Ultrasound examination, MRI, or ROMA for discriminating between inconclusive adnexal masses as determined by IOTA Simple Rules: a prospective study.

OBJECTIVE: To determine the best second-step approach for discriminating benign from malignant adnexal masses classified as inconclusive by International Ovarian Tumour Analysis Simple Rules (IOTA-SR). METHODS: Single-center prospective study comprising a consecutive series of patients diagnosed as having an adnexal mass classified as inconclusive according to IOTA-SR. All women underwent Risk of Ovarian Malignancy Algorithm (ROMA) analysis, MRI interpreted by a radiologist, and ultrasound examination by a gynecological sonologist. Cases were clinically managed according to the result of the ultrasound expert examination by either serial follow-up for at least 1 year or surgery. Reference standard was histology (patient was submitted to surgery if any of the tests was suspicious) or follow-up (masses with no signs of malignancy after 12 months were considered benign). Diagnostic performance of all three approaches was calculated and compared. Direct cost analysis of the test used was also performed. RESULTS: Eighty-two adnexal masses in 80 women (median age 47.6 years, range 16 to 73 years) were included. Seventeen patients (17 masses) were managed expectantly (none had diagnosis of ovarian cancer after at least 12 months of follow-up) and 63 patients (65 masses) underwent surgery and tumor removal (40 benign and 25 malignant tumors). Sensitivity and specificity for ultrasound, MRI, and ROMA were 96% and 93%, 100% and 81%, and 24% and 93%, respectively. The specificity of ultrasound was better than that for MRI (p=0.021), and the sensitivity of ultrasound was better than that for ROMA (p<0.001), sensitivity was better for MRI than for ROMA (p<0.001) and the specificity of ROMA was better than that for MRI (p<0.001). Ultrasound evaluation was the most effective and least costly method as compared with MRI and ROMA. CONCLUSION: In this study, ultrasound examination was the best second-step approach in inconclusive adnexal masses as determined by IOTA-SR, but the findings require confirmation in multicenter prospective trials.

Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography.

OBJECTIVE: To compare the diagnostic performance of ultrasound and computed tomography (CT) for detecting pelvic and abdominal tumor spread in women with epithelial ovarian cancer. METHODS: An observational cohort study of 93 patients (mean age 57.6 years) with an ultrasound diagnosis of adnexal mass suspected of malignancy and confirmed histologically as epithelial ovarian cancer was undertaken. In all cases, transvaginal and transabdominal ultrasound as well as CT scans were performed to assess the extent of the disease within the pelvis and abdomen prior to surgery. The exploration was systematic, analyzing 12 anatomical areas. All patients underwent surgical staging and/or cytoreductive surgery with an initial laparoscopy for assessing resectability. The surgical and pathological findings were considered as the 'reference standard'. Sensitivity and specificity of ultrasound and CT scanning were calculated for the different anatomical areas and compared using the McNemar test. Agreement between ultrasound and CT staging and the surgical stage was estimated using the weighted kappa index. RESULTS: The tumorous stage was International Federation of Gynecology and Obstetrics (FIGO) stage I in 26 cases, stage II in 11 cases, stage III in 47 cases, and stage IV in nine cases. Excluding stages I and IIA cases (n=30), R0 (no macroscopic residual disease) was achieved in 36 women (62.2%), R1 (macroscopic residual disease <1 cm) was achieved in 13 women (25.0%), and R2 (macroscopic residual disease >1 cm) debulking surgery occurred in three women (5.8%). Eleven patients (11.8%) were considered not suitable for optimal debulking surgery during laparoscopic assessment. Overall sensitivity of ultrasound and CT for detecting disease was 70.3% and 60.1%, respectively, and specificity was 97.8% and 93.7%, respectively. The agreement between radiological stage and surgical stage for ultrasound (kappa index 0.69) and CT (kappa index 0.70) was good for both techniques. Overall accuracy to determine tumor stage was 71% for ultrasound and 75% for CT. CONCLUSION: Detailed ultrasound examination renders a similar diagnostic performance to CT for assessing pelvic/abdominal tumor spread in women with epithelial ovarian cancer.

Three-Dimensional Transvaginal Sonography and Magnetic Resonance Imaging for Local Staging of Cervical Cancer: An Agreement Study.

OBJECTIVES: To evaluate the agreement of clinical examination, 2-dimensional (2D) sonography, and 3-dimensional (3D) sonography with magnetic resonance imaging (MRI) for local staging of cervical cancer. METHODS: We conducted a prospective study including women with a diagnosis of carcinoma of the cervix. All women were staged clinically and underwent 2D and 3D transvaginal sonography and MRI before treatment for assessing tumor size and parametrial, bladder, and rectal involvement using the examiner's subjective impression. Agreement between sonography and MRI was assessed by calculating the κ index and percentage of agreement. RESULTS: Forty women were included (mean age ± SD, 46.6 ± 11.4 years). Eleven had early-stage (IA and IB1) disease, and 29 had advanced-stage (IB2-IVB) disease. A significant correlation for tumor size estimation was found between MRI and pelvic examination (r = 0.754; P < .001), MRI and 2D sonography (r = 0.649; P < .001), and MRI and 3D sonography (r = 0.657; P< .001). Agreement for parametrial infiltration between MRI and pelvic examination was fair (κ = 0.26; 95% confidence interval [CI], 0.10-0.54; 62.5% agreement), between MRI and 2D sonography was moderate (κ = 0.41; 95% CI, 0.15-0.66; 70.0% agreement), and between MRI and 3D sonography was good (κ = 0.60; 95% CI, 0.35-0.85; 80.0% agreement). Agreement for bladder involvement between MRI and pelvic examination was moderate (κ = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), between MRI and 2D sonography was moderate (κ = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), and between MRI and 3D sonography was very good (κ = 0.84; 95% CI, 0.55-1.0; 97.5% agreement). Agreement for rectal involvement was not calculated because of the very small number of cases. CONCLUSIONS: Three-dimensional sonography showed good agreement with MRI for assessing parametrial infiltration and bladder involvement in cervical cancer.

Primary cystic peritoneal masses and mimickers: spectrum of diseases with pathologic correlation.

Cystic lesions within the peritoneum have been classified classically according to their lining on histology into four categories-endothelial, epithelial, mesothelial, and others (germ cell tumors, sex cord gonadal stromal tumors, cystic mesenchymal tumors, fibrous wall tumors, and infectious cystic peritoneal lesions). In this article, we will proceed to classify cystic peritoneal lesions focusing on the degree of radiological complexity into three categories-simple cystic, mildly complex, and cystic with solid component lesions. Many intra-abdominal collections within the peritoneal cavity such as abscess, seroma, biloma, urinoma, or lymphocele may mimic primary peritoneal cystic masses and need to be differentiated. Clinical history and imaging features may help differentiate intra-abdominal collections from primary peritoneal masses. Lymphangiomas are benign multilocular cystic masses that can virtually occur in any location within the abdomen and insinuate between structures. Ultrasound may help differentiate enteric duplication cysts from other mesenteric and omental cysts in the abdomen. Double-layered wall along the mesenteric side of bowel may suggest its diagnosis in the proper clinical setting. Characteristic imaging features of hydatid cysts are internal daughter cysts, floating membranes and matrix, peripheral calcifications, and collagenous pericyst. Non-pancreatic psuedocysts usually have a fibrotic thick wall and chylous content may lead to a fat-fluid level. Pseudomyxoma peritonei appears as loculated fluid collections in the peritoneal cavity, omentum, and mesentery and may scallop visceral surfaces. Many of the primary cystic peritoneal masses have specific imaging features which can help in accurate diagnosis and management of these entities. Knowledge of the imaging spectrum of cystic peritoneal masses is necessary to distinguish from other potential cystic abdominal mimicker masses.

Systolic prospectively ECG-triggered dual-source CT angiography for evaluation of the coronary arteries in heart transplant recipients.

OBJECTIVES: To assess feasibility, image quality, and radiation dose of prospectively ECG-triggered coronary CT angiography (CTA) in orthotopic heart transplant (OHT) recipients. METHODS: 47 consecutive OHT recipients (40 men, mean age 62.1 ± 10.9 years, mean heart rate 86.3 ± 14.4 bpm) underwent dual-source CTA to rule out coronary allograft vasculopathy in a prospectively ECG-triggered mode with data acquisition during 35% to 45% of the cardiac cycle. Two independent observers blindly assessed image quality on a per-segment and per-vessel basis using a four-point scale (1-excellent, 4-not evaluable). Scores 1-3 were considered acceptable for diagnosis. Multivariate analysis was performed to evaluate differences between image quality scores obtained at different reconstruction intervals. Effective radiation doses were calculated. RESULTS: 671 coronary segments were evaluated. Interobserver agreement on the image quality was κ=0.75. Diagnostic image quality was observed in 93.9%, 95.5% and 93.3% of the segments at 35%, 40% and 45% reconstruction intervals. Mean image quality score was 1.5 ± 0.7 for the entire coronary tree, 1.4 ± 0.7 for the RCA, 1.6 ± 0.8 for the LCA and 1.6 ± 0.7 for the Cx at the best reconstruction interval. Estimated mean radiation dose was 4.5 ± 1.2 mSv. CONCLUSION: Systolic prospectively ECG-triggered CTA allows diagnostic image quality coronary angiograms in OHT recipients at low radiation doses.

Dual-source CT for visualization of the coronary arteries in heart transplant patients with high heart rates.

OBJECTIVE: The purpose of this study was to evaluate the quality of dual-source CT images of the coronary arteries in heart transplant recipients with high heart rates. SUBJECTS AND METHODS: Contrast-enhanced dual-source CT coronary angiography was performed on 23 heart transplant recipients (20 men, three women; mean age, 61.1 +/- 12.8 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers using a 5-point scale (0, not evaluative; 4, excellent quality) assessed the quality of images of coronary segments. RESULTS: The mean heart rate during scanning was 89.2 +/- 10.4 beats/min. Interobserver agreement on the quality of images of the whole coronary tree was a kappa value of 0.78 and for selection of the optimal reconstruction interval was a kappa value of 0.82. The optimal reconstruction interval was systole in 17 (74%) of the 23 of heart transplant recipients. At the best reconstruction interval, diagnostic image quality (score >or= 2) was obtained in 92.1% (303 of 329) of the coronary artery segments. The mean image quality score for the whole coronary tree was 3.1 +/- 1.01. No significant correlation between mean heart rate (rho = 0.31) or heart rate variability (rho = 0.23) and overall image quality score was observed (p = not significant). CONCLUSION: Dual-source CT acquisition yields coronary angiograms of diagnostic quality in heart transplant recipients. Mean heart rate and heart rate variability during scanning do not have a negative effect on the overall quality of images of the coronary arteries.

Assessment of left ventricular parameters in orthotopic heart transplant recipients using dual-source CT and contrast-enhanced echocardiography: comparison with MRI.

OBJECTIVES: To establish the accuracy and reliability of cardiac dual-source CT (DSCT) and two-dimensional contrast-enhanced echocardiography (CE-Echo) in estimating left ventricular (LV) parameters with respect to cardiac magnetic resonance imaging (CMR) as the reference standard. METHODS: Twenty-five consecutive heart transplant recipients (20 male, mean age 62.7±10.4 years, mean time since transplantation 8.1±5.9 years) were prospectively recruited. Two blinded readers independently assessed LV ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) for each patient after manual tracing of the endo- and epicardial contours in DSCT, CE-Echo and CMR cine images. Student's t-test for paired samples for differences, and Bland and Altman plots and Lin's concordance-correlation coefficients (CCC) for agreement were calculated. RESULTS: There was no statistical difference between left ventricular parameters determined by DSCT and CMR. CE-Echo resulted in significant underestimation of left ventricular volumes (mean difference EDV: 15.94±14.19 ml and 17.1±17.06 ml, ESV: 8.5±9.3 and 7.32±9.14 ml with respect to DSCT and CMR), and overestimation of EF compared with the cross-sectional imaging modalities (3.78±8.47% and 2.14±8.35% with respect to DSCT and CMR). Concordance correlation coefficients for LV parameters using DSCT and CMR were higher (CCC≥0.75) than CCC values observed between CE-Echo and DSCT- or CMR-derived data (CCC≥0.54 and CCC≥0.49, respectively). Interobserver agreement was higher for DSCT and CMR values (CCC≥0.72 and CCC≥0.87, respectively). CONCLUSION: In orthotopic heart transplantation cardiac DSCT allows accurate and reliable estimation of LV parameters compared with CMR, whereas CE-Echo seems to be insufficient to obtain precise measurements.

Chemical composition of essential oil of Senecio coincyi, an endemic species of the Central Iberian Peninsula.

The essential oil has been studied of leaves of Senecio coincyi Rouy, an endemic species of Spain restricted to a very small area of the Central Iberian Peninsula. Samples from five locations were obtained by hydrodistillation and extraction and analysed by gas chromatography-mass spectrometry. The main compound was 1-tridecene (28.1 +/- 8.5%). The presence of unsaturated hydrocarbons (1-undecene, 1-dodecene and 1-tridecene) seems to indicate a chemotaxonomic relationship between Senecio coincyi and S. congestus.

Allograft morphology and function in heart transplant recipients surviving more than 15 years by magnetic resonance imaging and dual-source computed tomography.

OBJECTIVE: Cardiac allograft vasculopathy and late graft failure are the main limiting factors of long-term success of heart transplantation, and little is known about graft function in the long-term survivors. The aim of this study was to assess the ventricular function and the allograft vasculopathy in long-term survivors (>15 years) with the cardiac magnetic resonance imaging (MRI) and dual-source computed tomography (DSCT) coronary angiogram. METHODS: In our database, 34 cardiac recipients have more than 15 years of follow-up and were evaluated for this study; 22 (65%) of them were enrolled. Mean age at transplant was 46 ± 13.5 years, mean donor age was 28.5 ± 10.1 years, and mean graft ischemic time was 189 ± 58 min. Mean follow-up was 18.5 ± 2.4 years (range 15-22). All patients underwent cardiac MRI and DSCT. RESULTS: Mean left ventricular (LV) volumes indexed to the body surface area (BSA) were within normal range: the end-diastolic volume/BSA was 61 ± 16 ml m(-2), end-systolic volume/BSA was 22 ± 15 ml m(-2), stroke volume/BSA was 38 ± 6 ml m(-2), LV mass/BSA: 72 ± 18 g m(-2), and mean ejection fraction (EF) was 0.59 ± 0.08. Two patients (9%) showed a global cardiac hypokinesia and two other patients (9%) showed akinesia of one segment. At DSCT, 41% of patients had a strictly normal coronary angiogram, 41% had wall thickening and 18% presented a least one >60% stenosis. CONCLUSIONS: Cardiac MRI and DSCT coronary angiogram revealed a normal graft function and morphology after more than 15 years of transplantation. However, a certain number of patients have significant cardiac allograft vasculopathy and another consistent group has initial disease. These patients deserve further follow-up and tailoring of the immunosuppressive regimen.

Assessment of left atrial volumes and function in orthotopic heart transplant recipients by dual-source CT: comparison with MRI.

INTRODUCTION: To compare left atrial performance with dual-source CT (DSCT) with respect to magnetic resonance imaging (MRI) in orthotopic heart transplant recipients. METHODS: Twenty-nine consecutive heart transplant recipients (27 male; mean age 64.1 +/- 13 years; mean time from transplantation 122.8 +/- 69.7 months) referred for exclusion of cardiac allograft vasculopathy underwent cardiac DSCT and MRI. Standard biatrial technique was employed in 13 subjects whereas 16 were transplanted after the bicaval technique. Axial 5-mm slice-thickness DSCT datasets reconstructed in 5% steps of the cardiac cycle and axial 5-mm SSFP-MRI images were analyzed. Two blinded readers manually traced left atrial contours in random order to estimate end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF). Parameters were compared with a paired sample Student t test. Concordance correlation coefficient (CCC) was calculated to determine measurement agreement between techniques and observers. RESULTS: Left atrial volumes were significantly higher with cardiac DSCT (EDV: 170.9 +/- 78.1 mL; ESV: 139.5 +/- 76.6 mL) than with MRI (EDV: 158.2 +/- 72.5 mL; ESV: 124.2 +/- 68.2 mL), whereas left atrial EF was lower with DSCT (EF: 20.8% +/- 7.5% vs. 23.6% +/- 7.7%) (P < 0.05). Measurement agreement between DSCT and MRI was excellent for all parameters (CCC > or =0.82). Individuals operated with the biatrial anastomosis technique presented significantly higher left atrial volumes and lower EF compared with subjects with bicaval anastomosis. Interobserver agreement was excellent for all parameters (CCC > or =0.80). CONCLUSION: Even if DSCT slightly overestimates left atrial volumes with respect to MRI, results remain clinically valid. Bicaval surgical technique offers improved left atrial performance compared with standard biatrial anastomosis. DSCT may be used as a reliable tool to estimate left atrial parameters in orthotopic heart transplant recipients.

Dual-source CT in heart transplant recipients: quantification of global left ventricular function and mass.

OBJECTIVE: To evaluate reliability of global left ventricular (LV) function and mass quantification in heart transplant recipients undergoing cardiac dual-source computed tomography examinations by means of manual contour tracing and using a region-growing-based semiautomatic segmentation analysis software tool. MATERIALS AND METHODS: Twenty-six consecutive heart transplant recipients undergoing cardiac dual-source computed tomography examinations with tube current modulation were included. Double-oblique short-axis 8-mm slice thickness multiphase image reconstructions were used for manual contouring and axial 0.75 mm slices were used for the semiautomated segmentation. LV ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, cardiac output, and myocardial mass were assessed by both segmentation methods. Length of time needed for manual contour tracing and for the semiautomated software was recorded. Contrast-to-noise ratio was calculated in end-diastolic and end-systolic images. RESULTS: No statistically significant differences were observed in LV functional parameters derived from semiautomatic contour detection algorithm as compared with manual contouring, with excellent agreement (concordance-correlation coefficient >or=0.80). The semiautomated contour detection algorithm overestimated LV mass (mean difference 12.84+/-3.39) (P<0.001). The evaluated software allowed to quantify LV parameters in a significantly shorter period of time (mean difference 201.68+/-121.98 s, P<0.001). Contrast-to-noise ratio in end-systole and end-diastole statistically differed (mean difference 5.29+/-2.94 Hounsfield units; P<0.01) but did not significantly hamper the semiautomated segmentation. CONCLUSIONS: Objective quantification of LV volumes using the evaluated semiautomated segmentation software is precise, reproducible, and time effective.

Morphological and functional evaluation of intrapericardial cyst as a cause of severe right heart failure: dual source computed tomography and magnetic resonance imaging.

A case of an intrapericardial cyst causing heart failure due to right ventricular compression is presented. Characterization of the lesion and its repercussion on right ventricular function by means of state-of-the-art dual source computed tomography (DSCT) and magnetic resonance imaging (MRI) is shown. The diagnosis of intrapericardial cyst was confirmed after surgical excision and biopsy. Usefulness of these noninvasive techniques for the diagnosis of this rare entity is emphasized.

Low-dose volumetric computed tomography for quantification of emphysema in asymptomatic smokers participating in an early lung cancer detection trial.

PURPOSE: High-resolution computed tomography (CT) is a validated method to quantify the extent of pulmonary emphysema. In this study, we assessed the reliability of low-dose volumetric CT (LDCT) for the quantification of emphysema and its correlation with spirometric indices of airway obstruction. MATERIALS AND METHODS: The study population consisted of 102 consecutive current and former smokers participating in a lung cancer screening trial. All subjects underwent spirometry testing and LDCT at entry and a LDCT after 12 months. The extent of emphysema was estimated by 2 techniques; by using the lung attenuation threshold analysis and by visual assessment of the 2 independent radiologists. The reproducibility of these determinations was assessed using test-retest reliability and kappa coefficient of agreement. The correlation of LDCT-based emphysema determinations with indices of airway obstruction on spirometry was also calculated. RESULTS: Eighty percent of the participants were male, with a mean (standard deviation) age of 54.5 (7.5) years, and median pack-years (interquartile range) of 20 (24). Test-retest reliability of all LDCT-based emphysema determinations was very good (intraclass correlation coefficient of 0.92 for the volume of emphysema, and 0.93 for the emphysema index or emphysema volume/total lung volume). Similarly, there was an excellent interrater agreement for visual assessment of emphysema (kappa coefficient=0.91). Higher volumes of emphysema measured quantitatively or visually significantly correlated with spirometric markers of airway obstruction. CONCLUSIONS: Volumetric LDCT is a reliable and valid technique for the quantification of emphysema in asymptomatic smokers.

Quantification of left ventricular function and mass in cardiac Dual-Source CT (DSCT) exams: comparison of manual and semiautomatic segmentation algorithms.

The purpose of our study was to evaluate reliability of left ventricular (LV) function and mass quantification in cardiac DSCT exams comparing manual contour tracing and a region-growing-based semiautomatic segmentation analysis software. Thirty-three consecutive patients who underwent cardiac DSCT exams were included. Axial 1-mm slices were used for the semiautomated technique, and short-axis 8-mm slice thickness multiphase image reconstructions were the basis for manual contour tracing. Left ventricular volumes, ejection fraction and myocardial mass were assessed by both segmentation methods. Length of time needed for both techniques was also recorded. Left ventricular functional parameters derived from semiautomatic contour detection algorithm were not statistically different from manual tracing and showed an excellent correlation (p<0.001). The semiautomatic contour detection algorithm overestimated LV mass (180.30+/-44.74 g) compared with manual contour tracing (156.07+/-46.29 g) (p<0.001). This software allowed a significant reduction of the time needed for global LV assessment (mean 174.16+/-71.53 s, p<0.001). Objective quantification of LV function using the evaluated region-growing-based semiautomatic segmentation analysis software is feasible, accurate, reliable and time-effective. However, further improvements are needed to equal results achieved by manual contour tracing, especially with regard to LV mass quantification.

Quantification of left ventricular function and mass in heart transplant recipients using dual-source CT and MRI: initial clinical experience.

The purpose of this study was to compare LV function and mass quantification derived from cardiac dual-source CT (DSCT) exams with those obtained by MRI in heart transplant recipients. Twelve heart transplant recipients who underwent cardiac DSCT and MRI examination were included. Double-oblique short-axis 8-mm slice thickness images were evaluated. Left ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, cardiac output and myocardial mass were manually assessed for each patient by two blinded readers. A systematic overestimation of all left ventricular volumes by DSCT when compared with MRI was observed. Mean difference was 16.58 +/- 18.61 ml for EDV, 4.9 4 +/- 6.84 ml for ESV, 11.64 +/- 13.58 ml for SV and 5.73 +/- 1.14 l/min for CO. Slightly lower values for left ventricular ejection fraction with DSCT compared with MRI were observed (mean difference 0.34 +/- 3.18%, p = 0.754). Correlation between DSCT and MRI for left ventricular mass was excellent (rho = 0.972). Bland and Altman plots and CCC indicated good agreement between DSCT and MRI left ventricular function and mass measurements. The interobserver correlation was good. In conclusion, DSCT accurately estimates left ventricular ejection fraction, volumes and mass in heart transplant recipients.

Dual-source CT coronary imaging in heart transplant recipients: image quality and optimal reconstruction interval.

The image quality and optimal reconstruction interval for coronary arteries in heart transplant recipients undergoing non-invasive dual-source computed tomography (DSCT) coronary angiography was evaluated. Twenty consecutive heart transplant recipients who underwent DSCT coronary angiography were included (19 male, one female; mean age 63.1 +/- 10.7 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent observers assessed the image quality of each coronary segments using a five-point scale (from 0 = not evaluative to 4 = excellent quality). A total of 289 coronary segments in 20 heart transplant recipients were evaluated. Mean heart rate during the scan was 89.1 +/- 10.4 bpm. At the best reconstruction interval, diagnostic image quality (score > or = 2) was obtained in 93.4% of the coronary segments (270/289) with a mean image quality score of 3.04 +/- 0.63. Systolic reconstruction intervals provided better image quality scores than diastolic reconstruction intervals (overall mean quality scores obtained with the systolic and diastolic reconstructions 3.03 +/- 1.06 and 2.73 +/- 1.11, respectively; P < 0.001). Different systolic reconstruction intervals (35%, 40%, 45% of RR interval) did not yield to significant differences in image quality scores for the coronary segments (P = 0.74). Reconstructions obtained at the systolic phase of the cardiac cycle allowed excellent diagnostic image quality coronary angiograms in heart transplant recipients undergoing DSCT coronary angiography.

Hemorragia cerebelosa remota / No disponible

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