RESUMEN
Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic that has affected nearly 600 million people to date across the world. While COVID-19 is primarily a respiratory illness, cardiac injury is also known to occur. Cardiovascular magnetic resonance (CMR) imaging is uniquely capable of characterizing myocardial tissue properties in-vivo, enabling insights into the pattern and degree of cardiac injury. The reported prevalence of myocardial involvement identified by CMR in the context of COVID-19 infection among previously hospitalized patients ranges from 26 to 60%. Variations in the reported prevalence of myocardial involvement may result from differing patient populations (e.g. differences in severity of illness) and the varying intervals between acute infection and CMR evaluation. Standardized methodologies in image acquisition, analysis, interpretation, and reporting of CMR abnormalities across would likely improve concordance between studies. This consensus document by the Society for Cardiovascular Magnetic Resonance (SCMR) provides recommendations on CMR imaging and reporting metrics towards the goal of improved standardization and uniform data acquisition and analytic approaches when performing CMR in patients with COVID-19 infection.
Asunto(s)
COVID-19 , Cardiopatías , Imagen por Resonancia Magnética , Humanos , COVID-19/complicaciones , Corazón/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/normas , Espectroscopía de Resonancia Magnética , Miocarditis/diagnóstico por imagen , Valor Predictivo de las Pruebas , Cardiopatías/diagnóstico por imagen , Cardiopatías/etiologíaRESUMEN
The early career professionals in the field of Cardiovascular Magnetic Resonance (CMR) face unique challenges and hurdles while establishing their careers in the field. The Society for Cardiovascular Magnetic Resonance (SCMR) has expanded the role of the early career section within the society to foster the careers of future CMR leaders. This paper aims to describe the obstacles and available opportunities for the early career CMR professionals worldwide. Societal opportunities and actions targeted at the professional advancement of the early career CMR imagers are needed to ensure continuous growth of CMR as an imaging modality globally.
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Enfermedades Cardiovasculares , Humanos , Enfermedades Cardiovasculares/diagnóstico por imagen , Valor Predictivo de las Pruebas , Imagen por Resonancia Magnética , Espectroscopía de Resonancia MagnéticaRESUMEN
BACKGROUND: To ascertain presence of physiological uptake and derive standardized uptake values (SUV) of 68Ga-DOTANOC in normal myocardium and establish reference values. METHODS AND RESULTS: Dedicated cardiac 68Ga-DOTANOC PET/CT studies of patients referred for evaluation of cardiac sarcoidosis (CS) or myocarditis and found to be normal on visual assessment and on cardiac MRI were analyzed semiquantitatively. The studies were acquired 45-60 minutes after intravenous injection of 111-185 MBq of 68Ga-DOTANOC. Myocardial SUVmax normalized to lean body mass (SUVmax_lbm) values for septum, anterior wall, proximal lateral wall, distal lateral wall, inferior wall, and apical region were 1.12 ± .39, 1.09 ± .42, 1.26 ± .49, 1.16 ± .40, 1.23 ± .39, and 1.05 ± .40, respectively. Myocardial SUVmax_lbm-to-blood pool SUVmean_lbm ratios were calculated for each region and 95th percentile values of these ratios were considered the upper limit of normal. 95th percentile values of myocardial SUVmax_lbm-to-blood pool SUVmean_lbm ratio for the corresponding regions were 1.70, 1.70, 2.00 1.95, 2.05, and 1.70, respectively. CONCLUSION: There can be physiological uptake of 68Ga-DOTANOC in normal myocardium and the reference values of semiquantitative parameters established in this study may be employed as a corroborative tool for visual assessment in patients undergoing 68Ga-DOTANOC PET/CT for suspected CS or myocarditis.
Asunto(s)
Miocarditis , Compuestos Organometálicos , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Radioisótopos de Galio , Radiofármacos , Valores de Referencia , MiocardioRESUMEN
This study includes a series of 5 cases demonstrating cardiovascular manifestations of findings of IgG4-related disease. Two cases demonstrate peri-aortic soft tissue thickening in the infrarenal abdominal aorta and bilateral ostio--proximal common iliac artery. In 2 cases there were circumferential soft tissue lesions around the arch of the aorta. One of the cases showed coexistent, biopsy-proven Riedel's thyroiditis and infiltrative soft tissue along the right atrial wall and interatrial septum. In one case there was a partly calcified mass in the left hemi-thorax consistent with a diagnosis of IgG4-related fibrosing mediastinitis.
RESUMEN
The 25th Society for Cardiovascular Magnetic Resonance (SCMR) Annual Scientific Sessions saw 1524 registered participants from more than 50 countries attending the meeting virtually. Supporting the theme "CMR: Improving Cardiovascular Care Around the World", the meeting included 179 invited talks, 52 sessions including 3 plenary sessions, 2 keynote talks, and a total of 93 cases and 416 posters. The sessions were designed so as to showcase the multifaceted role of cardiovascular magnetic resonance (CMR) in identifying and prognosticating various myocardial pathologies. Additionally, various social networking sessions as well as fun activities were organized. The major areas of focus for the future are likely to be rapid efficient and high value CMR exams, automated and quantitative acquisition and post-processing using artificial intelligence and machine learning, multi-contrast imaging and advanced vascular imaging including 4D flow.
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Inteligencia Artificial , Sistema Cardiovascular , Humanos , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: Development of vaccines with high efficacy against COVID-19 disease has ushered a new ray of hope in the fight against the pandemic. Thromboembolic events have been reported after administration of vaccines. We aim to systematically review thromboembolic events reported after COVID-19 vaccination. METHODS: The available literature was systematically screened for available data on thromboembolic events after COVID-19 vaccination. Data were extracted from selected studies and analyzed for site of thromboembolism as well as other risk factors. All data were pooled to determine cumulative incidence of thromboembolism at various sites after vaccination. RESULTS: A total of 20 studies were selected for the final analysis. The mean age of the population was 48.5 ± 15.4 years (females - 67.4%). The mean time to event after vaccination was 10.8 ± 7.2 days. Venous thrombosis (74.8%, n = 214/286) was more common than arterial thrombosis (27.9%, n = 80/286). Cerebral sinus thrombosis was the most common manifestation (28.3%, n = 81/286) of venous thrombosis followed by deep vein thrombosis (19.2%, n = 49/254). Myocardial infarction was common (20.1%, n = 55/274) in patients with arterial thrombosis followed by ischemic stroke (8.02%, n = 22/274). Concurrent thrombosis at multiple sites was noted in 15.4% patients. Majority of patients had thrombocytopenia (49%) and antiplatelet factor 4 antibodies (78.6%). Thromboembolic events were mostly reported after the AstraZeneca vaccine (93.7%). Cerebral sinus thrombosis was the most common among thromboembolic events reported after the AstraZeneca vaccine. Among the reported cases, mortality was noted in 29.9% patients. CONCLUSIONS: Thromboembolic events can occur after COVID-19 vaccination, most commonly after the AstraZeneca vaccine. Cerebral sinus thrombosis is the most common manifestation noted in vaccinated individuals.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Tromboembolia , Trombosis , Adulto , Femenino , Humanos , Persona de Mediana Edad , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Trombosis de los Senos Intracraneales/inducido químicamente , Tromboembolia/inducido químicamente , Trombosis/inducido químicamente , Resultado del Tratamiento , Vacunación/efectos adversos , Trombosis de la Vena/inducido químicamenteRESUMEN
BACKGROUND: Automated centerline (CL) measurements have been conventionally used for stent-graft length estimation during thoracic endovascular aortic repair (TEVAR). The purpose of this study was to assess the accuracy of greater curvature length (GL), semiautomated CL and straightened centerline length (SCL) for preprocedural planning in TEVAR. METHODS: Immediate postprocedural CT Angiographies of 30 patients (22 males, age-49.2 ± 10.1years) who underwent TEVAR between 2015 and 2017 were retrospectively analyzed. CL, GL, SCL and the straightline length(SL) were measured between proximal and distal ends of the stent-graft and results were compared with the true length of the stent-graft (TL). Tortuosity index (TI = CL/SL) was calculated. RESULTS: GL (17.92 ± 4.78 cm) was the closest in predicting the TL (17.75 ± 4.29 cm) (P = 0.414) overall, as well as in both dissection and aneurysm subgroups (P= 0.9). There was a significant difference between CL (16.67 ± 4.07 cm) and TL (P< 0.0001) as well as between SCL (16.86 ± 4.16 cm) and TL (P= 0.001). These differences were greater in dissection subgroup than in the aneurysm group (P< 0.0001 and P= 0.03 for TL-CL and TL-SCL, respectively). The extent of mismatch between GL or CL and TL did not correlate with tortuosity, but the difference between TL and SCL had a significant positive correlation with tortuosity (r = 0.375, P= 0.04). TL-GL had a negative linear correlation with the stent-graft length (TL) in the dissection group (r = 0.50, P= 0.03). CONCLUSIONS: The greater curvature length predicts the actual total length of the deployed stent-graft more accurately than centerline or straightened centerline lengths. Hence, it should be used in planning for the length of stent-graft required for TEVAR.
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Aorta Torácica/anatomía & histología , Implantación de Prótesis Vascular , Prótesis Vascular , Procedimientos Endovasculares , Cuidados Preoperatorios , Adulto , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Stents , Tomografía Computarizada por Rayos XRESUMEN
We present a case of a 6-year-old girl with tetralogy of Fallot (TOF) and hypoplastic aortic arch with anomalous origin of left common carotid artery from the ascending aorta. The case highlights the importance of screening for abnormalities of aortic arch and arch vessels in TOF patients for accurate presurgical planning and to predict the postoperative outcomes.
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Coartación Aórtica , Cardiopatías Congénitas , Tetralogía de Fallot , Femenino , Humanos , Niño , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aorta Torácica/anomalías , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/cirugía , Aorta/cirugía , Cardiopatías Congénitas/complicaciones , Coartación Aórtica/cirugía , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/cirugíaRESUMEN
We hereby present a case of intrapulmonary invagination of the left internal mammary artery detected on CT angiography. We aim to highlight the role of CT angiography in identifying these course anomalies and their clinical implications.
Asunto(s)
Anomalías de los Vasos Coronarios , Arterias Mamarias , Humanos , Angiografía por Tomografía Computarizada , Arterias Mamarias/diagnóstico por imagen , Arterias Mamarias/cirugía , Anomalías de los Vasos Coronarios/cirugía , Periodo Posoperatorio , Angiografía CoronariaRESUMEN
We hereby present a case of congenitally corrected transposition of great arteries association of bicuspid aortic valve morphology and anomalous separate origin of the right ventricular branch of the right coronary artery. We aim to highlight the role of computed tomography angiography in identifying these rare associations.
Asunto(s)
Enfermedad de la Válvula Aórtica Bicúspide , Transposición de los Grandes Vasos , Angiografía , Transposición Congénitamente Corregida de las Grandes Arterias , Vasos Coronarios , Humanos , Transposición de los Grandes Vasos/complicaciones , Transposición de los Grandes Vasos/diagnóstico por imagen , Transposición de los Grandes Vasos/cirugíaRESUMEN
We hereby present a case of a unique intrathymic course of left brachiocephalic vein in a patient with Tetralogy of Fallot and aberrant right subclavian artery deciphered on computed tomography angiography.
Asunto(s)
Anomalías Cardiovasculares , Tetralogía de Fallot , Aorta Torácica , Venas Braquiocefálicas/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Humanos , Arteria Subclavia/cirugía , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/cirugíaRESUMEN
AIM: To study the imaging characteristics and the associations of left atrioventricular valve atresia with patent aortic root and lateralized atrial chambers on multidetector computed tomography (CT) angiography. MATERIALS AND METHODS: We retrospectively evaluated all the CT angiography studies performed for the evaluation of various congenital heart diseases at our center from January 2014 to December 2021. Cases with left atrioventricular valve atresia and patent aortic root with lateralized atrial chambers were identified. The types of cardiovascular involvement as identifiable on CT angiography were studied and compiled. RESULTS: A total of 38 patients with left atrioventricular valve atresia and patent aortic root were included (median age: 5 months, males: 31). A total of 89.5% had usual atrial arrangement and 10.5% had mirror imagery of atria. Normal drainage of right and left superior caval veins and inferior caval vein into systemic venous atrium was seen in 77.8%, 61.5%, and 86.6%, respectively. Anomalous pulmonary venous drainage was seen in 3 (7.9%) patients. Atrial and ventricular septal defects were the most common associations. Imperforate left atrioventricular membrane was seen in 9 (23.7%) patients and absent left atrioventricular connection in 27 (71.1%). Discordant right atrioventricular connection was seen in 5 (13.1%) patients. While a double outlet right ventricle (76.3%) was the most common ventriculoarterial connection, discordant ventriculo-arterial connection (transposition) in 4 (10.5%). Most patients had good sized pulmonary arteries. Patent arterial duct and right aortic arch were seen in 29% and 21%, respectively. Aberrant right subclavian artery was the most common arch vessel anomaly. Coronary anomalies were seen in 7 patients (19%); single coronary artery being the most common. CONCLUSIONS: Majority of the patients with left atrioventricular valve atresia and patent aortic root with lateralized atrial chambers have usual atrial arrangement, normal right atrioventricular connections and a double outlet configuration of the right ventricle. Absent left atrioventricular connection is a more common than imperforate left atrioventricular valve membrane. Atrial and ventricular septal defects are the most common associations. Comprehensive CT based evaluation of vascular and nonvascular thoracic structures is imperative before surgery or interventions in patients with mitral atresia.
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Cardiopatías Congénitas , Defectos del Tabique Interventricular , Situs Inversus , Atrios Cardíacos/cirugía , Cardiopatías Congénitas/diagnóstico por imagen , Ventrículos Cardíacos/cirugía , Humanos , Lactante , Masculino , Tomografía Computarizada Multidetector , Estudios Retrospectivos , Vena Cava SuperiorRESUMEN
We report an 11-year-old child with double-chambered right ventricle detected on echocardiography in whom computed tomography (CT) angiography revealed a rare arch anomaly double aortic arch with atretic left arch. This case highlights the ability of CT angiography in identifying such cardiovascular anomalies which have clinical and surgical implications.
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Anillo Vascular , Angiografía , Aorta Torácica/anomalías , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Niño , Angiografía por Tomografía Computarizada , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Tomografía Computarizada por Rayos X/métodosRESUMEN
We hereby present a patient with tetralogy of Fallot in whom a carotid trunk and aberrant right subclavian artery (arising just next to the origin of the left subclavian artery) were diagnosed on computed tomography (CT) angiography. We aim to highlight the role of CT angiography in identifying these rare aortic arch branching anomalies, which are crucial information for the operating surgeon.
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Cardiopatías Congénitas , Tetralogía de Fallot , Aorta Torácica/anomalías , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Anomalías Cardiovasculares , Cardiopatías Congénitas/complicaciones , Humanos , Arteria Subclavia/anomalías , Arteria Subclavia/diagnóstico por imagen , Arteria Subclavia/cirugía , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/cirugíaRESUMEN
We hereby present a case of tetralogy of Fallot with duplicated brachiocephalic vein having a preaortic and a subaortic component. We aim to highlight the role of computed tomography angiography in identifying these rare associations of tetralogy of Fallot.
Asunto(s)
Anomalías Cardiovasculares , Tetralogía de Fallot , Anillo Vascular , Angiografía , Venas Braquiocefálicas/anomalías , Humanos , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/cirugíaRESUMEN
We report a case of a 5-year-old child with tetralogy of Fallot-pulmonary atresia with anomalous origin of left pulmonary artery from ascending aorta and right lung supplied by collateral arteries. This case highlights the role of preoperative CT angiography in differentiating this entity from a common arterial trunk with discontinuous pulmonary arteries.
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Atresia Pulmonar , Tetralogía de Fallot , Anomalías Múltiples , Aorta/anomalías , Aorta/diagnóstico por imagen , Aorta/cirugía , Preescolar , Humanos , Pulmón/anomalías , Enfermedades Pulmonares , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Atresia Pulmonar/diagnóstico por imagen , Atresia Pulmonar/cirugía , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/cirugíaRESUMEN
AIM: The present study sought to study the imaging associations of left atrioventricular valve (mitral) atresia and patent aortic root in patients with isomerism of atrial appendages as detected on multidetector computed tomography (CT) angiography MATERIALS AND METHODS: The CT angiography studies performed at a tertiary medical center from January 2014 to December 2021 were retrospectively evaluated to identify patients with left atrioventricular valve atresia and patent aortic root with isometric atrial chambers. The morphology of the atrial appendage and extent of pectinate muscles was used to identify the type of isomeric atrial chambers. A comprehensive assessment of discordant arrangement of organs and the variations in venoatrial connections was done. RESULTS: Left atrioventricular valve atresia in the presence of patent aortic root and isomeric atrial appendages was identified in eight patients (four males). The mean age at diagnosis was 7 years. Right isomerism of the atrial appendages was seen in five patients while three patients had left isomerism. Disharmonious patterns of abdominal visceral arrangement were seen in two patients. Atrial and ventricular septal defects were seen in all patients. The most common pattern of ventricular arterial connection was DORV (double outlet right ventricle) (n = 4). While five patients had normally related great arteries, three had aorta anterior to the pulmonary trunk. Right ventricular outflow obstruction was seen in seven patients. Right aortic arch with mirror image branching was seen in four patients. Coronary artery anomalies were seen in four patients. CONCLUSIONS: The presence of left atrioventricular valve atresia and patent aortic root with isomeric atrial appendages is a rare congenital anomaly frequently associated with anomalous systemic and pulmonary drainage, conotruncal anomalies, and right ventricular outflow obstruction. Hence, comprehensive CT-based evaluation is indispensable in providing detailed anatomy and aids in presurgical planning.
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Apéndice Atrial , Ventrículo Derecho con Doble Salida , Cardiopatías Congénitas , Obstrucción del Flujo Ventricular Externo , Aorta , Apéndice Atrial/diagnóstico por imagen , Humanos , Masculino , Tomografía Computarizada Multidetector , Estudios RetrospectivosRESUMEN
BACKGROUND: Temporal lobe epilepsy (TLE) is the most common cause of partial seizures. However, there is a paucity of data on the correlation of clinical and semiological features of TLE with specific imaging findings on magnetic resonance imaging (MRI). OBJECTIVE: In this study, we sought to evaluate the association between the semiology of TLE with specific etiological findings as identified on MRI. MATERIALS AND METHODS: This was a single-center, observational study in which consecutive patients presenting with clinical features diagnostic of TLE underwent a brain MRI on a 1.5 T scanner. The data collected from the various MR parameters were then correlated with history. RESULTS: A total of 90 patients were included in the study. The mean age of the study population was 29.1 years. Females comprised 45% of the study population. Mesial temporal sclerosis (MTS) was the most common imaging finding in about 60% of patients. Four out of five patients had aura whereas 70% had automatisms. The presence of aura in TLE patients was significantly associated with MTS on MRI (p = 0.042). The presence of automatism and history of childhood febrile seizure did not have a significant association with any specific etiological findings on MRI (p = 0.254 and 0.731, respectively). Drug-refractory epilepsy was commonly associated with the presence of MTS on MRI (p = 0.004). The presence of dual pathology on MRI was associated with drug-refractory epilepsy (p = 0.031). CONCLUSIONS: The presence of aura and drug-refractory epilepsy point towards the presence of MTS. Dual pathology, on MRI, in TLE patients may be a risk factor for drug-refractory epilepsy.
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Epilepsia Refractaria , Epilepsia del Lóbulo Temporal , Esclerosis del Hipocampo , Femenino , Humanos , Adulto , Masculino , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia Refractaria/diagnóstico por imagen , Encéfalo , Fiebre , Imagen por Resonancia Magnética , ElectroencefalografíaRESUMEN
OBJECTIVE: Myocardial iron overload (MIO) in thalassemia major (TM) may cause subclinical left ventricular (LV) dysfunction which manifests with abnormal strain parameters before a decrease in ejection fraction (EF). Early detection of MIO using cardiovascular magnetic resonance (CMR)-T2* is vital. Our aim was to assess if CMR feature-tracking (FT) strain correlates with T2*, and whether it can identify early contractile dysfunction in patients with MIO but normal EF. METHODS: One hundred and four consecutive TM patients with LVEF > 55% on echocardiography were prospectively enrolled. Those fulfilling the inclusion criteria underwent CMR, with T2* being the gold standard for detecting MIO. Group 1 included patients without significant MIO (T2* > 20 ms) and group 2 with significant MIO (T2* < 20 ms). RESULTS: Eighty-six patients (mean age, 17.32 years, 59 males) underwent CMR. There were 68 (79.1%) patients in group 1 and 18 (20.9%) in group 2. Fourteen patients (16.3%) had mild-moderate MIO, and four (4.6%) had severe MIO. Patients in group 2 had significantly lower global radial strain (GRS). Global longitudinal strain (GLS) and global circumferential strain (GCS) did not correlate with T2*. T1 mapping values were significantly lower in patients with T2* < 10 ms than those with T2* of 10-20 ms; however, FT-strain values were not significantly different between these two groups. CONCLUSION: CMR-derived GRS, but not GLS and GCS, correlated with CMR T2*. GRS is significantly decreased in TM patients with MIO and normal EF when compared with those without. FT-strain may be a useful adjunct to CMR T2* and maybe an early marker of myocardial dysfunction in TM. KEY POINTS: ⢠A global radial strain of < 29.3 derived from cardiac MRI could predict significant myocardial iron overload in patients with thalassemia, with a sensitivity of 76.5% and specificity of 66.7%. ⢠Patients with any myocardial iron overload have significantly lower GRS, compared to those without, suggesting the ability of CMR strain to identify subtle myocardial contractile disturbances. ⢠T1 and T2 mapping values are significantly lower in those with severe myocardial iron than those with mild-moderate iron, suggesting a potential role of T1 and T2 mapping in grading myocardial iron.
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Cardiomiopatías , Sobrecarga de Hierro , Disfunción Ventricular Izquierda , Talasemia beta , Adolescente , Cardiomiopatías/diagnóstico por imagen , Humanos , Sobrecarga de Hierro/complicaciones , Sobrecarga de Hierro/diagnóstico por imagen , Imagen por Resonancia Cinemagnética , Espectroscopía de Resonancia Magnética , Masculino , Miocardio , Disfunción Ventricular Izquierda/diagnóstico por imagen , Función Ventricular Izquierda , Talasemia beta/complicaciones , Talasemia beta/diagnóstico por imagenRESUMEN
We describe the case of a 45-year-old man, with a history of blunt trauma to the chest 2 years back, presenting with diastolic dysfunction secondary to the development of a large, organized, intrapericardial hematoma. The case highlights the possibility of extremely delayed presentation in such cases and the importance of cardiac magnetic resonance imaging in making an accurate preoperative diagnosis and guiding optimal management strategies.