Appropriate use criteria for cardiovascular magnetic resonance imaging (CMR): SIC-SIRM position paper part 1 (ischemic and congenital heart diseases, cardio-oncology, cardiac masses and heart transplant).

Cardiac magnetic resonance (CMR) has emerged as new mainstream technique for the evaluation of patients with cardiac diseases, providing unique information to support clinical decision-making. This document has been developed by a joined group of experts of the Italian Society of Cardiology and Italian society of Radiology and aims to produce an updated consensus statement about the current state of technology and clinical applications of CMR. The writing committee consisted of members and experts of both societies who worked jointly to develop a more integrated approach in the field of cardiac radiology. Part 1 of the document will cover ischemic heart disease, congenital heart disease, cardio-oncology, cardiac masses and heart transplant.

Correlation between epicardial fat and cigarette smoking: CT imaging in patients with metabolic syndrome.

BACKGROUND: The aim of our study was to assess the relationship between cigarette smoking and epicardial fat in a cohort of patients with metabolic syndrome (MetS) at risk for coronary artery disease. METHODS: We studied, in primary prevention, 54 subjects diagnosed with MetS. According to their smoking habits, the subjects were divided into two groups: smokers and non-smokers. Besides anthropometric characterization and screening laboratory tests, the subjects had a multidetector computerized tomography scan, which allowed epicardial fat quantification and calcium score (CS) evaluation. RESULTS: Compared with non-smokers, smokers showed older age (61.6 ± 1.8 vs 56.8 ± 1.2 yrs; p < 0.05). Also, the smokers displayed increased epicardial fat volume (138 [123; 150] vs 101[79; 130] ml; p < 0.01) as well as higher CS (94 [3; 301.5] vs 0 [0;10.2]; p < 0.001), in comparison with non-smokers. Notably, CS was positively correlated with smoking habit (rs 0.469; p < 0.01), epicardial fat (rs 0.377; p < 0.01), age (rs 0.502; p < 0.001) and uric acid (rs 0.498; p < 0.01). Accordingly, the associations between both CS or epicardial fat and cigarette smoking were still maintained after adjustment for age (r 0.317; p < 0.05; r 0.427; p < 0.01). Finally, multiple regression analysis showed that smoke was the variable that best predicted CS (R(2) 0.131; ß 0.362; p < 0.05) and epicardial fat (R(2) 0.177; ß 0.453; p = 0.01). CONCLUSIONS: Our findings suggest that, in subjects with MetS, cigarette smoking is an independent predictor of increased epicardial fat volume and higher CS.

Enhancement patterns of prostate cancer in dynamic MRI.

Our objective was to analyze fast-field-echo dynamic subtracted (FFE/DS) MRI data in prostate cancer, in order to recognize enhancement patterns of tumoral tissue in comparison with non-tumoral peripheral prostatic tissue. Eleven consecutive patients with prostate cancer were proposed for radical prostatectomy. Before surgery, all patients underwent endorectal coil MRI examination. In addition to standard sequences, a dynamic study was performed by FFE/DS to evaluate tumoral behavior after Gd-DTPA rapid infusion. Analysis of the imaging was made by the means of the time/signal intensity curve obtained during early contrast medium enhancement, sampling both the abnormal enhancing focal area and the opposite lobe at the level of the main prostatic tissue. A focal area of increased enhancement was observed in the site of the tumor in all cases. The time/intensity curve sampled on this area and compared with the opposite lobe demonstrated a high confidence interval of the difference of the data: mean tumor maximal intensity 1331 (SD 187) vs normal 470 (SD 139) and mean tumor rise time 103 s (SD 30) vs normal 250 (SD 38; p<0.01). In tumoral tissue, the enhancement percentage of signal intensity (SI%=pre-contrast minus post-contrast/pre-contrast x100) was 316.7%. At FFE/DS, there is a typical behavior of the time/intensity curve of contrast enhancement in prostatic cancer that might be employed in diagnosis of the disease.