Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.140
Filtrar
1.
Vestn Oftalmol ; 137(5. Vyp. 2): 248-254, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34669334

RESUMO

PURPOSE: To study the value of functional multislice computed tomography (MSCT) of the orbits in examination of patients with complex incomitant strabismus. MATERIAL AND METHODS: The study included 34 patients. In 8 (23.5%) out of 34 patients, strabismus occurred as the result of an orbital injury. In some patients, incomitant strabismus was a complication of: retrobulbar injection of drugs (4 cases (11.7%)); endoscopic sinus surgery (6 cases (17.6%)); reconstructive surgery of orbits (7 cases (20.6%)). In 9 cases (26.5%), incomitant strabismus was detected in patients with thyroid eye disease (TED), of them 5 (14.7%) had previously undergone balanced orbital decompression (BOD). All patients underwent functional MSCT of the orbits. RESULTS: Complete absence of the contractile function of the studied muscles was noted in 6 cases with loss of ocular motility in one or several directions of gaze. Contraction of the injured muscle and its fixation in the area of iatrogenic defect in the orbital wall was observed in 6 patients with severe limitation of ocular motility. limitation of the excursion of the inferior and/or medial rectus muscles due to their fixation in the fracture of the orbital wall was observed in 5 patients after orbital trauma. Signs of contracture of the inferior rectus muscle were revealed in 4 cases of strabismus that occurred after retrobulbar anesthesia. Pronounced increase in the lateral dimensions of the extraocular muscles was determined in 4 patients with TED, as well as in patients who had underwent BOD. Displacement of the lateral and medial rectus muscles into the formed bony windows with a change in the vector of their action was observed in patients who had underwent BOD. CONCLUSION: The data obtained with functional MSCT of the orbits in 34 patients allowed more accurate characterization of the oculomotor disorders and evaluation of the functional state of the extraocular muscles.


Assuntos
Órbita , Estrabismo , Movimentos Oculares , Humanos , Tomografia Computadorizada Multidetectores , Músculos Oculomotores/diagnóstico por imagem , Órbita/diagnóstico por imagem , Estrabismo/diagnóstico por imagem , Estrabismo/etiologia
2.
J Card Surg ; 36(12): 4604-4610, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34637169

RESUMO

AIM: To evaluate the morphology and associated cardiovascular abnormalities in patients with an anomalous subaortic course of brachiocephalic vein on multidetector computed tomography (CT) angiography. MATERIAL AND METHODS: A retrospective study was performed at a tertiary referral institute to identify patients with subaortic brachiocephalic vein on multidetector CT (MDCT) angiography using dual source CT scanner between January 2014 and July 2021. The morphology of the subaortic brachiocephalic vein along with the cardiovascular anatomy and associated anomalies were evaluated. RESULTS: Out of 4349 patients who had undergone MDCT angiography for evaluation of congenital heart diseases, we identified 126 (2.9%) patients with subaortic brachiocephalic vein. The subaortic brachiocephalic vein was left-sided in 125 patients while a right-sided subaortic brachiocephalic vein was identified in a patient with left isomerism. Common cardiovascular associations included tetralogy of Fallot (109/126; 88.1%), double outlet right ventricle (8/126; 6.3%) and common arterial trunk (5/126; 3.9%). The presence of a right aortic arch was seen in 78/126 (62%) patients. Some degree of right ventricular outflow obstruction was present in 119/126 (94.4%) patients; pulmonary stenosis was seen in 78 (62%) patients while pulmonary atresia was seen in 41 (32.5%) patients. CONCLUSION: A subaortic brachiocephalic vein can coexist with various complex congenital heart diseases, most commonly tetralogy of Fallot and commonly associated with right aortic arch and pulmonary stenosis/atresia. It is important to identify this anomalous course of brachiocephalic vein before performing surgical procedures or venous catheterization to avoid potential complications.


Assuntos
Veias Braquiocefálicas , Síndrome de Heterotaxia , Angiografia , Veias Braquiocefálicas/diagnóstico por imagem , Humanos , Tomografia Computadorizada Multidetectores , Estudos Retrospectivos
3.
J Card Surg ; 36(12): 4751-4753, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34643297

RESUMO

BACKGROUND: Ruptured interventricular septal aneurysms are rare. We present a case of an interventricular membranous septal aneurysm in a 7-year-old boy who presented with features of congestive heart failure, 2 years after undergoing a patch closure of perimembranous ventricular septal defect and tricuspid valve repair. Material and methods and results: Transthoracic echocardiography suggested the presence of an aneurysm that has ruptured into the right ventricle (RV), however, the precise origin of the aneurysm could not be identified on echocardiography. Subsequently, a computed tomography (CT) angiography was done which revealed that the aneurysm was originating from the membranous interventricular septum with evidence of rupture into the RV inflow. DISCUSSION: Due to its close proximity to the aortic annulus, an aneurysm of the membranous interventricular septum may be confused with a sinus of Valsalva aneurysm, especially if the former is associated with aortic regurgitation. CONCLUSION: This case highlights the importance of CT in the precise differentiation of these two abnormalities.


Assuntos
Aneurisma Aórtico , Comunicação Interventricular , Seio Aórtico , Septo Interventricular , Criança , Ecocardiografia , Comunicação Interventricular/diagnóstico por imagem , Comunicação Interventricular/cirurgia , Humanos , Masculino , Tomografia Computadorizada Multidetectores , Septo Interventricular/diagnóstico por imagem , Septo Interventricular/cirurgia
4.
JACC Cardiovasc Interv ; 14(19): 2158-2169, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34620395

RESUMO

OBJECTIVES: This study sought to investigate the impact of computed tomography (CT)-based area and perimeter oversizing on the incidence of paravalvular regurgitation (PVR) and valve hemodynamics in patients treated with the SAPIEN 3 transcatheter heart valve (THV). BACKGROUND: The incremental value of considering annular perimeter or left ventricular outflow tract measurements and the impact of THV oversizing on valve hemodynamics are not well defined. METHODS: The PARTNER 3 (Placement of Aortic Transcatheter Valves 3) trial included 495 low-surgical-risk patients with severe aortic stenosis who underwent THV implantation. THV sizing was based on annular area assessed by CT. Area- and perimeter-based oversizing was determined using systolic annular CT dimensions and nominal dimensions of the implanted THV. PVR, effective orifice area, and mean gradient were assessed on 30-day transthoracic echocardiography. RESULTS: Of 485 patients with available CT and echocardiography data, mean oversizing was 7.9 ± 8.7% for the annulus area and 2.1 ± 4.1% for the perimeter. A very low incidence of ≥moderate PVR (0.6%) was observed, including patients with minimal annular oversizing. Incidence of ≥mild PVR and need for procedural post-dilatation were inversely related to the degree of oversizing. For patients with annular dimensions suitable for 2 THV sizes, the larger THV with both area and perimeter oversizing was associated with the lowest incidence of ≥mild PVR (12.0% vs 43.4%; P < 0.0001). Left ventricular outflow tract area oversizing was not associated with PVR. THV prosthesis size, rather than degree of oversizing, had greatest impact on effective orifice area and mean gradient. CONCLUSIONS: In low-surgical-risk patients, a low incidence of ≥moderate PVR was observed, including patients with minimal THV oversizing. The degree of prosthesis oversizing had the greatest impact on reducing mild PVR and incidence of post-dilatation, without impacting valve hemodynamics. In selected patients with annular dimensions in between 2 valve sizes, the larger THV device oversized to both the annular area and perimeter reduced PVR and optimized THV hemodynamics.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Hemodinâmica , Humanos , Tomografia Computadorizada Multidetectores , Desenho de Prótese , Substituição da Valva Aórtica Transcateter/efeitos adversos , Resultado do Tratamento
5.
Braz J Med Biol Res ; 54(11): e11371, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550273

RESUMO

Dietary factors may influence the process of atherosclerosis and coronary artery calcification (CAC). This study assessed CAC and its association with dietary intake in asymptomatic men. We evaluated 150 asymptomatic men with mean age of 58.2±5.3 years. The dietary intake was assessed by the Food Consumption Register method. CAC was measured through multidetector computed tomography (MDCT) and assessed in accordance with the Agatston score. Modified Poisson regression model was used to estimate the effects of intake of different nutrients that are prevalent in moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals [95%CI]. An association was found between the intake of some nutrients and moderate/severe CAC. Lower carbohydrate intake (P=0.021) and higher lipid intake (P=0.006) were associated with moderate/severe CAC. After adjustment, the nutrients associated with the prevalence of moderate/severe CAC were carbohydrates (P=0.040), lipids (P=0.005), and saturated fatty acids (SFA) (P=0.013). A 1% increase in lipids and SFA intake caused an increase of 4% [95%CI: 1-7%] and 8% [95%CI: 2-14%] in the prevalence of moderate/severe CAC, respectively. A 1% increase of carbohydrate intake led to a 2% decrease in the likelihood of moderate/severe CAC [95%CI: 1-4%]. These conclusions showed that the higher intake of total lipids and SFA was associated with higher CAC scores, whereas higher carbohydrate intake was associated with lower CAC scores in asymptomatic men.


Assuntos
Aterosclerose , Doença da Artéria Coronariana , Calcificação Vascular , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Vasos Coronários/diagnóstico por imagem , Ingestão de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Fatores de Risco , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/epidemiologia
6.
J Pak Med Assoc ; 71(9): 2151-2155, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34580505

RESUMO

OBJECTIVE: To determine aortic root dimensions in younger patients presenting with chest pain. METHODS: The descriptive cross-sectional study was conducted at the Armed Forces Institute of Cardiology and the National Institute of Heart Diseases, Rawalpindi, Pakistan, from September 12, 2018, to March 11, 2019, and comprised patients of either gender aged 18-55 years presenting with chest pain falling into Canadian Cardiovascular Society class I-IV and dyspnoea falling into New York Heart Association class I-IV. Multi-slice computed tomography image acquisition was performed in a single breath-hold of about 5-10 seconds, while electrocardiogram gated synchronised data acquisition was done with 60-100ml contrast. Multiphase data-sets were reconstructed followed by data analysis. Required measurements were recorded with software caliper and tracer. Data was analysed using SPSS 23. RESULTS: Of the 330 patients, 236(71.5%) were males and 94(28.5%) were females. The overall mean age was 45.5±7.9 years. Bicuspid aortic valve was found in 3(0.9%) patients, while 327(99.1%) were tricuspid. Mean aortic valve area was 4.01±0.70cm2, mean aortic annular size was 21.9±2.37mm, sinotubular junction diameter was 23.9±3.45mm, and mean sinotubular junction height was 21.09±2.77mm. The mean diameter at sinuses of valsalva was 33.0±3.99mm. CONCLUSIONS: Mean aortic root dimensions and general morphology of the aortic valve was determined to establish normal reference values.


Assuntos
Estenose da Valva Aórtica , Valva Aórtica , Adulto , Valva Aórtica/diagnóstico por imagem , Canadá , Dor no Peito/diagnóstico por imagem , Dor no Peito/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores
7.
J Card Surg ; 36(12): 4537-4545, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34580919

RESUMO

BACKGROUND: The dual-filter Sentinel™ Cerebral Protection System (Sentinel-CPS) is increasingly used during transcatheter aortic valve replacement (TAVR). However, complex vascular anatomy may challenge Sentinel-CPS deployment. AIM OF THE STUDY: We sought to investigate the impact of anatomic features of the aortic arch and the supra-aortic arteries on technical device failure of Sentinel-CPS application. METHODS: Analysis of the multislice computed tomography pre-TAVR aortograms of all patients undergoing TAVR with Sentinel-CPS between 2016 and 2020 (n = 92) was performed. We investigated the impact of aortic arch anatomy, configuration, and the angles of the supra-aortic arteries, including the determination of vascular tortuosity index on device failure of Sentinel-CPS application. RESULTS: The Sentinel-CPS was applied successfully in 83 patients (90.2%). Device failure in nine patients (9.8%) was due to the infeasibility to perform correct deployment of both filters (n = 7) and to obtain peripheral radial access (n = 2). Patients with a failure of Sentinel-CPS application had a higher right subclavian tortuosity index (217 [92-324] vs. 150 [42-252], p = .046), a higher brachiocephalic tortuosity index (27 [5-51] vs. 10 [0-102], p = 0.033) and a larger angulation of the brachiocephalic artery (59° [22-80] vs. 39° [7-104], p = .014) compared with patients with successful application. A brachiocephalic angle more than 59° was predictive for device failure. No differences in aortic arch anatomy or common carotid artery tortuosity were detected between the groups. CONCLUSIONS: Brachiocephalic tortuosity was found to be associated with failure of Sentinel-CPS application. Filter-based usage should be avoided in TAVR patients with a brachiocephalic angle more than 59°.


Assuntos
Estenose da Valva Aórtica , Dispositivos de Proteção Embólica , Substituição da Valva Aórtica Transcateter , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Humanos , Tomografia Computadorizada Multidetectores , Desenho de Prótese , Fatores de Risco , Resultado do Tratamento
8.
J Card Surg ; 36(12): 4746-4748, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34553423

RESUMO

We present a case of berry syndrome and bovine aortic arch in a 2-month old child, detected on multidetector computed tomography.


Assuntos
Aorta Torácica , Aorta , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Humanos , Lactente , Tomografia Computadorizada Multidetectores , Síndrome
9.
World J Surg Oncol ; 19(1): 283, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34537058

RESUMO

BACKGROUND: To study the clinical value of miR-135 and miR-20a combined with multi-detector computed tomography (MDCT) in the diagnosis of gastric cancer (GC). METHOD: A total of 146 patients with GC admitted to our hospital from January 2017 to June 2019 were selected and enrolled in the GC group. Another 103 patients with gastritis received in the same period were selected for the non-GC group. Besides, 95 healthy subjects who received physical examination in our hospital were selected into the healthy control group. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of serum miR-135 and miR-20a for each group. MDCT was used for detecting the clinical staging map of the enrolled patients. Pearson's correlation analysis was used to analyze the correlation between serum miR-135 and miR-20a in patients with GC. The receiver operating characteristic (ROC) curve was drawn to analyze value of miR-135 and miR-20a in the diagnosis of GC. RESULTS: Compared with non-GC group and healthy control group, the levels of serum miR-135 and miR-20a increased significantly in the GC group, while no significant difference was found between non-GC group and healthy control group (P > 0.05). Analysis of the relationship with clinical characteristics showed that the expression of serum miR-135 and miR-20a in the GC group was significantly correlated with the progression of GC, TNM stage, degrees of differentiation, status of lymph node metastasis, and distant metastasis (P < 0.01). Pearson's correlation analysis results showed positive correlations between miR-135 and miR-20a (r = 0.634, P = 0.000). The ROC analysis results showed that the optimal diagnostic values of miR-135 and miR-20a for GC were 7.56 and 5.82 respectively. The area under the curve (AUC) was 0.873 and 0.793 respectively. The 95% confidence interval (CI) was 0.811-0.935 and 0.697-0.890 respectively. The sensitivity and specificity of miR-135 and miR-20a combined with MDCT in the diagnosis of GC were 90.41% and 93.20% respectively. The sensitivity of combined use was significantly higher than that of single detection (P < 0.01). CONCLUSION: There are high expression levels of serum miR-135 and miR-20a in patients with GC. A combined detection of miR-135 and miR-20a with MDCT can improve the diagnostic sensitivity of GC and improve the accuracy of the final diagnosis. Therefore, multiple combined detection is valuable in the diagnosis of GC.


Assuntos
MicroRNAs , Neoplasias Gástricas , Biomarcadores Tumorais/genética , Humanos , MicroRNAs/genética , Tomografia Computadorizada Multidetectores , Prognóstico , Curva ROC , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/genética
10.
Pol Arch Intern Med ; 131(10)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34569767

RESUMO

INTRODUCTION Transcatheter aortic valve implantation (TAVI) is an effective treatment of significant aortic stenosis. Paravalvular leaks (PVLs) are one of the most common complications after the procedure. OBJECTIVES The aim of this study was to assess whether the aortic root morphology affects the occurrence of PVL after TAVI. PATIENTS AND METHODS We enrolled 50 patients with bicuspid and 50 patients with tricuspid aortic valve who underwent multislice computed tomography (MSCT) and transthoracic echocardiography prior to TAVI. The dimensions of the aortic root were assessed by MSCT. PVL after TAVI was assessed by transthoracic echocardiography. Patients were divided in 2 groups according to the PVL severity: less than moderate PVL (n = 80) and moderate or worse PVL (n = 20), and comparisons between the groups were performed. RESULTS Patients with at least moderate PVL, compared with those with less than moderate PVL, had greater mean (SD) area (5.2 [1.1] cm2 vs 4.7 [0.8] cm2; P = 0.02), perimeter (8.4 [0.9] cm vs 7.9 [0.7] cm; P = 0.01), and long axis (29.5 [2.7] mm vs 28 [2.7] mm; P = 0.04) of the aortic annulus and greater mean (SD) area (5.3 [1.3] cm2 vs 4.7 [1.1] cm2; P = 0.04) and perimeter (8.6 [1.1] cm vs 8.1 [0.9] cm; P = 0.02) of the left ventricular outflow tract. In multivariable analysis, bicuspid aortic valve disease, interventricular septum hypertrophy, greater left ventricular outflow tract, and postdilatation were significant predictors of moderate PVL following TAVI. CONCLUSIONS The assessment of the aortic root morphology with MSCT can be helpful in predicting PVL after TAVI.


Assuntos
Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Tomografia Computadorizada Multidetectores , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Resultado do Tratamento
11.
Am J Cardiol ; 157: 85-92, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34404506

RESUMO

The pathophysiology of thrombocytopenia after transcatheter aortic valve implantation (TAVI) thrombocytopenia is still poorly understood. We assessed the association of spleen size with acquired thrombocytopenia in patients undergoing TAVI. We included 732 patients who underwent TAVI with new generation transcatheter heart valves (THVs) at our center from February 2016 to July 2019. We measured splenic volume index in consecutive patients derived from multidetector row computed tomographic datasets. Patients were stratified according to post-TAVI thrombocytopenia, which was defined as a decline in platelet count (DPC) ≥50% at nadir, and evaluated regarding baseline characteristics and outcome parameters. After the procedure, platelet counts declined from 212.9 ± 67.4 × 109/L at baseline to 138.8 ± 49.8 × 109/L at nadir after a median of 2 days (interquartile range [IQR] 2 to 3). Of all patients, 10.1% showed a DPC ≥50%. Compared with patients with DPC <50%, patients with DPC ≥50% had significantly lower splenic volume index (95.5 ml/m2 [IQR 78.0 to 123.7] vs 85.8 ml/m2 [IQR 71.4 to 102.6], p = 0.008). A multivariable analysis revealed that the splenic volume index was negatively associated with a DPC ≥50% (OR 0.89, 95% CI 0.82 to 0.97, p = 0.005), independent of the type of THV (balloon-expandable THV: OR 2.06, 95% CI 1.13 to 3.76, p = 0.02), major bleeding (OR 13.40, 95% CI 3.58 to 50.40, p <0.001), blood transfusion (OR 3.63, 95% CI 1.54 to 8.56, p = 0.003), or postprocedural paravalvular leakage ≥moderate (OR 5.48, 95% CI 1.23 to 24.40, p = 0.03). Furthermore, DPC ≥50% was independently associated with 1-year mortality (HR 3.36, 95% CI 1.66 to 6.81, p <0.001). In conclusion, acquired thrombocytopenia remains prevalent in modern TAVI patients. Spleen size appears to be associated with the occurrence of thrombocytopenia after TAVI, which is independently correlated with 1-year mortality.


Assuntos
Estenose da Valva Aórtica/cirurgia , Sistema de Registros , Baço/diagnóstico por imagem , Trombocitopenia/etiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso de 80 Anos ou mais , Valva Aórtica/cirurgia , Estudos Transversais , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Tomografia Computadorizada Multidetectores , Contagem de Plaquetas , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Trombocitopenia/sangue , Trombocitopenia/epidemiologia
13.
Korean J Radiol ; 22(9): 1555-1568, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34448383

RESUMO

Pulmonary embolism (PE) is a potentially fatal disease if the diagnosis or treatment is delayed. Currently, multidetector computed tomography (MDCT) is considered the standard imaging method for diagnosing PE. Dual-energy CT (DECT) has the advantages of MDCT and can provide functional information for patients with PE. The aim of this review is to present the potential clinical applications of DECT in PE, focusing on the diagnosis and risk stratification of PE.


Assuntos
Embolia Pulmonar , Humanos , Tomografia Computadorizada Multidetectores , Embolia Pulmonar/diagnóstico por imagem
15.
Rev Port Cardiol (Engl Ed) ; 40(8): 583-590, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392902

RESUMO

INTRODUCTION: Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement. OBJECTIVES: The aim of this study is to determine the impact of new CTA technology in the diagnosis of CHD and to compare echo and CTA in terms of diagnostic accuracy. METHODS: Forty-five patients who underwent preoperative echo and CTA assessment in the intensive care unit were included in this study. The results were assessed for three main types of CHD (cardiac malformations, cardiac-major vessel connections and major vessels). The main groups were also divided into subgroups according to surgical features in order to assess them more objectively. Imaging methods were compared for diagnostic accuracy, sensitivity and specificity, while surgical findings were accepted as the gold standard. RESULTS: Patients' median age and weight were two months (three days-eight years) and 12 kg (2.5-60 kg), respectively. In 45 operated cases, 205 subgroup malformations were assessed. Diagnostic accuracy was significantly greater in echo (echo vs. CTA: 98.4% and 96.2% [chi-square=6.4, p=0.011]). During surgery, 84 cardiac malformations (echo vs. CTA: 97.4% and 95.1% [chi-square=4.9, p=0.03]), 47 cardiac-major vessel connections (echo vs. CTA: 98.3% and 95.4% [chi-square=7.5, p=0.03]), and 74 major vessel malformations (echo vs. CTA: 96% and 98% [chi-square=1.8, p=0.48]) were confirmed. CONCLUSION: Echocardiography and CTA are imaging methods with high diagnostic accuracy in children with CHD. The use of echocardiography together with CTA, especially for the visualization of extracardiac anatomy, provides additional information for clinicians.


Assuntos
Cardiopatias Congênitas , Tomografia Computadorizada Multidetectores , Angiografia , Criança , Angiografia por Tomografia Computadorizada , Ecocardiografia , Cardiopatias Congênitas/diagnóstico por imagem , Humanos
16.
J Cardiothorac Surg ; 16(1): 221, 2021 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-34348752

RESUMO

BACKGROUND: Patient-prosthesis mismatch (PPM) is a major concern in aortic valve replacement (AVR) and leads to perioperative morbidity and rehospitalization. Predicting aortic annulus diameter pre-procedurally is crucial to managing patients with high-risk of PPM. OBJECTIVES: To compare preoperative measurements of aortic annulus from echocardiography and CT scan with surgical sizing and develop an imaging-based algorithm to predict PPM. METHODS: From January 2017 to December 2020, patients underwent AVR at a teaching hospital were examined. The relationship between imaging measurements with operative values was assesed using scatter plots and Pearson's correlation coefficient. Univariable linear regression was then used to build the predictive model. RESULTS: A total of 144 patients underwent AVR during the study period. Suture types and surgical approaches were not significantly associated with prosthesis size. CT scan-based measurements showed strong correlation with prosthesis size: mean diameter (R = 0.79), perimeter-derived diameter (R = 0.76), and area-derived diameter (R = 0.75). Mechanical valve and tissue valve shared similar correlation coefficients. Prosthesis size predictive models based on CT scan were 12.89 + 0.335 × d for mean diameter, 13.275 + 0.315 × d for perimeter-derived diameter and 13.626 + 0.309 × d for area-derived diameter. CONCLUSIONS: Preoperative CT scan measurements are a reliable predictor of aortic prosthesis size. Transthoracic echocardiography is a possible alternative, though it is highly performer-dependent and unable to represent the aortic annulus fully. Together, these two imaging modalities can be used to quantitatively anticipate PPM preoperatively.


Assuntos
Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Adulto , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Desenho de Prótese
17.
J Card Surg ; 36(11): 4043-4053, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34414605

RESUMO

AIM: To evaluate the various imaging features and associations on multidetector computed tomography (CT) angiography in patients with anomalous origin of left main coronary artery (LMCA) from pulmonary artery (ALCAPA). MATERIALS AND METHODS: We retrospectively reviewed multidetector CT angiography studies done for the evaluation of congenital heart diseases at our institution through 2014 to 2021. Cases with ALCAPA were identified and relevant history and imaging findings including the origin of coronary arteries, left ventricular (LV) morphology and functions, intercoronary collaterals, and associated abnormalities were evaluated. RESULTS: Twelve patients (eight males, three adults, and nine children; age range: 2 months to 54 years) with ALCAPA were included. Gradually progressive dyspnea and failure to thrive (6/9; 66.67% each) were the most common symptoms among children, whereas adults were commonly asymptomatic (2/3; 66.67%). The LMCA was originating from pulmonary sinus, main, and right pulmonary artery in 6 (50%), 5 (41.66%), and 1 (8.3%) patients, respectively. In adult-type ALCAPA, right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCx) were dilated and tortuous, with the presence of well-developed intercoronary collaterals and preserved LV ejection fractions; these features were not seen in patients of infantile ALCAPA. LV dysfunction with global hypokinesia was the most common wall motion abnormality (7/12; 58.33%). CONCLUSION: Degree of collateralization could be the key factor determining the time of presentation, clinical symptoms, and LV function, thus influencing clinical outcomes. Patients with infantile ALCAPA present with features of heart failure and have dilated and dysfunctional LV consequent to lack of collaterals, unlike adult-type ALCAPA.


Assuntos
Síndrome de Bland-White-Garland , Anomalias dos Vasos Coronários , Adulto , Síndrome de Bland-White-Garland/diagnóstico por imagem , Criança , Angiografia Coronária , Anomalias dos Vasos Coronários/diagnóstico por imagem , Humanos , Lactente , Masculino , Tomografia Computadorizada Multidetectores , Artéria Pulmonar/diagnóstico por imagem , Estudos Retrospectivos
18.
Pan Afr Med J ; 38: 362, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34367441

RESUMO

Introduction: atherosclerosis could be a sequela of long-term activation of cell-mediated immunity as the case of latent tuberculosis infection. Atherosclerosis is the main pathological event in ischemic heart disease. The present study aimed to assess the prevalence of Latent tuberculosis infection (LTBI) among patients with ischemic heart disease (IHD) and to detect the association between both diseases. Methods: this cross-sectional study included 98 patients with a history of previously diagnosed ischemic heart disease who did a multi-detector computed tomography coronary angiogram (MDCTCA). Detailed clinical examination and investigations as chest X-ray and sputum examination were done for those with positive QuantiFERON-TB Gold test (QFT) to exclude active tuberculosis (TB). Participants having positive QFT results but with no evidence of active TB were considered as LTBI positive. Results: the prevalence of LTBI in patients with IHD was 19.3% as only nineteen of the ninety-eight patients were diagnosed with latent tuberculosis infection using the QuantiFERON serum test. Eighty-four percent (84.2%) of patients with LTBI had coronary artery atherosclerosis (CAA) compared to only 55.6% in patients without LTBI with a statistically significant difference. In multivariable analysis, Diabetes Mellitus (DM) (AOR 0.179, 95% C.I.: 0.03-0.967), and LTBI (AOR 1.024, 95% C.I.: 1.002-1.736) were significantly associated with coronary artery atherosclerosis (p=0.0001, and p= 0.003 respectively). Conclusion: the prevalence of latent tuberculosis infection among patients with ischemic heart diseases is high. Among different factors that are already well known to precipitate ischemic heart disease, latent tuberculosis should be considered.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Tuberculose Latente/epidemiologia , Isquemia Miocárdica/epidemiologia , Adulto , Idoso , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etiologia , Estudos Transversais , Feminino , Humanos , Tuberculose Latente/diagnóstico , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/etiologia , Prevalência , Fatores de Risco , Arábia Saudita
19.
Eur J Radiol ; 142: 109885, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34364047

RESUMO

PURPOSE: Knowledge of normal anatomy and variations of testicular arteries are critical for planning before minimally invasive surgery. In this article, we aimed to evaluate the morphological characteristics of testicular arteries by MDCT and propose a new classification system. METHOD: A total of 400 adult patients (total of 819 testicular arteries) who underwent abdominal CT angiography examination for several unrelated reasons were enrolled in this study. Testicular arteries (TAs) were evaluated in terms of number, origin, course, and caliber. Based on our findings, we also proposed a novel anatomical classification for the TAs according to their origin (divided into 5 types-type 1-5-) and course (divided into three types-type a-c-). Type 4 origin and type a course are the expected normal origin and course of bilateral TAs. RESULTS: The most common type based on the origin was type 4, with the testicular artery originating from the abdominal aorta, inferior to the level of the renal artery within 5 cm distal to the renal arteries. 70.7% of the right and 75.6% of the left testicular arteries were type 4. The most common type of the vessel course was the normal expected trajectory (type a) with an incidence of 76.3% for the right and 82.6% for the left testicular arteries. CONCLUSION: Normal anatomy and variations of testicular arteries may be effectively evaluated by CT angiography in a non-invasive manner.


Assuntos
Aorta Abdominal , Artéria Renal , Adulto , Angiografia , Angiografia por Tomografia Computadorizada , Humanos , Tomografia Computadorizada Multidetectores
20.
Radiat Prot Dosimetry ; 196(1-2): 10-16, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34423365

RESUMO

The present study compares three different multidetector CT (MDCT) scanners for routine brain imaging in terms of image quality and radiation doses. The volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (E) were calculated. Subjective image assessment was obtained based on a scale ranging from 1 (unacceptable) to 5 (optimum). All images scored 3.5 or over, with the 160-slice MDCT images being favoured. For the 4-, 16- and 160-slice MDCT scanners, the respective median values for CTDIvol were 57 mGy, 41 mGy, and 28 mGy; DLP values were 901 mGy.cm, 680 mGy.cm, and 551 mGy.cm; and effective doses were 2 mSv, 1.5 mSv, and 1 mSv, respectively. Compared to the 160-slice MDCT, the dose values for the 4- and 16-slice units were significantly greater. In practice, the CT modality used must be carefully selected to avoid elevated radiation doses and maintain image quality.


Assuntos
Cabeça , Tomografia Computadorizada Multidetectores , Tomografia Computadorizada de Feixe Cônico , Cabeça/diagnóstico por imagem , Doses de Radiação , Tomógrafos Computadorizados
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...