Prospective Coronary CT Angiography 128-MDCT Versus Retrospective 64-MDCT: Improved Image Quality and Reduced Radiation Dose.

OBJECTIVE: new technologies for computed tomography coronary arteries imaging aim to reduce the radiation dose whilst maintaining image quality. The purpose of our study was to compare radiation dose and image quality parameters of Coronary Computed Tomography Angiography (CCTA) performed with retrospective 64-MDCT and prospective 128-MDCT. PATIENTS AND METHODS: a series of 77 consecutive patients were first randomised to either retrospective 64-MDCT (n=37) or prospective 128-MDCT (n=40) for CCTA. All patients in the retrospective 64-MDCT group were scanned with tube current modulation as strategy for reduction dose. Data regarding acquisition time and radiation dose were recorded. Two blinded radiologists independently assessed image quality of all coronary segments by using a four-point scale (1, excellent; 4, poor). Discrepancies were settled by consensus. RESULTS: No significant differences were found regarding sex, age, body weight and heart rate. CTTA effective radiation dose was 2.1 ± 0.9 vs. 8.2 ± 4mSv in prospective and retrospective ECG-gating MDCT groups, respectively. Mean image quality score was 2.2 ± 0.9 for prospective 128-MDCT group and 1.4 ± 0.7 points for retrospective 64-MDCT representing a mean difference of 0.8 points (CI: 0.9 to 0.7). CONCLUSION: in selected patients, CCTA using a 128-MDCT with prospective ECG-gating provides higher image quality with significant lower radiation dose when compared to 64-MDCT using retrospective ECG-gating.

Left ventricular apical diseases.

There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

Kawasaki disease: a review with emphasis on cardiovascular complications.

Kawasaki disease (KD) is an acute systemic vasculitis that is currently the leading cause of acquired heart disease in childhood in the United States. Cardiovascular complications are the major cause of morbidity, are responsible for virtually all deaths from KD and should be evaluated as soon as possible after the acute phase to establish the baseline status, in order to predict disease progression and determine adequate treatment. In selected patients, electrocardiography (ECG)-gated cardiac computed tomography (CT) and magnetic resonance (MR) imaging are valuable non-invasive techniques that can be used to help diagnose the cardiovascular complications associated with KD. In this article, we review the epidemiology, aetiology and pathogenesis, histopathology, clinical features, cardiovascular complications and imaging, focusing on the role of cardiac CT and MR on the initial assessment and follow-up of the cardiovascular complications of KD.