM AUTHOR]

Purpose: Although arachnoid granulations (AGs) were initially described by Pacchioni more than 300 years ago, they are still poorly described, especially those in middle cranial fossa. The aim of this study was to identify anatomical features of AGs in middle cranial fossa of cadaver and compare such features with that of 64-slice computed tomography. Methods: The study involved anatomical dissection of 33 adult cadaveric heads and computed tomographic (CT) examinations of 40 patients with various intracranial diseases. The number, size, distribution, and morphology of the AGs in middle cranial fossa of the cadavers and patients were examined and compared. Results: The number of AGs observed on the middle cranial fossa of the cadaveric specimens was greater than that of the patients ( P < 0.05). While anatomic dissection revealed a total of 228 AGs in 24 of 33 cadaveric heads, CT scans demonstrated only 80 AGs in 23 of 40 patients. In cadavers, the AGs occurred in the following sites in order of frequency: the middle meningeal sinus (144 AGs, 63.2%), sphenoparietal sinus (47 AGs, 20.6%), lateral foramen rotundum (19 AGs, 8.3%), and cavernous sinus (18 AGs, 7.9%). In CT images, the AGs occurred in the following sites in order of frequency: the middle meningeal sinus (50 AGs, 62.5%), sphenoparietal sinus (23 AGs, 28.8%), and lateral foramen rotundum (7 AGs, 8.8%). The AGs of cavernous sinus and venous lacunae adjacent to the middle meningeal sinus were hardly identified on CT images. Most of the AGs were spherical or finger-like in shape. Histologically, the AGs can be divided into two types: single type and lobulated type. Conclusions: The study provides a detailed description of AGs in or near the middle meningeal sinus, sphenoparietal sinus, lateral foramen rotundum, and cavernous sinus. It also reveals a difference in the ability of detecting cranial AGs between microanatomy and CT scans. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the value of multislice computed tomography (CT) for the assessment of valvular abnormalities in patients with infective endocarditis (IE) in comparison with transesophageal echocardiography (TEE) and intraoperative findings. Background: Multislice CT has recently shown promising data regarding valvular imaging in a 4-dimensional fashion. Methods: Thirty-seven consecutive patients with clinically suspected IE were examined with TEE and 64-slice CT or dual-source CT. Twenty-nine patients had definite IE and underwent surgery. Results: The diagnostic performance of CT for the detection of evident valvular abnormalities for IE compared with TEE was: sensitivity 97%, specificity 88%, positive predictive value (PPV) 97%, and negative predictive value (NPV) 88% on a per-patient basis (n = 37; excellent intermodality agreement κ = 0.84). CT correctly identified 26 of 27 (96%) patients with valvular vegetations and 9 of 9 (100%) patients with abscesses/pseudoaneurysms compared with the intraoperative specimen. On a per-valve–based analysis, diagnostic accuracy for the detection of vegetations and abscesses/pseudoaneurysms compared with surgery was: sensitivity 96%, specificity 97%, PPV 96%, NPV 97%, and sensitivity 100%, specificity 100%, PPV 100%, NPV 100%, respectively, without significant differences as compared with TEE. Vegetation size measurements by CT correlated (r = 0.95; p <0.001) with TEE (mean 7.6 ± 5.6 mm). The mobility of vegetations was accurately diagnosed in 21 of 22 (96%) patients with CT, but all of 4 leaflet perforations (≤2 mm) were missed. CT provided more accurate anatomic information regarding perivalvular extent of abscess/pseudoaneurysms than TEE. Conclusions: Multislice CT shows good results in detecting valvular abnormalities in IE and could be applied in pre-operative planning and exclusion of coronary artery disease before surgery. [Copyright &y& Elsevier]

Abstract: Purpose: To identify, using logistic regression models, factors impairing evaluation of patency of drug-eluting stents (DES) and bare metal stents (BMS) in coronary arteries by 64-slice MSCT versus conventional coronary angiography (CAG). Materials and methods: We evaluated 75 stents (16 DES and 59 BMS; 57 in males) implanted in 49 consecutive subjects (35 males; aged 68±10 years) by enhanced ECG-gated MSCT (Light Speed VCT, General Electrics) and CAG. Stents were classified by implantation site: (1) right coronary artery, (2) left anterior descending branch (LAD), and (3) left circumflex branch. Logistic regression models were used to predict agreement of findings between CT and CAG and impossibility of evaluating stent patency by CT, using age, sex, body mass index (BMI), heart rate, stent type, stent size, diabetes mellitus, and hypertension. Results: By CAG, patency was confirmed in 15 DES (94%) and 54 BMS (91%); significant in-stent restenosis of ≥50% was observed in 1 DES (6%) and 4 BMS (7%), and total occlusion in 1 BMS (2%). By CT, patency was confirmed in 69% DES and 78% BMS; 5 BMS (8%) revealed a low CT area inside the stent with significant in-stent restenosis, and 2 BMS (3%) revealed total occlusion. Patency of 31% DES and 22% BMS was unconfirmed by CT. Agreement of findings between CT and CAG was observed in 69% DES and 80% BMS. Significant negative predictors of agreement of findings between CT and CAG were, by category: (1) BMI (relative risks, 0.77; 95% confidence intervals [95% CI], 0.62–0.97); (2) site of implantation in LAD only (positive predictor) and BMI (relative risks, 4.59 and 0.77; 95% CI, 1.02–20.6 and 0.61–0.97, respectively); (3) BMI (relative risks, 0.77; 95% CI, 0.62–0.97). Significant predictors of impossibility of evaluating stent patency by CT were, by category: (1) BMI (relative risks, 1.54; 95% CI, 1.01–2.36); (2) none; (3) BMI (relative risk, 1.65; 95% CI, 1.03–2.63). Stent type and size were not significant predictors in any category. The percentage agreement of findings between CT and CAG was significantly higher in subjects with BMI<22 kg/m2 than in those with 22 kg/m2 ≤BMI<25 kg/m2 (p =0.035) and 30 kg/m2 ≤BMI (p <0.01). Analysis of evaluable stents by CT only revealed no significant negative predictor of agreement of findings between CT and CAG. Conclusion: 64-slice MSCT is a non-invasive diagnostic modality with potential for evaluating patency of DES with a low incidence of restenosis. When BMI is high, however, it remains difficult to accurately evaluate stent patency irrespective of stent type and size. [Copyright &y& Elsevier]

Abstract: Objective: To elucidate the usefulness of CT in evaluating left ventricular (LV) volumes and ejection fraction (EF) in ischemic heart disease (IHD), we compared 64-slice CT with conventional left ventriculography (CLVG). Materials and methods: 71 subjects with suspected or confirmed IHD underwent ECG-gated enhanced CT before or after cardiac catheterization. End-diastolic volume (EDV) and end-systolic volume (ESV) of LV were selected in 20 phases of R–R interval of ECG, and data sets were reconstructed to determine EDV, ESV, SV, and EF of LV using a multislice area summation method; in CLVG these parameters were calculated from the right anterior oblique 30-degree projection. Results: Correlation coefficients between CT and CLVG for EDV, ESV, SV, and EF were 0.759, 0.895, 0.550, and 0.836, respectively (P <0.01). In 35 subjects without apical asynergy of LV wall motion, correlation coefficients between CT and CLVG were 0.77, 0.91, 0.63, and 0.87 respectively (P <0.01); in 36 subjects, with apical asynergy, the correlation coefficients were 0.751, 0.875, 0.503, and 0.738, respectively (P <0.01). The limits of agreement of all parameters were wider in the subjects with apical asynergy of LV wall motion than the subjects without. Conclusion: There was good correlation between EDV, ESV, SV, and EF estimated by CT and those by CLVG, but CT tended to overestimate EDV and ESV and underestimate EF. In subjects with apical asynergy of LV wall motion, estimates of EF were less correlated between CT and CLVG and the limits of agreement of all parameters were wider than in those without. These discrepancies may come from the capability of CT to estimate LV wall asynergy 3-dimensionally and more accurately. [Copyright &y& Elsevier]

Rationale and Objectives: The aim of this study was to compare the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) in groups of patients with low, intermediate, and high risk for coronary artery disease (CAD) events. Materials and Methods: The institutional review board approved this study; written informed consent was obtained from all patients. Eighty-eight consecutive patients with suspected CAD (40 women; mean age, 64.3 ± 9.4 years; range, 39–82) underwent CTCA, calcium scoring, and invasive coronary angiography and were grouped according to their Framingham 10-year risk for hard coronary events into low (<10%), intermediate (10%–20%), and high (>20%) risk categories. Significant stenoses (luminal diameter narrowing ≥50%) were assessed on an intention-to-diagnose-basis; no coronary segment was excluded and nonevaluative segments were rated false positive. To determine differences between groups, Kruskal-Wallis tests were performed for individually determined values of diagnostic performance. Results: Per-patient sensitivity, specificity, negative predictive, and positive predictive values were 90.0%, 79.2%, 95.0%, and 64.3%, respectively, with low (n = 34), 87.5%, 92.3%, 85.7%, and 93.3%, respecitively, with intermediate (n = 29), and 100%, 75.0%, 100%, and 89.5%, respectively, with high risk (n = 25), with a trend toward higher positive predictive value (P = .07). Per-segment negative predictive value was lower with high pretest probability (P < .01). Mean calcium-score units were 90, 220, and 312 (P = .23), and the prevalence of CAD was 29.4%, 55.2%, and 68.0% (P < .01) with low, intermediate, and high risk. Conclusion: Sensitivity and specificity of CTCA are not influenced by the prevalence of CAD, whereas the negative predictive value is lower and the positive predictive value tends to be higher in patients with a high prevalence of CAD. [Copyright &y& Elsevier]

Temporal windows providing the best image quality of different segments and types of coronary artery bypass grafts (CABGs) with 64-slice computed tomography (CT) were evaluated in an experimental set-up. Sixty-four-slice CT with a rotation time of 330 ms was performed in 25 patients (four female; mean age 59.9 years). A total of 84 CABGs (62 individual and 22 sequential grafts) were evaluated, including 28 internal mammary artery (33.3%), one radial artery with sequential grafting (2.4%), and 54 saphenous vein grafts (64.3%). Ten data sets were reconstructed in 10% increments of the RR-interval. Each graft was separated into segments (proximal and distal anastomosis, and body), and CABG types were grouped according to target arteries. Two readers independently assessed image quality of each CABG segment in each temporal window. Diagnostic image quality was found with good inter-observer agreement (kappa=0.62) in 98.5% (202/205) of all graft segments. Image quality was significantly better for saphenous vein grafts versus arterial grafts (P<0.001) and for distal anastomosis to the right coronary compared with other target coronary arteries (P<0.05). Overall, best image quality was found at 60%. Image quality of proximal segments did not significantly vary with the temporal window, whereas for all other segments image quality was significantly better at 60% compared with other temporal windows (P<0.05). Sixty-four-slice CT provides best image quality of various segments and types of CABG at 60% of the RR-interval. [ABSTRACT FROM AUTHOR]

Anomalous coronary artery (ACA) has either an unusual origin or different anatomical course and is associated with sudden cardiac death. The absence or nonspecific symptoms of ACA make its diagnosis difficult. Mostly, ACA is diagnosed coincidentally during invasive coronary angiogram (ICA). A conventional computed tomography (CT) cannot provide detailed images of coronary arteries of the moving heart, but 64-slice CT, with its short acquisition time, can provide detailed anatomy of coronary arteries non-invasively. In this study, we assessed the validity of contrast-enhanced 64-slice CT in the evaluation of ACA. ICA was performed in 7,574 patients for the diagnosis or evaluation of occlusive coronary artery disease and detected coronary anomalies in 56 patients (0.7%). We then performed 64-slice CT in 53 patients out of the 56 patients with demonstrated or suspected coronary anomaly, showing the origin and the course of the ACA along with stenosis, except for one patient who could not be evaluated due to image distortion artifacts. Contrast-enhanced 64-slice CT was also performed in 374 patients with vague signs and symptoms, detecting coronary anomalies in 7 patients (1.2%). Thus, in the total of 59 patients undergone 64-slice CT, we were able to visualize the entire abnormal coronary tree with a high diagnostic image quality. This is the first study to demonstrate the utility of 64-slice CT in a large series of ACA. Contrast-enhanced 64-slice CT is superior to ICA to identify the presence and course of ACA and should be the first line diagnostic tool in the evaluation of ACA. [ABSTRACT FROM AUTHOR]

Abstract: Coronary artery disease is the leading cause of death in the United States. Invasive coronary angiography is the accepted reference standard for the assessment of coronary artery stenoses. However, noninvasive imaging techniques such as the 64-slice computed tomography (CT) are promising new methods in detecting coronary artery stenoses. This article reviews indications and benefits of using he 64-slice CT scan in detecting coronary artery disease and its implications for nurse practitioners in identifying patients at risk of coronary artier disease. [Copyright &y& Elsevier]

Abstract: Introduction: 64-Slice computed tomography (CT) has been introduced with high expectations. This study illustrates the value of 64-slice CT for the diagnosis of significant coronary artery stenoses when images are analysed by cardiovascular surgeons. Methods: Fifty patients (39 males, 11 females) underwent invasive coronary angiography and 64-slice CT. In these patients, 40 had coronary artery disease and 10 patients had valvular disease. Evaluation of right coronary artery (RCA), left main (LM), left anterior descending artery (LAD), diagonal branch 1 (D1), circumflex branch (CX), and 1st marginal branch was performed by two cardiovascular surgeons. All vessels with a diameter ≥1.5mm were analysed and a lumen restriction of >50% was considered a significant stenosis. CT image quality was classified as excellent, reduced but still diagnostic, and not assessable. Invasive coronary angiography was taken as gold standard for calculations of diagnostic accuracy. Results: Mean heart rate during CT scan was 65±11 beats per minute (bpm). Image quality of 92% (506/550) of all segments was rated as excellent, 5% (27/550) were rated as being of reduced quality but still diagnostic, and 3% (17/550) were considered not assessable. The sensitivity for diagnosing a significant stenosis with CT when including all reliably evaluated segments was 93% (106/114), specificity was 97% (381/392), positive predictive value was 91% (106/117), and negative predictive value was 98% (381/389). Conclusion: 64-Slice CT provides a high diagnostic accuracy in assessing significant coronary artery stenosis. Nevertheless, still exist some disadvantages such as strong vessel wall calcifications reducing the reliability for image interpretation. At the moment, 64-slice CT should be used as a complementary imaging modality to invasive coronary angiography. [Copyright &y& Elsevier]

The purpose of this study was to evaluate the influence of ejection fraction (EF), stroke volume (SV), heart rate, and cardiac output (CO) on coronary artery opacification with 64-slice computed tomography (CT). Sixty patients underwent, retrospectively, electrocardiography-gated 64-slice CT coronary angiography. Left ventricular EF, SV, and CO were calculated with semi-automated software. Attenuation values were measured and contrast-to-noise ratios (CNRs) were calculated in the proximal right coronary artery (RCA) and left main artery (LMA). Mean EF during scanning was 61.5+/-12.4%, SV was 63.2+/-15.6 ml, heart rate was 62.5+/-11.8 beats per minute (bpm), and CO was 3.88+/-1.06 l/min. There was no significant correlation between the EF and heart rate and the attenuation and CNR in either coronary artery. A significant negative correlation was found in both arteries between SV and attenuation (RCA r=-0.26, P<0.05; LMA r=-0.34, P<0.01) and between SV and CNR (RCA r=-0.26, P<0.05; LMA r=-0.26, P<0.05). Similarly, a significant negative correlation was found between the CO and attenuation (RCA r=-0.42, P<0.05; LMA r=-0.56, P<0.001) and between the CO and CNR (RCA r=-0.39, P<0.05; LMA r=-0.44, P<0.001). The actual hemodynamic status of the patient influences the coronary artery opacification with 64-slice CT, in that vessel opacification decreases as SV and CO increase. [ABSTRACT FROM AUTHOR]

In children, myocardial bridge is an inborn coronary anomaly and is usually found in the patients with hypertrophic cardiomyopathy or left ventricular hypertrophy. Myocardial bridges were long thought to be a benign anatomical variant, even in patients with obstructive and non-obstructive hypertrophic cardiomyopathy. However some patients suffer from myocardial infarction, arrhythmia and even sudden cardiac death. In the present report, we describe a 7-year-old girl with the manifestation of recurrent precordial discomfort, and subsequently diagnosed as having an isolated myocardial bridge in the distal segment of left anterior descending coronary artery using 64-slice computed tomography coronary angiography. [ABSTRACT FROM AUTHOR]

Objective Coronary artery anomaly (CAA) is a remarkable etiological factor for sudden cardiac death in young adults. The incidence of CAA is unknown, with most reliable data available based on postmortem/angiography investigations. This study aimed to assess the prevalence of different forms of coronary anomalies, and to investigate the relationships between demographic data and occurrence of CAA. Methods A total of 2401 consecutive patients (1805 men; mean age, 56 ± 11.7 years), who were referred between January 2005 and December 2008 for noninvasive multi-slice computed tomography (MSCT) imaging, were retrospectively analysed. Results A total of 225 cases (191 men; mean age, 55.9 ± 12) of CAAs were identified (9.37%). Because 11 patients had multiple muscular bridges of the coronary arteries, 236 coronary artery anomalies were found in these 225 patients. Cases were classified into three groups: group 1, coronary anomalies of origin and distribution (n = 36, 1.5%); group 2, anomalies of intrinsic coronary arterial anatomy (n = 180, 7.49%); and group 3, anomalies of coronary termination (n = 9, 0.4%). Conclusion The prevalence of CAA was 9.37% in our single-centre study, which is consistent with previous research. A minimally invasive tool, such as MSCT angiography, should be used to identify CAA.

Abstract: Coronary–pulmonary artery fistula is an uncommon congenital cardiac anomaly. Most coronary–pulmonary artery fistulas are clinically and haemodynamically non-significant and they are usually found incidentally. We report a case of a woman admitted to our hospital for symptoms of myocardial ischemia in which MSCT allowed us to do the right diagnosis, with high-quality images and in a non-invasive way. [Copyright &y& Elsevier]

Aim: To investigate the role of 64-slice computed tomography (CT) in portal vein cavernous transformation to determine surgical strategy., Methods: The site of lesions and extent of collateral circulation in 12 pediatric cases of cavernous transformation of the portal vein with surgical treatment were analyzed., Results: Eleven of 12 children had esophageal varices and were treated with lower esophageal and gastric devascularization and splenectomy, and the other case was only treated with splenectomy. There were eight cases with spontaneous spleen/stomach-renal shunt, four with Retzius vein opening, which was reserved during surgery. Three cases of lesions involving the intrahepatic portal vein (PV) were treated with living donor liver transplantation. One patient died from PV thrombosis after liver transplantation, and the rest had no significant complications., Conclusion: The PV, its branches and collateral circulation were clearly seen by 64-slice spiral CT angiography, which helped with preoperative surgical planning.