Association between ventricular filling patterns and the extent of late enhancement on magnetic resonance imaging in patients with hypertrophic cardiomyopathy

OBJECTIVE

To explore the relationship between ventricular filling curves and the extent of late enhancement on cardiac magnetic resonance imaging (MRI) in patients with hypertrophic cardiomyopathy.

MATERIAL AND METHODS

We retrospectively included consecutive patients with suspected and/or confirmed hypertrophic cardiomyopathy and a control group of patients matched for age and sex who underwent cardiac MRI with evaluation of late enhancement. Among other determinations, we evaluated the following parameters on cine sequences: peak filling rate, time to the first peak filling rate, and filling rate normalized to the filling volume.

RESULTS

Late enhancement was observed in 29 (73%) of the 40 patients with hypertrophic cardiomyopathy. The normalized peak filling rate was significantly lower in patients with late enhancement (4.9 ± 1.6 in those with hypertrophic cardiomyopathy positive for late enhancement vs. 5.8 ± 2.2 in those with hypertrophic cardiomyopathy negative for late enhancement vs. 6.3 ± 1.5 in controls, p = 0.008) and the time to peak filling was longer in patients with late enhancement (540.6 ± 89.7 ms vs. 505.5 ± 99.3 ms in those with hypertrophic cardiomyopathy negative for late enhancement vs. 486.9 ± 86.3 ms in controls, p = 0.02). When the population was stratified into three groups in function of the normalized peak filling rate, significant differences were observed among groups for age (p = 0.002), mean wall thickness (p = 0.036), and myocardial mass (p = 0.046) and atrial dimensions, whereas no significant differences with respect to late enhancement were seen.

CONCLUSIONS

In patients with hypertrophic cardiomyopathy, we found a significant association between ventricular filling patterns and age, wall thicknesses, and atrial dimensions, but not with the extent of late enhancement.

[CT colonography: evaluation of two 3D algorithms in a screening population]

PURPOSE

The purpose of this multicenter study was to compare a dissection display and an endoluminal display for CT colonography (CTC) by means of detection rates and evaluation time in a screening collective.

MATERIALS AND METHODS

4 blinded readers evaluated CTC datasets from 42 patients with 55 endoscopically confirmed polyps. The datasets were read in a randomized order using two different 3D visualization methods (endoluminal view vs. dissection display; EBW 2.0.1, Philips Medical Systems, Best/NL). Patients underwent cathartic cleansing as well as stool and fluid tagging. All readers except one were experienced in performing CTC. The per-lesion/per-patient sensitivity, per-patient specificity, and evaluation time were calculated.

RESULTS

The overall per-lesion sensitivity using the dissection display (and endoluminal view) was 60% (53 %) for reader 1, 58% (60%) for reader 2, 67% (71%) for reader 3 and 55% (58%) for reader 4. The per-patient sensitivity using the dissection display (and endoluminal view) was 85% (85%) for reader 1, 80% (85%) for reader 2, 95% (90%) for reader 3 and 80% (80%) for reader 4. The per-patient specificity was 68% with dissection view (77% endoluminal view) for reader 1, 82% (82%) for reader 2, 59% (59%) for reader 3 and 82% (73%) for reader 4. The experienced readers were significantly faster using the perspective-filet view.

CONCLUSION

Using a dissection display of CTC datasets does not result in superior detection rates for polyps if datasets are stool and fluid-tagged. 3 out of 4 readers evaluated the datasets significantly faster with the dissection display.

Luxación inveterada carpo-metacarpiana del quinto dedo: diagnóstico y tratamiento

Las luxaciones aisladas de la articulación carpometacarpiana del quinto dedo son infrecuentes. Nalebuff clasificó estas luxaciones según el desplazamiento de la base del quinto metacarpiano. Una paciente con luxación volar-cubital carpometacarpiana del quinto dedo fue remitida a la consulta de mano doce meses después de la lesión. En lesiones agudas la reducción cerrada es la técnica utilizada. Sin embargo en situación de retraso en el tratamiento la reducción abierta proporciona mayor éxito funcional

Elevated gastric lesions: virtual gastroscopy

With the development of multidetector computed tomography and the improvement in the capabilities of workstations, the use of high-quality three-dimensional reconstructions and virtual images can be applied to organs other than the colon such as the stomach. As a noninvasive technique, virtual gastroscopy represents an alternative to conventional endoscopy for the detection of elevated lesions. Findings of this technique are illustrated.

Multislice CT virtual angioscopy of the abdomen

BACKGROUND

Computed tomographic (CT) angiography represents an important clinical tool in the evaluation of vascular disorders. Virtual angioscopy can be reconstructed with volumetric CT data sets. We evaluated the feasibility and clinical value of this application in the assessment of abdominal vessels.

METHODS

Data sets of CT angiographic studies obtained with helical (n = 120) and multislice (n = 180) CT scanners were analyzed on a workstation for postprocessing. Vascular evaluation was done on conventional enhanced axial images, three-dimensional reconstructions, and virtual angioscopic images.

RESULTS

We made 123 studies in patients without aortic disease. Of the patients evaluated for stent-graft treatment, 63 showed normal patency, seven had partial thrombosis of the stent-graft, five showed total occlusion of the stent-graft, and 10 had leaks. From the 92 remaining CT studies, 63 vascular aneurysms and nine dissections were diagnosed.

CONCLUSION

The current technology produces high-quality virtual angioscopic images. Although axial and multiplanar views are usually adequate for detecting a vascular disorder, virtual angioscopic views better define anatomic details.