1
|
Lee S, Kim IC, Kim YD, Nam HS, Kim SY, Choi SM, Chang HJ. The role of cardiac CT throughout the full cardiac cycle in diagnosing patent foramen ovale in patients with acute stroke. Eur Radiol 2021; 31:8983-8990. [PMID: 34075451 DOI: 10.1007/s00330-021-08037-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We explored the hypothesis that the diagnostic performance of cardiac computed tomography (CT) throughout the full cardiac cycle would be superior to single-phase CT and comparable to transesophageal echocardiography (TEE) in diagnosing patent foramen ovale (PFO). METHODS AND RESULTS From May 2011 to April 2015, 978 patients with stroke were diagnosed with PFO by TEE. In patients with stroke, cardiac CT was performed if the patients had more than two cardiovascular risk factors. We prospectively enrolled 70 patients with an indication for cardiac CT. Cardiac CT images were reconstructed at 10% increments of the R-R interval. The sensitivity of cardiac CT throughout the full cardiac cycle in diagnosing PFO was compared to that for TEE and single-phase cardiac CT. To evaluate the specificity of cardiac CT, we analyzed patients without PFO confirmed by TEE who underwent cardiac CT within 1 month of pre-cardiac surgery. Sixty-six patients with cardiac CT and TEE were included in the final analysis. Throughout the full cardiac cycle, cardiac CT had a sensitivity of 89.4% and a specificity of 92.3% in diagnosing PFO, compared to TEE as a reference. PFO was primarily detected in the 60% and 70% intervals in 10-phase reconstructed images. The sensitivity of PFO diagnosis with cardiac CT was 81.8% when analyzing both the 60% and 70% intervals instead of the full cardiac cycle. CONCLUSION Cardiac CT throughout the full cardiac cycle outperforms single-phase cardiac CT in detecting PFO. Cardiac CT can be used as an alternative method to TEE for detecting PFO in stroke patients. KEY POINTS • Throughout the full cardiac cycle, cardiac computed tomography (CT) had a sensitivity of 89.4% and a specificity of 92.3% in diagnosing patent foramen ovale (PFO), compared to transesophageal echocardiography. • The sensitivity of diagnosing patent foramen ovale with cardiac CT was 81.8% when analyzing 60% and 70% R-R intervals instead of the full cardiac cycle. • Cardiac CT with retrospective electrocardiographic gating throughout the full cardiac cycle can increase the detectability of PFO, compared to single-phase cardiac CT.
Collapse
Affiliation(s)
- Seonhwa Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - In-Cheol Kim
- Department of Cardiology, Cardiovascular Center, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Young Dae Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyo Suk Nam
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - So Yeon Kim
- CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Seon Mi Choi
- CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyuk-Jae Chang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
| |
Collapse
|
2
|
Ishihara A, Funabashi N, Ozawa K, Takaoka H, Kobayashi Y. The use of whole thoracic ECG-gated MDCT for the de novo diagnosis of isolated patent ductus arteriosus in middle aged or older subjects. Int J Cardiol 2016; 224:62-64. [PMID: 27611919 DOI: 10.1016/j.ijcard.2016.08.335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Anna Ishihara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| |
Collapse
|
3
|
Funabashi N, Takaoka H, Ozawa K, Tanabe N, Tatsumi K, Saeki N, Higashide T, Uno T, Kobayashi Y. Combined ostium secundum type ASD and pulmonary arterial thromboembolism causing pulmonary artery enlargement, pulmonary hypertension and recurrent paradoxical cerebral embolism due to deep venous thrombosis. Int J Cardiol 2016; 207:303-7. [PMID: 26814633 DOI: 10.1016/j.ijcard.2016.01.178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 01/12/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Naokatsu Saeki
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Takashi Higashide
- Diagnostic Radiology and Radiation Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| |
Collapse
|
4
|
Nanba T, Funabashi N, Takahara M, Takaoka H, Ozawa K, Kobayashi Y. Giant pulmonary trunk with Eisenmenger flow through patent ductus arteriosus. Int J Cardiol 2016; 204:248-51. [PMID: 26682956 DOI: 10.1016/j.ijcard.2015.11.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 11/22/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Toshifumi Nanba
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | - Masayuki Takahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| |
Collapse
|
5
|
Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults. Eur Radiol 2014; 25:1614-22. [DOI: 10.1007/s00330-014-3547-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 11/26/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023]
|
6
|
Never forget the abdomen in the evaluation of pediatric cardiac computed tomography. Int J Cardiol 2012; 157:e31-2. [DOI: 10.1016/j.ijcard.2011.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 09/06/2011] [Indexed: 11/23/2022]
|
7
|
Goo HW. Haemodynamic findings on cardiac CT in children with congenital heart disease. Pediatr Radiol 2011; 41:250-61. [PMID: 21127855 DOI: 10.1007/s00247-010-1886-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 09/01/2010] [Accepted: 09/19/2010] [Indexed: 12/18/2022]
Abstract
In patients with congenital heart disease, haemodynamic findings demonstrated on cardiac CT might provide useful hints for understanding the haemodynamics of cardiac defects. In contrast to morphological features depicted on cardiac CT, such haemodynamic findings on cardiac CT have not been comprehensively reviewed in patients with congenital heart disease. This article describes normal haemodynamic phenomena of cardiovascular structures and various abnormal haemodynamic findings with their mechanisms and clinical significance on cardiac CT in patients with congenital heart disease.
Collapse
Affiliation(s)
- Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, South Korea.
| |
Collapse
|
8
|
Hori Y, Funabashi N, Uehara M, Ueda M, Takaoka H, Nakamura K, Murayama T, Komuro I. Positive influence of aging on the occurrence of fat replacement in the right ventricular myocardium determined by multislice-CT in subjects with atherosclerosis. Int J Cardiol 2010; 142:152-8. [DOI: 10.1016/j.ijcard.2008.12.187] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Accepted: 12/13/2008] [Indexed: 10/21/2022]
|
9
|
New classification of aortic dissection during the cardiac cycle as pulsating type and static type evaluated by electrocardiogram-gated multislice CT. Int J Cardiol 2010; 142:177-86. [DOI: 10.1016/j.ijcard.2008.12.194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 12/17/2008] [Indexed: 01/19/2023]
|
10
|
Amplatzer septal occluder closure of atrial septal defect: evaluation of transthoracic echocardiography, cardiac CT, and transesophageal echocardiography. AJR Am J Roentgenol 2010; 193:1522-9. [PMID: 19933643 DOI: 10.2214/ajr.09.2854] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare transthoracic echocardiography (TTE), cardiac CT, and transesophageal echocardiography (TEE) in the evaluation of secundum atrial septal defect (ASD) for closure with an Amplatzer septal occluder in pediatric patients. SUBJECTS AND METHODS The cases of 28 children with ASD initially diagnosed with TTE who were scheduled for cardiac CT for evaluation for insertion of an Amplatzer septal occluder under TEE guidance were reviewed. The patients were divided into a group with small ASD (long axis < 1.5 cm) and a group with large ASD (long axis > or = 1.5 cm). Measurements of the ASD obtained at TTE, cardiac CT, and TEE were compared. Kappa statistics were used to correlate the diagnostic value of cardiac CT assessed by two independent reviewers. RESULTS After cardiac CT, six patients were excluded from occluder implantation; therefore, 22 patients (seven boys, 15 girls; mean age, 4.95 years; range, 2-11 years) were included in the study. There were no significant differences in the ages and sexes of the patients in the two groups, but pulmonary-to-systemic blood flow ratio in the large-ASD group was significantly greater than that in the small-ASD group (3.54 +/- 1.43 vs 1.89 +/- 0.36; p = 0.001). With respect to long- and short-axis lengths of the ASD, interatrial septum, and four rims and to detection of rim deficiency, neither group had a significant difference between cardiac CT findings at ventricular end-systole and TEE findings. The long axis of the ASD in the large-ASD group measured at cardiac CT at end-systole and TEE was significantly longer than the long axis measured at TTE (p = 0.012). A high diagnostic score with good interobserver correlation (kappa = 0.674-0.750) validated the feasibility of cardiac CT in the assessment of ASD for closure with an Amplatzer septal occluder. CONCLUSION The long axis of a large ASD can be underestimated at TTE. Cardiac CT seems comparable with TEE in the assessment of ASD and is helpful in noninvasive evaluation for Amplatzer septal occluder implantation, especially for large ASD.
Collapse
|
11
|
Patanè S, Marte F, Anfuso C, Minutoli F, Coglitore S, Di Bella G. An unusual diagnosis of atrial shunt defect by magnetic resonance imaging. Int J Cardiol 2009; 134:e4-6. [DOI: 10.1016/j.ijcard.2007.12.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Accepted: 12/11/2007] [Indexed: 11/26/2022]
|
12
|
Kim YJ, Hur J, Shim CY, Lee HJ, Ha JW, Choe KO, Heo JH, Choi EY, Choi BW. Patent Foramen Ovale: Diagnosis with Multidetector CT—Comparison with Transesophageal Echocardiography. Radiology 2009; 250:61-7. [DOI: 10.1148/radiol.2501080559] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
13
|
Interatrial shunt detected in coronary computed tomography angiography: differential features of a patent foramen ovale and an atrial septal defect. J Comput Assist Tomogr 2008; 32:663-7. [PMID: 18830093 DOI: 10.1097/rct.0b013e31815b6421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine differential findings of patent foramen ovales (PFOs) and atrial septal defects (ASDs) demonstrating interatrial shunting on coronary computed tomography (CT) angiography. METHODS We retrospectively analyzed 15 cases of patients demonstrating a contrast jet from the left to the right atrium on CT and interatrial shunting on echocardiography. According to the echocardiography results, patients were divided into PFO (n = 10) or ASD (n = 5) groups. The contrast jet direction and atrial septum appearance on CT were compared between the 2 groups. RESULTS The PFO group had a contrast jet flowing toward the inferior vena cava, and the atrial septum appeared channel-like. The ASD group had a contrast jet flowing perpendicular to the atrial septum in all but one of the patients, and the atrial septum appeared as a membrane with a hole. CONCLUSIONS Atrial septal defects and PFOs can be differentiated using the characteristic direction of the contrast jet from the left to right atrium and the appearance of the atrial septum on coronary CT angiography.
Collapse
|
14
|
Evaluation of Efficacy of 64-Slice Multidetector Computed Tomography in Patients With Congenital Coronary Fistulas. J Comput Assist Tomogr 2008; 32:265-70. [DOI: 10.1097/rct.0b013e318074eb88] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Funabashi N, Maeda F, Nakamura K, Suzuki K, Mita Y, Matsuo K, Niwa K, Komuro I. Channel-like appearance of a patent foramen ovale with left to right shunt demonstrated by 64-slice computed tomography. Int J Cardiol 2007; 119:119-21. [PMID: 17045672 DOI: 10.1016/j.ijcard.2006.07.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Accepted: 07/15/2006] [Indexed: 11/22/2022]
|
16
|
Tsai IC, Lee T, Chen MC, Fu YC, Jan SL, Tsai WL, Wang CC. Gradual Pulmonary Artery Enhancement: New Sign of Septal Defects on CT. AJR Am J Roentgenol 2007; 188:1660-4. [PMID: 17515391 DOI: 10.2214/ajr.06.0572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Hemodynamic information observed on serial images obtained with bolus tracking might help in diagnosing septal defects on CT. Our purpose was to qualitatively and quantitatively examine a new sign called gradual pulmonary artery enhancement. CONCLUSION Gradual pulmonary artery enhancement is a newly recognized CT sign that may be helpful in evaluating septal defects.
Collapse
Affiliation(s)
- I-Chen Tsai
- Department of Radiology, 407, Taichung Veterans General Hospital, No. 160, Section 3, Taichung Harbor Rd., Taichung, Taiwan, ROC
| | | | | | | | | | | | | |
Collapse
|
17
|
Yamanaka K, Fujita M, Doi K, Tsuneyoshi H, Yamazato A, Ueno K, Zen E, Komeda M. Multislice Computed Tomography Accurately Quantifies Left Atrial Size and Function After the MAZE Procedure. Circulation 2006; 114:I5-9. [PMID: 16820627 DOI: 10.1161/circulationaha.105.000968] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Although the MAZE procedure allows for the recovery of sinus rhythm and left atrial (LA) mechanical function in the great majority of patients with chronic atrial fibrillation (AF), the effects of MAZE on the precise LA geometry and wall motion remain to be elucidated. We hypothesized that LA size and mechanical function in patients with chronic AF and mitral valvular disease are well restored after MAZE.
Methods and Results—
We studied 14 patients (MAZE group: mean±SD age, 63.9±8.6 years; 8 men and 6 women) who underwent MAZE for chronic AF and mitral valve surgery and 10 patients with sinus rhythm (coronary artery bypass graft [CABG] group: age, 70.0±7.9 years; 5 men and 5 women) who underwent CABG at Takeda Hospital between February 2002 and September 2005. MAZE was conducted by the endocardial application of radiofrequency ablation with a temperature-controlled multipolar radiofrequency catheter. LA volume and booster function were quantitatively evaluated by multislice computed tomography at 17.9±10.0 months (MAZE group) and 15.3±13.6 months (CABG group) postoperatively. All patients with MAZE were free of AF and other atrial arrhythmias during the follow-up period. In the CABG group, LA maximal and minimal volumes and ejection fraction were 109±12 mL, 82±11 mL, and 26±10%, respectively. In the MAZE group, LA maximal volume was 139±17 mL (
P
=0.187 versus CABG), and LA minimal volume was 121±16 mL (
P
=0.082 versus CABG), with an ejection fraction of 15±7% (
P
=0.004 versus CABG). In both groups, all parts of the LA wall contracted toward the geometric center of the LA. The extent of wall motion was significantly worse in the MAZE group compared with the CABG group. In both groups, LA booster function was inversely correlated with LA maximal volume.
Conclusions—
MAZE with radiofrequency ablation is safe and effective for the restoration of sinus rhythm in patients with chronic AF and mitral valve disease. However, chronic AF associated with mitral valve disease deteriorates LA mechanical function diffusely throughout the LA wall. Further studies with the use of multislice computed tomography are needed to sequentially evaluate LA function after MAZE in patients with and without mitral valve surgery.
Collapse
Affiliation(s)
- Kazuo Yamanaka
- Division of Cardiovascular Surgery, Takeda Hospital, Japan
| | | | | | | | | | | | | | | |
Collapse
|