Assuntos
Aneurisma Aórtico , Ruptura Aórtica , Insuficiência da Valva Aórtica , Comunicação Interventricular , Seio Aórtico , Humanos , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/cirurgia , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/cirurgiaRESUMO
Sepsis is a clinical syndrome caused by a dysregulated host response to infection that can lead to multiple organ dysfunction and death. Cardiovascular abnormalities are frequent in sepsis and may result in myocardial injury unrelated to coronary artery disease. Myocardial calcification is a rare complication of sepsis, which shows rapid-onset extensive myocardial calcifications. We present a case of a 67-year-old man who developed severe sepsis complicated with shock, acute renal failure, and acute respiratory distress syndrome. Initial chest computed tomography (CT) on admission showed normal left ventricular (LV) myocardial attenuation. However, serial chest CT demonstrated a gradual increase of the LV myocardial attenuation, which ultimately resulted in extensive myocardial calcification within 6 weeks. Sepsis-related myocardial calcification is usually found in patients with severe sepsis complicated with hemodynamic failure requiring vasopressors, acute renal failure necessitating renal replacement therapy, and acute respiratory distress syndrome. Although the prognostic significance of this pathology is unclear, it may be a precursor to long-term irreversible cardiomyopathy or an arrhythmogenic substrate that induces life-threatening arrhythmias. Therefore, patients who have survived the acute phase of severe sepsis need to be monitored carefully for signs of this complication by an imaging modality such as CT.
Assuntos
Fístula Artério-Arterial/diagnóstico , Aneurisma Coronário/diagnóstico , Vasos Coronários/diagnóstico por imagem , Imagem Multimodal/métodos , Artéria Pulmonar/anormalidades , Idoso , Fístula Artério-Arterial/complicações , Angiografia por Tomografia Computadorizada , Aneurisma Coronário/complicações , Ecocardiografia , Feminino , Humanos , Artéria Pulmonar/diagnóstico por imagemAssuntos
Angiografia Digital/métodos , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Reestenose Coronária/diagnóstico , Vasos Coronários/diagnóstico por imagem , Intervenção Coronária Percutânea/efeitos adversos , Stents/efeitos adversos , Idoso , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/cirurgia , Humanos , Masculino , Valor Preditivo dos Testes , Falha de PróteseRESUMO
Left ventricular (LV) involvement in the advanced stage of arrhythmogenic right ventricular cardiomyopathy (ARVC) is a well recognized phenomenon. T wave inversion in the lateral leads has been reported to be an electrocardiographic marker of LV involvement. Variants of ARVC that preferentially affect the left ventricle (left-dominant subtype of arrhythmogenic cardiomyopathy) have recently been recognized. We herein report a case in which an initial electrocardiogram that was similar to the left-dominant subtype of arrhythmogenic cardiomyopathy progressed to definitive ARVC over a period of 7 years. This case supports the hypothesis that LV involvement in ARVC may precede the evident onset of significant RV dysfunction.
Assuntos
Displasia Arritmogênica Ventricular Direita/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Arritmias Cardíacas/fisiopatologia , Displasia Arritmogênica Ventricular Direita/diagnóstico , Cardiomiopatias/fisiopatologia , Progressão da Doença , Eletrocardiografia/métodos , Seguimentos , Sistema de Condução Cardíaco/fisiopatologia , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Disfunção Ventricular Esquerda/diagnósticoAssuntos
Artéria Gastroepiploica/anormalidades , Artéria Gastroepiploica/diagnóstico por imagem , Artéria Mesentérica Superior/anormalidades , Artéria Mesentérica Superior/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Artéria Celíaca/anormalidades , Artéria Celíaca/diagnóstico por imagem , Ponte de Artéria Coronária , Humanos , MasculinoRESUMO
The advantage of the higher signal-to-noise ratio (SNR) of 3-Tesla magnetic resonance imaging (3-Tesla) has the possibility of contributing to the improvement of high spatial resolution without causing image deterioration. In this study, we compared SNR and the apparent diffusion coefficient (ADC) value with 3-Tesla as the condition in the diffusion-weighted image (DWI) parameter of the 1.5-Tesla magnetic resonance imaging (1.5-Tesla) and we examined the high spatial resolution images in the imaging method [respiratory-triggering (RT) method and breath free (BF) method] and artifact (motion and zebra) in the upper abdominal region of DWI at 3-Tesla. We have optimized scan parameters based on phantom and in vivo study. As a result, 3-Tesla was able to obtain about 1.5 times SNR in comparison with the 1.5-Tesla, ADC value had few differences. Moreover, the RT method was effective in correcting the influence of respiratory movement in comparison with the BF method, and image improvement by the effective acquisition of SNR and reduction of the artifact were provided. Thus, DWI of upper abdominal region was a useful sequence for the high spatial resolution in 3-Tesla.