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Cau R, Pisu F, Suri JS, Pontone G, D’Angelo T, Zha Y, Salgado R, Saba L. Atrial and Ventricular Strain Imaging Using CMR in the Prediction of Ventricular Arrhythmia in Patients with Myocarditis. J Clin Med 2024; 13:662. [PMID: 38337355 PMCID: PMC10856157 DOI: 10.3390/jcm13030662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Objective: Myocarditis can be associated with ventricular arrhythmia (VA), individual non-invasive risk stratification through cardiovascular magnetic resonance (CMR) is of great clinical significance. Our study aimed to explore whether left atrial (LA) and left ventricle (LV) myocardial strain serve as independent predictors of VA in patients with myocarditis. (2) Methods: This retrospective study evaluated CMR scans in 141 consecutive patients diagnosed with myocarditis based on the updated Lake Louise criteria (29 females, mean age 41 ± 20). The primary endpoint was VA; this encompassed ventricular fibrillation, sustained ventricular tachycardia, nonsustained ventricular tachycardia, and frequent premature ventricular complexes. LA and LV strain function were performed on conventional cine SSFP sequences. (3) Results: After a median follow-up time of 23 months (interquartile range (18-30)), 17 patients with acute myocarditis reached the primary endpoint. In the multivariable Cox regression analysis, LA reservoir (hazard ratio [HR] and 95% confidence interval [CI]: 0.93 [0.87-0.99], p = 0.02), LA booster (0.87 95% CI [0.76-0.99], p = 0.04), LV global longitudinal (1.26 95% CI [1.02-1.55], p = 0.03), circumferential (1.37 95% CI [1.08-1.73], p = 0.008), and radial strain (0.89 95% CI [0.80-0.98], p = 0.01) were all independent determinants of VA. Patients with LV global circumferential strain > -13.3% exhibited worse event-free survival compared to those with values ≤ -13.3% (p < 0.0001). (4) Conclusions: LA and LV strain mechanism on CMR are independently associated with VA events in patients with myocarditis, independent to LV ejection fraction, and late gadolinium enhancement location. Incorporating myocardial strain parameters into the management of myocarditis may improve risk stratification.
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Affiliation(s)
- Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
| | - Francesco Pisu
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
| | - Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA;
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy;
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital, University of Messina, 98124 Messina, Italy;
- Department of Radiology and Nuclear Medicine, Erasmus MC, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan 430064, China;
| | - Rodrigo Salgado
- Department of Radiology, Universitair Ziekenhuis Antwerpen, 2650 Edegem, Belgium;
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
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2
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Restelli D, Carerj ML, Bella GD, Zito C, Poleggi C, D’Angelo T, Donato R, Ascenti G, Blandino A, Micari A, Mazziotti S, Minutoli F, Baldari S, Carerj S. Constrictive Pericarditis: An Update on Noninvasive Multimodal Diagnosis. J Cardiovasc Echogr 2023; 33:161-170. [PMID: 38486689 PMCID: PMC10936705 DOI: 10.4103/jcecho.jcecho_61_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 03/17/2024] Open
Abstract
Constrictive pericarditis (CP) is a rare condition that can affect the pericardium after every pericardial disease process and has been described even after SARS-CoV-2 infection or vaccine. In CP, the affected pericardium, usually the inner layer, is noncompliant, constraining the heart to a fixed maximum volume and impairing the diastolic function. This leads to several clinical features, that, however, can be pleomorphic. In its difficult diagnostic workup, noninvasive multimodal imaging plays a central role, providing important morphological and functional data, like the enhanced ventricular interdependence and the dissociation between intrathoracic and intracardiac pressures. An early and proper diagnosis is crucial to set an appropriate therapy, changing the prognosis of patients affected by CP. In this review, we cover in detail the main elements of each imaging technique, after a reminder of pathophysiology useful for understanding the diagnostic findings.
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Affiliation(s)
- Davide Restelli
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Maria Ludovica Carerj
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Concetta Zito
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Cristina Poleggi
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Tommaso D’Angelo
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Rocco Donato
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Antonio Micari
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Diagnostic and Interventional Radiology Unit, University of Messina, Messina, Italy
| | - Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging (BIOMORF), Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy
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D’Angelo T, Lanzafame LRM, Micari A, Blandino A, Yel I, Koch V, Gruenewald LD, Vogl TJ, Booz C, Bucolo GM, Cannizzaro MT, Ascenti G, Mazziotti S. Improved Coronary Artery Visualization Using Virtual Monoenergetic Imaging from Dual-Layer Spectral Detector CT Angiography. Diagnostics (Basel) 2023; 13:2675. [PMID: 37627934 PMCID: PMC10453590 DOI: 10.3390/diagnostics13162675] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Background: To evaluate if coronary CT angiography (CCTA) monoenergetic reconstructions, obtained with a dual-layer spectral detector computed tomography (DLCT) system, offer improved image quality compared with 120 kVp conventional images without affecting the quantitative assessment of coronary stenoses. Methods: Fifty CCTA datasets (30 men; mean age: 61.6 ± 12.3 years) acquired with a DLCT system were reconstructed using virtual monoenergetic images (VMI) from 40 to 100 keV with 10 keV increment and compared with conventional images. An analysis of objective image quality was performed, evaluating the signal- and contrast-to-noise ratio. For the subjective assessment, two readers used a 5-point Likert scoring system to evaluate sharpness, noise, demarcation of coronary plaques, vascular contrast, and an overall score. Furthermore, coronary stenoses were analyzed for each vessel to describe the diagnostic agreement between monoenergetic images and conventional images. Results: The objective image analysis showed that all reconstructions from 70 keV to 40 keV show higher SNR (from 61.33 ± 12.46 to 154.22 ± 42.91, respectively) and CNR (from 51.45 ± 11.19 to 135.63 ± 39.38, respectively) compared with conventional images (all p < 0.001). The 40 keV monoenergetic images obtained the best average score for sharpness, vascular contrast, and for the overall impression (all with p < 0.001). The detection and grading of stenoses of the coronary arteries with conventional and monoenergetic images at 70 keV and 40 keV showed an overall excellent interobserver agreement (k= 0.81 [0.72-0.91]). Conclusions: The 40 keV virtual monoenergetic images obtained with a DLCT system allow the objective and subjective image quality of coronary CT angiography to be improved.
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Affiliation(s)
- Tommaso D’Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Ludovica R. M. Lanzafame
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
| | - Antonino Micari
- Department of Clinical and Experimental Medicine, DIMED, University Hospital Messina, 98124 Messina, Italy;
| | - Alfredo Blandino
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany; (I.Y.); (V.K.); (L.D.G.); (T.J.V.); (C.B.)
| | - Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany; (I.Y.); (V.K.); (L.D.G.); (T.J.V.); (C.B.)
| | - Leon D. Gruenewald
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany; (I.Y.); (V.K.); (L.D.G.); (T.J.V.); (C.B.)
| | - Thomas J. Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany; (I.Y.); (V.K.); (L.D.G.); (T.J.V.); (C.B.)
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany; (I.Y.); (V.K.); (L.D.G.); (T.J.V.); (C.B.)
| | - Giuseppe M. Bucolo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
| | - Maria Teresa Cannizzaro
- Radiology Unit (CAST), University Hospital Catania, “Policlinico G. Rodolico–San Marco”, 95123 Catania, Italy;
| | - Giorgio Ascenti
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
| | - Silvio Mazziotti
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy; (L.R.M.L.); (A.B.); (G.M.B.); (G.A.); (S.M.)
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D’Angelo T, Arico FM, Broccio L, Ascenti G, Mazziotti S, Booz C, Martin SS, Yel I, Lanzafame LRM, Blandino A, Sofia C. Multi-Contrast Differentiation by Dual-Energy Spectral CT Angiography in a Patient with Pulmonary Barium Granulomas. Diagnostics (Basel) 2023; 13:diagnostics13050832. [PMID: 36899976 PMCID: PMC10000742 DOI: 10.3390/diagnostics13050832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Barium inhalation usually relates to accidental aspiration during radiological procedures with an oral contrast agent. When present, barium lung deposits are visible as high-density opacities on chest X-ray or CT scan due to high atomic number, and they may be indistinguishable from calcifications. Dual-layer spectral CT has shown good material differentiation capabilities, due to its increased high-Z element range and smaller spectral separation between low- and high-energy spectral data. We present the case of a 17-year-old female with a history of tracheoesophageal fistula, who underwent chest CT angiography on a dual-layer spectral platform. Despite the close Z numbers and K-edge energy levels of the two different contrast materials, spectral CT was able to identify barium lung deposits from a previous swallowing study and to clearly distinguish them from calcium and the surrounding iodine-containing structures.
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Affiliation(s)
- Tommaso D’Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Correspondence: (T.D.); (F.M.A.)
| | - Francesco M. Arico
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
- Correspondence: (T.D.); (F.M.A.)
| | - Lydia Broccio
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
| | - Giorgio Ascenti
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
| | - Silvio Mazziotti
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Simon S. Martin
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ibrahim Yel
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Ludovica R. M. Lanzafame
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
| | - Alfredo Blandino
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
| | - Carmelo Sofia
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital “Policlinico G. Martino”, 98124 Messina, Italy
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5
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D’Angelo T, Vizzari G, Lanzafame LRM, Pergolizzi F, Mazziotti S, Gaeta M, Costa F, Di Bella G, Vogl TJ, Booz C, Micari A, Blandino A. Spectral CT Imaging of Prosthetic Valve Embolization after Transcatheter Aortic Valve Implantation. Diagnostics (Basel) 2023; 13:diagnostics13040678. [PMID: 36832165 PMCID: PMC9955456 DOI: 10.3390/diagnostics13040678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Transcatheter heart valve (THV) embolization is a rare complication of transcatheter aortic valve implantation (TAVI) generally caused by malpositioning, sizing inaccuracies and pacing failures. The consequences are related to the site of embolization, ranging from a silent clinical picture when the device is stably anchored in the descending aorta to potentially fatal outcomes (e.g., obstruction of flow to vital organs, aortic dissection, thrombosis, etc.). Here, we present the case of a 65-year-old severely obese woman affected by severe aortic valve stenosis who underwent TAVI complicated by embolization of the device. The patient underwent spectral CT angiography that allowed for improved image quality by means of virtual monoenergetic reconstructions, permitting optimal pre-procedural planning. She was successfully re-treated with implantation of a second prosthetic valve a few weeks later.
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Affiliation(s)
- Tommaso D’Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Giampiero Vizzari
- Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Ludovica R. M. Lanzafame
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
- Correspondence:
| | - Federica Pergolizzi
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Silvio Mazziotti
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Michele Gaeta
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Francesco Costa
- Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Gianluca Di Bella
- Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Thomas J. Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - Antonio Micari
- Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Alfredo Blandino
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
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Booz C, Yel I, Wichmann JL, Martin SS, Koch V, Gruenewald LD, Alizadeh LS, Vogl TJ, D’Angelo T. Diagnosis of Uric Acid-Based Urine Sedimentation in the Bladder Using Dual-Energy CT. Diagnostics (Basel) 2023; 13:diagnostics13030542. [PMID: 36766647 PMCID: PMC9913993 DOI: 10.3390/diagnostics13030542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/07/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Urine sedimentation in the bladder can occur in various circumstances and can lead to urinary obstruction/stasis with associated pain. It is usually diagnosed with an ultrasound; however, CT is also used to assess the amount and to further check for urinary stones. Depending on the composition, urine sedimentation and stones can be treated medically by alkalinisation of the urine with potassium sodium hydrogen citrate in the case of uric acid-based sedimentation/stones. Due to technical developments and improved material differentiation and characterisation in CT imaging, dual-energy CT allows for differentiation of uric acid from calcium, which can be used for sedimentation/stone composition analysis. Subsequently, treatment decisions can be made based on the findings in dual-energy CT.
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Affiliation(s)
- Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Correspondence:
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Julian L. Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Simon S. Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Leon D. Gruenewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Leona S. Alizadeh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Tommaso D’Angelo
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Division of Experimental Imaging, University Hospital Frankfurt, 60590 Frankfurt, Germany
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98158 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands
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D’Angelo T, Martin S, Micari A, Booz C, Steyer A, Blandino A, Lanzafame LR, Koch V, Ascenti G, Mazziotti S. Coronary angiography using spectral detector dual-energy CT: is it the time to assess myocardial first-pass perfusion? Eur Radiol Exp 2022; 6:60. [PMID: 36480065 PMCID: PMC9732170 DOI: 10.1186/s41747-022-00313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/30/2022] [Indexed: 12/13/2022] Open
Abstract
Coronary computed tomography angiography (CCTA) represents a common approach to the diagnostic workup of patients with suspected coronary artery disease. Technological development has recently allowed the integration of conventional CCTA information with spectral data. Spectral CCTA used in clinical routine may allow for improving CCTA diagnostic performance by measuring myocardial iodine distribution as a marker of first-pass perfusion, thus providing additional functional information about coronary artery disease.
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Affiliation(s)
- Tommaso D’Angelo
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy ,grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Simon Martin
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Antonino Micari
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Christian Booz
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Alexandra Steyer
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Alfredo Blandino
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Ludovica R. Lanzafame
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Vitali Koch
- grid.411088.40000 0004 0578 8220Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Giorgio Ascenti
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Silvio Mazziotti
- grid.412507.50000 0004 1773 5724Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
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8
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Lanzafame LRM, Carerj ML, Rizzo G, Minutoli F, Bucolo GM, Irrera N, Muscogiuri G, Sironi S, Blandino A, D’Angelo T. Multimodality Imaging Evaluation of Coronary IgG4-Related Disease: A "Tumor-Like" Cardiac Lesion. Diagnostics (Basel) 2022; 12:diagnostics12112814. [PMID: 36428873 PMCID: PMC9689228 DOI: 10.3390/diagnostics12112814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibro-inflammatory disorder. Coronary IgG4-RD has been scarcely reported and may present as "tumor-like" lesions. These pseudo-masses may be underdiagnosed mainly due to a vague clinical picture that can vary from complete lack of symptoms to acute coronary syndrome or sudden cardiac death. Early recognition of coronary IgG4-RD is essential to monitor disease activity and prevent life-threatening complications. We report a comprehensive non-invasive imaging evaluation of a patient affected by coronary IgG4-RD, which was diagnosed as an incidental finding during routine pre-laparoscopic cholecystectomy checkup. Non-invasive imaging revealed the presence of a peri-coronary soft-tissue mass that was stable at 12 months follow-up.
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Affiliation(s)
- Ludovica R. M. Lanzafame
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Maria Ludovica Carerj
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Giovanna Rizzo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Fabio Minutoli
- Nuclear Medicine Unit, BIOMORF Department, University of Messina, 98124 Messina, Italy
| | - Giuseppe M. Bucolo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Natasha Irrera
- Pharmacology Unit, DIMED Department, University Hospital Messina, 98124 Messina, Italy
| | - Giuseppe Muscogiuri
- Department of Radiology, Istituto Auxologico Italiano IRCCS, San Luca Hospital, 20149 Milan, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Alfredo Blandino
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
| | - Tommaso D’Angelo
- Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 Rotterdam, The Netherlands
- Correspondence:
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9
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Mannino F, D’Angelo T, Pallio G, Ieni A, Pirrotta I, Giorgi DA, Scarfone A, Mazziotti S, Booz C, Bitto A, Squadrito F, Irrera N. The Nutraceutical Genistein-Lycopene Combination Improves Bone Damage Induced by Glucocorticoids by Stimulating the Osteoblast Formation Process. Nutrients 2022; 14:4296. [PMID: 36296984 PMCID: PMC9612338 DOI: 10.3390/nu14204296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/28/2022] [Accepted: 10/12/2022] [Indexed: 01/24/2023] Open
Abstract
Chronic glucocorticoid (GC) therapy is the most common cause of iatrogenic osteoporosis and represents an important risk factor for osteoporosis and bone fractures. New therapeutic approaches are required in order to treat osteoporosis and reduce the side effects related to the use of anti-osteoporotic drugs. In this context, previous studies reported the efficacy of some isoflavones and carotenoids, such as lycopene and genistein, on the reduction of the risk of fracture related to osteoporosis. The aim of this study was to investigate the effects of a combined oral treatment, consisting of genistein and lycopene, in an experimental model of glucocorticoid-induced osteoporosis (GIO). GIO was induced by subcutaneous injection of methylprednisolone (MP, 30 mg/kg) for 60 days, whereas the control group (Sham) received saline solution only. Following induction, MP animals randomly were assigned to receive alendronate, genistein, lycopene, or the association of genistein and lycopene or saline solution for additional 60 days together with MP. Femurs obtained from the Sham group were used for osteoblasts extraction; they were then incubated with dexamethasone (DEX) for 24 h to be then treated with lycopene or genistein or the association of lycopene and genistein for an additional 24 h. Treatments with lycopene and genistein restored the impaired mineralization of cells observed following DEX treatment and stimulated osteoblast differentiation by increasing the depressed expression of bALP and RUNX2 (p < 0.0001). Wnt5a, β-catenin, and Nrf-2 expression were significantly increased following genistein and lycopene treatment (p < 0.0001), thus confirming their antioxidant activity as well as their ability in stimulating osteoblast function, mostly when genistein and lycopene were used in association. The combined treatment of genistein and lycopene improved the bone damage induced by glucocorticoids and significantly restored the normal architecture of bones as well as adequate interconnectivity of bone trabeculae, thus increasing bone mineral density parameters. The obtained data demonstrated that genistein and lycopene but in particular their association might prevent GC’s adverse effects, thus stimulating bone formation and reducing bone resorption, improving bone structure and microarchitecture, through different molecular pathways, such as the Wnt/β-catenin and the Nrf-2 signaling.
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Affiliation(s)
- Federica Mannino
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Tommaso D’Angelo
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Antonio Ieni
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Igor Pirrotta
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Domenico Antonio Giorgi
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Alessandro Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria Gazzi, 98125 Messina, Italy
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10
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Koch V, Abt J, Gruenewald LD, Eichler K, D’Angelo T, Martin SS, Albrecht MH, Thalhammer A, Booz C, Yel I, Bernatz S, Mahmoudi S, Harth M, Derwich W, Vogl TJ, Gray D, Gruber-Rouh T, Jung G. Systematic evaluation of imaging techniques and baseline characteristics in patients with suspected vasculitis. Eur J Radiol Open 2022; 9:100445. [PMID: 36262692 PMCID: PMC9574707 DOI: 10.1016/j.ejro.2022.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To assess the diagnostic value of different imaging modalities in distinguishing systemic vasculitis from other internal and immunological diseases. Methods This retrospective study included 134 patients with suspected vasculitis who underwent ultrasound, magnetic resonance imaging (MRI), or 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) between 01/2010 and 01/2019, finally consisting of 70 individuals with vasculitis. The main study parameter was the confirmation of the diagnosis using one of the three different imaging modalities, with the adjudicated clinical and histopathological diagnosis as the gold standard. A secondary parameter was the morphological appearance of the vessel affected by vasculitis. Results Patients with systemic vasculitis had myriad clinical manifestations with joint pain as the most common symptom. We found significant correlations between different imaging findings suggestive of vasculitis and the final adjudicated clinical diagnosis. In this context, on MRI, vessel wall thickening, edema, and diameter differed significantly between vasculitis and non-vasculitis groups (p < 0.05). Ultrasound revealed different findings that may serve as red flags in identifying patients with vasculitis, such as vascular occlusion or halo sign (p = 0.02 vs. non-vasculitis group). Interestingly, comparing maximal standardized uptake values from PET/CT examinations with vessel wall thickening or vessel diameter did not result in significant differences (p > 0.05). Conclusions We observed significant correlations between different imaging findings suggestive of vasculitis on ultrasound or MRI and the final adjudicated diagnosis. While ultrasound and MRI were considered suitable imaging methods for detecting and discriminating typical vascular changes, 18F-FDG PET/CT requires careful timing and patient selection given its moderate diagnostic accuracy.
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Affiliation(s)
- Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany,Correspondence to: University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
| | - Julia Abt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Leon D. Gruenewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Katrin Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Messina, Italy
| | - Simon S. Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Moritz H. Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Axel Thalhammer
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Simon Bernatz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Scherwin Mahmoudi
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Marc Harth
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Wojciech Derwich
- Department of Vascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Daphne Gray
- Department of Vascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Georg Jung
- Department of Vascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
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11
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Marzaro M, Pozzato G, Tedesco S, Algeri M, Pozzato A, Tomao L, Montano I, Torroni F, Balassone V, Contini ACI, Guerra L, D’Angelo T, Federici di Abriola G, Lupoi L, Caristo ME, Boškoski I, Costamagna G, Francalanci P, Astori G, Bozza A, Bagno A, Todesco M, Trovalusci E, Oglio LD, Locatelli F, Caldaro T. Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration. Front Bioeng Biotechnol 2022; 10:912617. [PMID: 36267444 PMCID: PMC9576845 DOI: 10.3389/fbioe.2022.912617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Current surgical options for patients requiring esophageal replacement suffer from several limitations and do not assure a satisfactory quality of life. Tissue engineering techniques for the creation of customized “self-developing” esophageal substitutes, which are obtained by seeding autologous cells on artificial or natural scaffolds, allow simplifying surgical procedures and achieving good clinical outcomes. In this context, an appealing approach is based on the exploitation of decellularized tissues as biological matrices to be colonized by the appropriate cell types to regenerate the desired organs. With specific regard to the esophagus, the presence of a thick connective texture in the decellularized scaffold hampers an adequate penetration and spatial distribution of cells. In the present work, the Quantum Molecular Resonance® (QMR) technology was used to create a regular microchannel structure inside the connective tissue of full-thickness decellularized tubular porcine esophagi to facilitate a diffuse and uniform spreading of seeded mesenchymal stromal cells within the scaffold. Esophageal samples were thoroughly characterized before and after decellularization and microperforation in terms of residual DNA content, matrix composition, structure and biomechanical features. The scaffold was seeded with mesenchymal stromal cells under dynamic conditions, to assess the ability to be repopulated before its implantation in a large animal model. At the end of the procedure, they resemble the original esophagus, preserving the characteristic multilayer composition and maintaining biomechanical properties adequate for surgery. After the sacrifice we had histological and immunohistochemical evidence of the full-thickness regeneration of the esophageal wall, resembling the native organ. These results suggest the QMR microperforated decellularized esophageal scaffold as a promising device for esophagus regeneration in patients needing esophageal substitution.
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Affiliation(s)
| | | | | | - Mattia Algeri
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Luigi Tomao
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Ilaria Montano
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Filippo Torroni
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Valerio Balassone
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | | | - Luciano Guerra
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Tommaso D’Angelo
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | | | - Lorenzo Lupoi
- Cen.Ri.S. Policlinico Gemelli UNICATT Rome, Rome, Italy
| | | | - Ivo Boškoski
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy
- Università Cattolica del Sacro Cuore, Centre For Endoscopic Research Therapeutics and Training (CERTT), Rome, Italy—CERTT Gemelli, Rome, Italy
- *Correspondence: Ivo Boškoski,
| | - Guido Costamagna
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy
- Università Cattolica del Sacro Cuore, Centre For Endoscopic Research Therapeutics and Training (CERTT), Rome, Italy—CERTT Gemelli, Rome, Italy
| | | | - Giuseppe Astori
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Angela Bozza
- Advanced Cellular Therapy Laboratory, Haematology Unit, San Bortolo Hospital, Vicenza, Italy
- Consorzio Per la Ricerca Sanitaria (CORIS) of the Veneto Region, Padova, Italy
| | - Andrea Bagno
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Martina Todesco
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Emanuele Trovalusci
- Pediatric Surgery Department AULSS2 Treviso, University of Padova, Padova, Italy
| | - Luigi Dall’ Oglio
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Pediatrics, Sapienza University of Rome, Roma, Italy
| | - Tamara Caldaro
- Digestive Endoscopy and Surgical Unit, Bambino Gesù Children’s Hospital, Rome, Italy
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12
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Lanzafame LRM, Blandino A, Cicero G, Romeo P, Agati S, Zanai R, Celona A, Booz C, Koch V, Mazziotti S, D’Angelo T. Diagnosis and Management of Button Battery Ingestion Complicated by Tracheo-Esophageal and Aorto-Esophageal Fistulas. Diagnostics (Basel) 2022; 12:diagnostics12102369. [PMID: 36292059 PMCID: PMC9600074 DOI: 10.3390/diagnostics12102369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Button battery ingestion (BBI) is common in children and its prevalence has increased in the last decades. BBI can be responsible for very severe and potentially fatal complications if not promptly detected. We describe the successful management of two cases of BBI that occurred in two previously healthy infants. Both patients presented with vague symptoms and no witness of foreign body ingestion. The prolonged time of exposure to the corrosive effects of disk batteries was responsible for the development of tracheo-esophageal fistula (TEF) and aorto-esophageal fistula (AEF). We demonstrate how prompt diagnosis and management are crucial for the infants’ survival.
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Affiliation(s)
- Ludovica R. M. Lanzafame
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98121 Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98121 Messina, Italy
| | - Giuseppe Cicero
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98121 Messina, Italy
| | - Placido Romeo
- Department of Diagnostic and Interventional Radiology, A.O.U. Policlinico San Marco, 95123 Catania, Italy
| | - Salvatore Agati
- Pediatric Cardiac Surgery, “Centro Cardiologico Pediatrico del Mediterraneo-Bambino Gesù”, 98039 Taormina, Italy
| | - Rosanna Zanai
- Pediatric Intensive Care Unit, “Centro Cardiologico Pediatrico del Mediterraneo-Bambino Gesù”, 98039 Taormina, Italy
| | - Antonio Celona
- Department of Radiology, “S. Vincenzo” Hospital Taormina, 98121 Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt, Germany
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98121 Messina, Italy
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98121 Messina, Italy
- Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 Rotterdam, The Netherlands
- Correspondence:
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13
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D’Angelo T, Booz C, Bucolo GM, Micari A, Lanzafame LR, Koch V, Blandino A, Mazziotti S. Cardiac Involvement of Metastatic Clear Cell Sarcoma: A Multimodality Imaging Report. Circ Cardiovasc Imaging 2022; 15:e013902. [PMID: 35481360 PMCID: PMC9112960 DOI: 10.1161/circimaging.121.013902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands (T.D.)
| | - Christian Booz
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands (T.D.)
| | - Giuseppe M. Bucolo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
| | - Antonino Micari
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
| | - Ludovica R.M. Lanzafame
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
| | - Vitali Koch
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany (C.B., V.K.)
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, Italy (T.D., G.M.B., A.M., L.R.M.L., A.B., S.M.)
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14
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Bagnato G, Imbalzano E, Aragona CO, Ioppolo C, Di Micco P, La Rosa D, Costa F, Micari A, Tomeo S, Zirilli N, Sciacqua A, D’Angelo T, Cacciola I, Bitto A, Irrera N, Russo V, Roberts WN, Gangemi S, Versace AG. New-Onset Atrial Fibrillation and Early Mortality Rate in COVID-19 Patients: Association with IL-6 Serum Levels and Respiratory Distress. Medicina (Kaunas) 2022; 58:medicina58040530. [PMID: 35454369 PMCID: PMC9032834 DOI: 10.3390/medicina58040530] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 01/09/2023]
Abstract
Background and objectives: COVID-19 is associated with an aberrant inflammatory response that may trigger new-onset cardiac arrhythmias. The aim of this study was to assess the mortality risk in hospitalized COVID-19 patients according to IL-6 serum levels and new-onset atrial fibrillation (AF) according to PaO2/FiO2 stratification. Materials and Methods: 175 COVID-19 patients (25 new-onset AF, 22 other types of AF and 128 no-AF) were included in this single-center, retrospective study; clinical and demographic data, vital signs, electrocardiograms and laboratory results were collected and analyzed. The primary outcome of the study was to evaluate the mortality rate in new-onset AF patients according to IL-6 serum levels and PaO2/FiO2 stratification. Results: The incidence of new-onset AF in the study population was 14.2%. Compared to the no-AF group, new-onset AF patients were older with a positive history of chronic kidney disease and heart failure, had higher IL-6, creatinine and urea serum levels whereas their platelet count was reduced. After PaO2/FiO2 stratification, 5-days mortality rate was higher in new-onset AF patients compared to patients with other types of AF and no-AF patients, and mortality risk increases 5.3 fold compared to no-AF (p = 0.0014) and 4.8 fold compared to other forms of AF (p = 0.03). Conclusions: New-onset AF is common in COVID-19 patients and is associated with increased IL-6 serum levels and early mortality. Further studies are needed to support the use of IL-6 as an early molecular target for COVID-19 patients to reduce their high rate of mortality.
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Affiliation(s)
- Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
- Correspondence:
| | - Caterina Oriana Aragona
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Carmelo Ioppolo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Pierpaolo Di Micco
- Department of Medicine, Buonconsiglio Fatebenefratelli Hospital, 80122 Naples, Italy;
| | - Daniela La Rosa
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Francesco Costa
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Antonio Micari
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Simona Tomeo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Natalia Zirilli
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy;
| | - Tommaso D’Angelo
- BIOMORF Department, University of Messina, 98125 Messina, Italy; (F.C.); (A.M.); (T.D.)
| | - Irene Cacciola
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Division of Cardiology, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | | | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
| | - Antonio Giovanni Versace
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (G.B.); (C.O.A.); (C.I.); (D.L.R.); (S.T.); (N.Z.); (I.C.); (A.B.); (N.I.); (S.G.); (A.G.V.)
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15
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Gatti M, D’Angelo T, Muscogiuri G, Dell'aversana S, Andreis A, Carisio A, Darvizeh F, Tore D, Pontone G, Faletti R. Cardiovascular magnetic resonance of cardiac tumors and masses. World J Cardiol 2021; 13:628-649. [PMID: 34909128 PMCID: PMC8641001 DOI: 10.4330/wjc.v13.i11.628] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/19/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiac masses diagnosis and treatment are a true challenge, although they are infrequently encountered in clinical practice. They encompass a broad set of lesions that include neoplastic (primary and secondary), non-neoplastic masses and pseudomasses. The clinical presentation of cardiac tumors is highly variable and depends on several factors such as size, location, relation with other structures and mobility. The presumptive diagnosis is made based on a preliminary non-invasive diagnostic work-up due to technical difficulties and risks associated with biopsy, which is still the diagnostic gold standard. The findings should always be interpreted in the clinical context to avoid misdiagnosis, particularly in specific conditions (e.g., infective endocarditis or thrombi). The modern multi-modality imaging techniques has a key role not only for the initial assessment and differential diagnosis but also for management and surveillance of the cardiac masses. Cardiovascular magnetic resonance (CMR) allows an optimal non-invasive localization of the lesion, providing multiplanar information on its relation to surrounding structures. Moreover, with the additional feature of tissue characterization, CMR can be highly effective to distinguish pseudomasses from masses, as well as benign from malignant lesions, with further differential diagnosis of the latter. Although histopathological assessment is important to make a definitive diagnosis, CMR plays a key role in the diagnosis of suspected cardiac masses with a great impact on patient management. This literature review aims to provide a comprehensive overview of cardiac masses, from clinical and imaging protocol to pathological findings.
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Affiliation(s)
- Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, “G. Martino” University Hospital Messina, Messina 98100, Italy
| | - Giuseppe Muscogiuri
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan 20149, Italy
| | | | | | - Andrea Carisio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Fatemeh Darvizeh
- School of Medicine, Vita-Salute San Raffaele University, Milan 20121, Italy
| | - Davide Tore
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Gianluca Pontone
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan 20138, Italy
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Turin 10126, Italy
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Cicero G, Pallio S, D’Angelo T, Mazziotti S. Lipomatosis of the ileocecal valve: A not to miss diagnosis when performing magnetic resonance enterography. Clin Case Rep 2021; 9:e04316. [PMID: 34084526 PMCID: PMC8142311 DOI: 10.1002/ccr3.4316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 04/13/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Abstract
Lipomatosis of ileocecal valve is a rare condition that can be missed using the standard protocol of Magnetic Resonance Enterography. Additional T1-weighted scans without fat saturation can be helpful when adipose lesions of the bowel are suspected.
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Affiliation(s)
- Giuseppe Cicero
- Section of Radiological SciencesDepartment of Biomedical Sciences and Morphological and Functional ImagingUniversity of MessinaMessinaItaly
| | - Socrate Pallio
- Digestive Diseases Endoscopy UnitUniversity of MessinaMessinaItaly
| | - Tommaso D’Angelo
- Section of Radiological SciencesDepartment of Biomedical Sciences and Morphological and Functional ImagingUniversity of MessinaMessinaItaly
| | - Silvio Mazziotti
- Section of Radiological SciencesDepartment of Biomedical Sciences and Morphological and Functional ImagingUniversity of MessinaMessinaItaly
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Mia I, Le M, Arendt C, Brand D, Bremekamp S, D’Angelo T, Puntmann VO, Nagel E. Quantitative perfusion-CMR is significantly influenced by the placement of the arterial input function. Int J Cardiovasc Imaging 2021; 37:1023-1031. [PMID: 33047177 PMCID: PMC7969553 DOI: 10.1007/s10554-020-02049-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study is to provide a systematic assessment of the influence of the position on the arterial input function (AIF) for perfusion quantification. In 39 patients with a wide range of left ventricular function the AIF was determined using a diluted contrast bolus of a cardiac magnetic resonance imaging in three left ventricular levels (basal, mid, apex) as well as aortic sinus (AoS). Time to peak signal intensities, baseline corrected peak signal intensity and upslopes were determined and compared to those obtained in the AoS. The error induced by sampling the AIF in a position different to the AoS was determined by Fermi deconvolution. The time to peak signal intensity was strongly correlated (r2 > 0.9) for all positions with a systematic earlier arrival in the basal (- 2153 ± 818 ms), the mid (- 1429 ± 928 ms) and the apical slice (- 450 ± 739 ms) relative to the AoS (all p < 0.001). Peak signal intensity as well as upslopes were strongly correlated (r2 > 0.9 for both) for all positions with a systematic overestimation in all positions relative to the AoS (all p < 0.001 and all p < 0.05). Differences between the positions were more pronounced for patients with reduced ejection fraction. The error of averaged MBF quantification was 8%, 13% and 27% for the base, mid and apex. The location of the AIF significantly influences core parameters for perfusion quantification with a systematic and ejection fraction dependent error. Full quantification should be based on obtaining the AIF as close as possible to the myocardium to minimize these errors.
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Affiliation(s)
- Ibnul Mia
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Melanie Le
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Christophe Arendt
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Diana Brand
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Sina Bremekamp
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria 1, 98100 Messina, Italy
| | - Valentina O. Puntmann
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital, Goethe University, Frankfurt am Main, Germany
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Le MTP, Zarinabad N, D’Angelo T, Mia I, Heinke R, Vogl TJ, Zeiher A, Nagel E, Puntmann VO. Sub-segmental quantification of single (stress)-pass perfusion CMR improves the diagnostic accuracy for detection of obstructive coronary artery disease. J Cardiovasc Magn Reson 2020; 22:14. [PMID: 32028980 PMCID: PMC7006214 DOI: 10.1186/s12968-020-0600-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 01/07/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Myocardial perfusion with cardiovascular magnetic resonance (CMR) imaging is an established diagnostic test for evaluation of myocardial ischaemia. For quantification purposes, the 16 segment American Heart Association (AHA) model poses limitations in terms of extracting relevant information on the extent/severity of ischaemia as perfusion deficits will not always fall within an individual segment, which reduces its diagnostic value, and makes an accurate assessment of outcome data or a result comparison across various studies difficult. We hypothesised that division of the myocardial segments into epi- and endocardial layers and a further circumferential subdivision, resulting in a total of 96 segments, would improve the accuracy of detecting myocardial hypoperfusion. Higher (sub-)subsegmental recording of perfusion abnormalities, which are defined relatively to the normal reference using the subsegment with the highest value, may improve the spatial encoding of myocardial blood flow, based on a single stress perfusion acquisition. OBJECTIVE A proof of concept comparison study of subsegmentation approaches based on transmural segments (16 AHA and 48 segments) vs. subdivision into epi- and endocardial (32) subsegments vs. further circumferential subdivision into 96 (sub-)subsegments for diagnostic accuracy against invasively defined obstructive coronary artery disease (CAD). METHODS Thirty patients with obstructive CAD and 20 healthy controls underwent perfusion stress CMR imaging at 3 T during maximal adenosine vasodilation and a dual bolus injection of 0.1 mmol/kg gadobutrol. Using Fermi deconvolution for blood flow estimation, (sub-)subsegmental values were expressed relative to the (sub-)subsegment with the highest flow. In addition, endo-/epicardial flow ratios were calculated based on 32 and 96 (sub-)subsegments. A receiver operating characteristics (ROC) curve analysis was performed to compare the diagnostic performance of discrimination between patients with CAD and healthy controls. Observer reproducibility was assessed using Bland-Altman approaches. RESULTS Subdivision into more and smaller segments revealed greater accuracy for #32, #48 and # 96 compared to the standard #16 approach (area under the curve (AUC): 0.937, 0.973 and 0.993 vs 0.820, p < 0.05). The #96-based endo-/epicardial ratio was superior to the #32 endo-/epicardial ratio (AUC 0.979, vs. 0.932, p < 0.05). Measurements for the #16 model showed marginally better reproducibility compared to #32, #48 and #96 (mean difference ± standard deviation: 2.0 ± 3.6 vs. 2.3 ± 4.0 vs 2.5 ± 4.4 vs. 4.1 ± 5.6). CONCLUSIONS Subsegmentation of the myocardium improves diagnostic accuracy and facilitates an objective cut-off-based description of hypoperfusion, and facilitates an objective description of hypoperfusion, including the extent and severity of myocardial ischaemia. Quantification based on a single (stress-only) pass reduces the overall amount of gadolinium contrast agent required and the length of the overall diagnostic study.
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Affiliation(s)
- Melanie T. P. Le
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Niloufar Zarinabad
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Tommaso D’Angelo
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria 1, Messina, 98100 Italy
| | - Ibnul Mia
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Robert Heinke
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Thomas J. Vogl
- Department of Radiology, University Hospital Frankfurt, Theodor-Stern Kai 7, Frankfurt am Main, Germany
| | - Andreas Zeiher
- Department of Cardiology, University Hospital Frankfurt, Theodor-Stern Kai 7, Frankfurt am Main, Germany
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - Valentina O. Puntmann
- Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
- Department of Cardiology, University Hospital Frankfurt, Theodor-Stern Kai 7, Frankfurt am Main, Germany
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Elen E, D’Angelo T, Tjubandi A, Raharjo SB. A rare case of superior vena cava lipoma: its presentation from non-invasive examination. Eur Heart J Cardiovasc Imaging 2019; 20:1183. [DOI: 10.1093/ehjci/jez085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Elen Elen
- Department of Cardiology and Vascular Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Indonesian Heart Association, Jakarta, Indonesia
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Italy
| | - Amin Tjubandi
- Department of Thoracic and Cardiovascular Surgery, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Sunu Budhi Raharjo
- Department of Cardiology and Vascular Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Indonesian Heart Association, Jakarta, Indonesia
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D’Angelo T, Vogl TJ, Wichmann JL. From low-dose to no-dose: thin-section magnetic resonance imaging for evaluation of pulmonary nodules. J Thorac Dis 2018; 10:S1055-S1057. [DOI: 10.21037/jtd.2018.04.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Pathan F, Puntmann V, Zhou H, Zainal Abidin H, D’Angelo T, Arendt C, Elen E, Winau L, Marwick T, Nagel E. Real-Time Rapid Two-Breath-Hold Cardiovascular Magnetic Resonance to Image Entire Left and Right Ventricle. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pathan F, Puntmann V, Zainal Abidin H, Zhou H, Elen E, D’Angelo T, Arendt C, Winau L, Marwick T, Nagel E. Echo Plane Flow Imaging to Evaluate Diastolic Function on Cardiac Magnetic Resonance. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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D’Angelo T, Grigoratos C, Mazziotti S, Bratis K, Pathan F, Blandino A, Elen E, Puntmann VO, Nagel E. High-throughput gadobutrol-enhanced CMR: a time and dose optimization study. J Cardiovasc Magn Reson 2017; 19:83. [PMID: 29110679 PMCID: PMC5674223 DOI: 10.1186/s12968-017-0400-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/16/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Reducing time and contrast agent doses are important goals to provide cost-efficient cardiovascular magnetic resonance (CMR) imaging. Limited information is available regarding the feasibility of evaluating left ventricular (LV) function after gadobutrol injection as well as defining the lowest dose for high quality scar imaging. We sought to evaluate both aspects separately and systematically to provide an optimized protocol for contrast-enhanced CMR (CE-CMR) using gadobutrol. METHODS This is a prospective, randomized, single-blind cross-over study performed in two different populations. The first population consisted of 30 patients with general indications for a rest CE-CMR who underwent cine-imaging before and immediately after intravenous administration of 0.1 mmol/kg body-weight of gadobutrol. Quantitative assessment of LV volumes and function was performed by the same reader in a randomized and blinded fashion. The second population was composed of 30 patients with indication to late gadolinium enhancement (LGE) imaging, which was performed twice at different gadobutrol doses (0.1 mmol/kg vs. 0.2 mmol/kg) and at different time delays (5 and 10 min vs. 5, 10, 15 and 20 min), within a maximal interval of 21 days. LGE images were analysed qualitatively (contrast-to-noise ratio) and quantitatively (LGE%-of-mass). RESULTS Excellent correlation between pre- and post-contrast cine-imaging was found, with no difference of LV stroke volume and ejection fraction (p = 0.538 and p = 0.095, respectively). End-diastolic-volume and end-systolic-volume were measured significantly larger after contrast injection (p = 0.008 and p = 0.001, respectively), with a mean difference of 3.7 ml and 2.9 ml, respectively. LGE imaging resulted in optimal contrast-to-noise ratios 10 min post-injection for a gadobutrol dose of 0.1 mmol/kg body-weight and 20 min for a dose of 0.2 mmol/kg body-weight. At these time points LGE quantification did not significantly differ (0.1 mmol/kg: 11% (16.4); 0.2 mmol/kg: 12% (14.5); p = 0.059), showing excellent correlation (ICC = 0.957; p < 0.001). CONCLUSION A standardized CE-CMR rest protocol giving a dose of 0.1 mmol/kg of gadobutrol before cine-imaging and performing LGE 10 min after injection represents a fast low-dose protocol without significant loss of information in comparison to a longer protocol with cine-imaging before contrast injection and a higher dose of gadobutrol. This approach allows to reduce examination time and costs as well as minimize contrast-agent exposure.
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Affiliation(s)
- Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria, 1, 98100 Messina, Italy
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
| | - Chrysanthos Grigoratos
- G. Monasterio CNR-Tuscany Foundation, Pisa, Italy
- Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria, 1, 98100 Messina, Italy
| | - Konstantinos Bratis
- Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK
| | - Faraz Pathan
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
- Department of Cardiology, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria, 1, 98100 Messina, Italy
| | - Elen Elen
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
- Department of Cardiology, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta, Indonesia
| | - Valentina O. Puntmann
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
- Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK
- Department of Cardiology, University Hospital Frankfurt, DZHK Rhein-Main, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
| | - Eike Nagel
- Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
- Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK
- Department of Cardiology, University Hospital Frankfurt, DZHK Rhein-Main, Theodor-Stern- Kai 7, Frankfurt am Main, Germany
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D’Angelo T, Bucher AM, Lenga L, Arendt CT, Peterke JL, Caruso D, Mazziotti S, Blandino A, Ascenti G, Othman AE, Martin SS, Leithner D, Vogl TJ, Wichmann JL. Optimisation of window settings for traditional and noise-optimised virtual monoenergetic imaging in dual-energy computed tomography pulmonary angiography. Eur Radiol 2017; 28:1393-1401. [DOI: 10.1007/s00330-017-5059-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/16/2017] [Accepted: 09/05/2017] [Indexed: 12/30/2022]
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D’Angelo T, Mazziotti S, Ascenti G, Wichmann JL. Miscellaneous and Emerging Applications of Dual-Energy Computed Tomography for the Evaluation of Pathologies in the Head and Neck. Neuroimaging Clin N Am 2017; 27:469-482. [DOI: 10.1016/j.nic.2017.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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D’Angelo T, Blandino A, Ascenti G, Vinci S, Gaeta M, Mazziotti S. Solitary metastasis of renal cell carcinoma in infratemporal fossa. Clin Imaging 2015; 39:155-7. [DOI: 10.1016/j.clinimag.2014.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 12/31/2022]
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