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Jahnke C, Bollmann A, Oebel S, Lindemann F, Daehnert I, Riede FT, Hindricks G, Paetsch I. Cardiovascular magnetic resonance pulmonary perfusion for guidance of interventional treatment of pulmonary vein stenosis. J Cardiovasc Magn Reson 2022; 24:70. [PMID: 36503589 PMCID: PMC9743617 DOI: 10.1186/s12968-022-00904-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Pulmonary vein (PV) stenosis represents a rare but serious complication following radiofrequency ablation of atrial fibrillation with a comprehensive diagnosis including morphological stenosis grading together with the assessment of its functional consequences being imperative within the relatively narrow window for therapeutic intervention. The present study determined the clinical utility of a combined, single-session cardiovascular magnetic resonance (CMR) imaging protocol integrating pulmonary perfusion and PV angiographic assessment for pre-procedural planning and follow-up of patients referred for interventional PV stenosis treatment. METHODS CMR examinations (cine imaging, dynamic pulmonary perfusion, three-dimensional PV angiography) were performed in 32 consecutive patients prior to interventional treatment of PV stenosis and at 1-day and 3-months follow-up. Degree of PV stenosis was visually determined on CMR angiography; visual and quantitative analysis of pulmonary perfusion imaging was done for all five lung lobes. RESULTS Interventional treatment of PV stenosis achieved an acute procedural success rate of 90%. Agreement between visually evaluated pulmonary perfusion imaging and the presence or absence of a ≥ 70% PV stenosis was nearly perfect (Cohen's kappa, 0.96). ROC analysis demonstrated high discriminatory power of quantitative pulmonary perfusion measurements for the detection of ≥ 70% PV stenosis (AUC for time-to-peak enhancement, 0.96; wash-in rate, 0.93; maximum enhancement, 0.90). Quantitative pulmonary perfusion analysis proved a very large treatment effect attributable to successful PV revascularization already after 1 day. CONCLUSION Integration of CMR pulmonary perfusion imaging into the clinical work-up of patients with PV stenosis allowed for efficient peri-procedural stratification and follow-up evaluation of revascularization success.
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Affiliation(s)
- Cosima Jahnke
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Sabrina Oebel
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Frank Lindemann
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Ingo Daehnert
- Department of Pediatric Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Frank-Thomas Riede
- Department of Pediatric Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Ingo Paetsch
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany.
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Okuda I, Takeda M, Taira M, Kobayashi T, Inomata K, Yoshioka N. Objective analysis of the effectiveness of facial massage using breakthrough computed tomographic technology: A preliminary pilot study. Skin Res Technol 2022; 28:472-479. [PMID: 35416349 PMCID: PMC9907650 DOI: 10.1111/srt.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Facial massage is empirically known to be associated with morphological changes, such as improvements in facial sagging. However, quantified objective evaluations of massage-induced changes have not been performed to date. This preliminary pilot study aimed to verify the effectiveness of facial massages by using breakthrough computed tomographic technology. MATERIALS AND METHODS Five healthy adult volunteers (three women and two men; age, 29-37 years) were enrolled, and computed tomography (CT) examinations using a 320 detectors-spiral CT system known as 320-multidetector-row CT (MDCT) were performed before and after facial massages. Each participant performed a self-massage twice daily for 2 weeks. Massage-induced changes in the cheeks and the superficial musculoaponeurotic system (SMAS) were analyzed by two radiologists on a workstation with a high-accuracy imaging analysis system. RESULTS After facial massage, the malar top became thinner by -0.8% ± 0.45% and shifted cranially and horizontally over a distance of 3.9 ± 1.94 mm. The SMAS-height, defined as the highest vertical distance of the SMAS, increased by 2.6% ± 2.6%. The change rate in cheek thickness and SMAS-height showed a significant correlation (r = -0.63; P < 0.05). These changes were attributed to the lifting and tightening effects of facial massage. CONCLUSION We conducted a detailed analysis of the effects of facial massages by using the breakthrough CT technology. Our results provide useful information for beauty treatments and could contribute to the collection of objective scientific evidence for facial massages.
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Affiliation(s)
- Itsuko Okuda
- Department of Diagnostic Radiology, International University of Health and Welfare (IUHW), Mita Hospital, Tokyo, Japan.,Department of Clinical Anatomy, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Aging Imaging Laboratory Inc., Tokyo, Japan
| | | | | | | | - Ken Inomata
- Research Laboratories, KOSÉ Corporation, Tokyo, Japan
| | - Naoki Yoshioka
- Department of Radiology, International University of Health and Welfare (IUHW), Chiba, Japan
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Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation. Diagnostics (Basel) 2022; 12:diagnostics12030612. [PMID: 35328165 PMCID: PMC8947727 DOI: 10.3390/diagnostics12030612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 01/27/2023] Open
Abstract
(1) Background: Computer tomography (CT) is an imaging modality used in the pre-planning of radiofrequency catheter ablation (RFA) procedure in patients with cardiac arrhythmias. However, it is associated with a considerable ionizing radiation dose for patients. This study aims to develop and validate low-dose CT scanning protocols of the left atrium (LA) for RFA guidance. (2) Methods: 68 patients scheduled for RFA of atrial fibrillation were sequentially assigned to four groups of ECG-gated scanning protocols, based on the set tube current (TC): Group A (n = 20, TC = 33 mAs), Group B (n = 18, TC = 67 mAs), Group C (n = 10, TC = 135 mAs), and control Group D (n = 20, TC = 600 mAs). We used a 256-row multidetector CT with body weight-dependent tube voltage of 80 kVp (<70 kg), 100 kVp (70−90 kg), and 120 kVp (>90 kg). We evaluated scanning parameters including radiation dose, total scanning procedure time and signal-to-noise ratio (SNR). (3) Results: The average effective radiation dose (ED) was lower in Group A in comparison to Group B, C and D (0.83 (0.76−1.10), 1.55 (1.36−1.67), 2.91 (2.32−2.96) and 9.35 (8.00−10.04) mSv, p < 0.05). The total amount of contrast media was not significantly different between groups. The mean SNR was 6.5 (5.8−7.3), 7.1 (5.7−8.2), 10.8 (10.1−11.3), and 12.2 (9.9−15.7) for Group A, B, C and D, respectively. The comparisons of SNR in group A vs. B and C vs. D were without significant differences. (4) Conclusions: Optimized pre-ablation CT scanning protocols of the LA can reduce an average ED by 88.7%. Three dimensional (3D) models created with the lowest radiation protocol are useful for the integration of electro-anatomic-guided RFA procedures.
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Gitsioudis G, Marwan M, Schneider S, Schmermund A, Korosoglou G, Hausleiter J, Schroeder S, Rixe J, Leber A, Bruder O, Katus HA, Senges J, Achenbach S. A systematic report on non-coronary cardiac CTA in 1097 patients from the German cardiac CT registry. Eur J Radiol 2020; 130:109136. [DOI: 10.1016/j.ejrad.2020.109136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/31/2022]
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Tudos Z, Skala T, Homola M, Moravec O, Taborsky M, Kocher M, Cerna M, Ctvrtlik F, Odstrcil F, Langova K, Klementova O. ECG non-gated multi-detector computed tomography protocol prior to catheter ablation of atrial fibrillation provides sufficient data quality with lower radiation exposure compared to ECG-gated protocol - results of a prospective, randomized and blinded study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 162:310-318. [PMID: 30181665 DOI: 10.5507/bp.2018.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The role of ECG-gating in left atrium (LA) computed tomography (MDCT) imaging is not precisely defined. METHODS AND RESULTS 62 patients were randomized according to ECG gating with prospective evaluation of image quality, Volume CT Dose Index, Dose Length Product, Effective Dose and registration error between anatomical map and MDCT. We found significant difference in all radiation variables, but not in visual quality, registration error, CA duration, CA fluoroscopy time and CA fluoroscopy dose. CONCLUSION Helical non-gated MDCT achieved a radiation dose more than four times lower with comparable image quality and course of ablation compared to ECG-gated protocol.
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Affiliation(s)
- Zbynek Tudos
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Martin Homola
- Department of Medical Physics and Radiation Protection, University Hospital Olomouc, Czech Republic
| | - Ondrej Moravec
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Martin Kocher
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Marie Cerna
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Filip Ctvrtlik
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Frantisek Odstrcil
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
- Department of Radiological Methods, Faculty of Health Sciences, Palacky University Olomouc, Czech Republic
| | - Katerina Langova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
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Skowerski M, Wozniak-Skowerska I, Hoffmann A, Nowak S, Skowerski T, Sosnowski M, Wnuk-Wojnar AM, Mizia-Stec K. Pulmonary vein anatomy variants as a biomarker of atrial fibrillation - CT angiography evaluation. BMC Cardiovasc Disord 2018; 18:146. [PMID: 30005637 PMCID: PMC6045862 DOI: 10.1186/s12872-018-0884-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
Background It has been suggested that changes in pulmonary veins (PV) and left atrium (LA) anatomy may have an influence on initiating atrial fibrillation (AF) and the effectiveness of pulmonary vein isolation (PVI) in patients (pts) with atrial fibrillation. The aim of the study was to assess anatomy abnormalities of the PV and LA in the patients with the history of AF and compare it with the control group(CG). Methods The multi-slice tomography (MSCT) scans were performed in 224 AF pts. before PVI (129 males, mean age 59 ± 9 yrs). The CG consisted of 40 pts. without AF (26 males, age 45 ± 9 yrs). LA and PV anatomy were evaluated. Diameters of PV ostia were measured in two directions: anterior-posterior (AP) and superior-inferior (SI) automatically using Vitrea 4.0. Results Pulmonary veins anatomy variants were observed more frequently in the atrial fibrillation group - 83 pts. (37%) vs 6 pts. (15%) in CG; 9% (21 pts) left common ostia (CO), 2% (5 pts) right CO, 19% (42 pts) additional right PV (APV), (1.8%) 4 pts. APV left, 8% right early branching (EB) and 3.5% left EB. The LA diameter differed significantly in AF vs CG group (41.2 ± 6 mm vs 35 ± 4.2 mm, p < 0.0001) respectively. Conclusions The anomalies of pulmonary vein anatomy occurred more often in pts. with AF. They can be defined as an image biomarkers of atrial fibrillation. Right additional (middle) pulmonary vein was the most important anomaly detected in AF patients as well as enlargered diameters of the LA and PV ostia.
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Affiliation(s)
- M Skowerski
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - I Wozniak-Skowerska
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - A Hoffmann
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - S Nowak
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - T Skowerski
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland.
| | - M Sosnowski
- Unit of Noninvasive Cardiovascular Diagnostics, Medical University of Silesia, Katowice, Poland
| | - A M Wnuk-Wojnar
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - K Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Fahlenkamp UL, Diaz Ramirez I, Wagner M, Schwenke C, Huppertz A, Hamm B, Lembcke A. Image quality of low-radiation dose left atrial CT using filtered back projection and an iterative reconstruction algorithm: intra-individual comparison in unselected patients undergoing pulmonary vein isolation. Acta Radiol 2018; 59:161-169. [PMID: 28513211 DOI: 10.1177/0284185117708472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Computed tomography (CT) of the left atrium (LA) is performed prior to pulmonary vein isolation (PVI) to improve success of circumferential ablation for atrial fibrillation. The ablation procedure itself exposes patients to substantial radiation doses, therefore radiation dose reduction in pre-ablational imaging is of concern. Purpose To assess and compare diagnostic performance of low-radiation dose preprocedural CT in patients scheduled for PVI using two types of reconstruction algorithms. Material and Methods Forty-six patients (61 ± 10 years) scheduled for PVI were enrolled in this study irrespective of body-mass-index or cardiac rhythm at examination. An electrocardiographically triggered dual-source CT scan was performed. Filtered back projection (FBP) and iterative reconstruction (IR) algorithms were applied. Images were integrated into an electroanatomic mapping (EAM) system. Subjective image quality was scored independently by two readers on a five-point scale for both reconstruction algorithms (1 = excellent to 5 = non-diagnostic). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and effective radiation dose were calculated. Results Data acquisition and EAM integration were successful in all patients. Median image quality score was 1 for both FBP (quartiles = 1, 1.62; range = 1-3) and IR (quartiles = 1, 1.5; range = 1-3). Mean SNR was 7.61 ± 2.14 for FBP and 9.02 ± 2.69 for IR. Mean CNR was 5.92 ± 1.80 for FBP and 6.95 ± 2.29 for IR. Mean effective radiation dose was 0.3 ± 0.1 mSv. Conclusion At a radiation dose of 0.3 ± 0.1 mSv, high-pitch dual-source CT yields LA images of consistently high quality using both FBP and IR. IR raises SNR and CNR without significantly improving subjective image quality.
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Affiliation(s)
- Ute Lina Fahlenkamp
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ivan Diaz Ramirez
- Department of Cardiology, Charité – Universitätsmedizin, Berlin, Germany
| | - Moritz Wagner
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Alexander Huppertz
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Present address: Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Bernd Hamm
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Lembcke
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Liddy S, Buckley U, Kok HK, Loo B, Glover B, Dhillon GR, Buckley O. Applications of cardiac computed tomography in electrophysiology intervention. Eur Heart J Cardiovasc Imaging 2017; 19:253-261. [DOI: 10.1093/ehjci/jex312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 11/23/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Liddy
- Department of Radiology, Tallaght Hospital, Tallaght, Dublin 24, Ireland
| | - U Buckley
- UCLA Cardiac Arrhythmia Center & Neurocardiology Research Center of Excellence, David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - H K Kok
- Department of Radiology, Papworth Hospital NHS Foundation Trust, Cambridge, CB23 3RE, UK
| | - B Loo
- Department of Cardiology, Tallaght Hospital, Tallaght, Dublin 24, Ireland
| | - B Glover
- Cardiac Arrhythmia Department, Queens University, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - G R Dhillon
- Cardiac Arrhythmia Department, Queens University, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - O Buckley
- Department of Radiology, Tallaght Hospital, Tallaght, Dublin 24, Ireland
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Abstract
Cardiac computed tomography (CT) is increasingly used in the evaluation of cardiomyopathies, particularly in patients who are not able to undergo other non-invasive imaging tests such as magnetic resonance imaging (MRI) due to the presence of MRI-incompatible pacemakers/defibrillators or other contraindications or due to extensive artifacts from indwelling metallic devices. Advances in scanner technology enable acquisition of CT images with high spatial resolution, good temporal resolution, wide field of view and multi-planar reconstruction capabilities. CT is useful in cardiomyopathies in several ways, particularly in the evaluation of coronary arteries, characterization of cardiomyopathy phenotype, quantification of cardiac volumes and function, treatment-planning, and post-treatment evaluation. In this article, we review the imaging techniques and specific applications of CT in the evaluation of cardiomyopathies.
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Affiliation(s)
- Kevin Kalisz
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, Texas, USA
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Pursnani A, Narang A, Edelman R. Cardiac computed tomography and magnetic resonance imaging: complementary or competing? EUROINTERVENTION 2016; 12 Suppl X:X75-X80. [DOI: 10.4244/eijv12sxa14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hioki M, Matsuo S, Tokutake K, Yokoyama K, Narui R, Ito K, Tanigawa S, Tokuda M, Yamashita S, Anan I, Inada K, Sakuma T, Sugimoto KI, Yoshimura M, Yamane T. Filling defects of the left atrial appendage on multidetector computed tomography: their disappearance following catheter ablation of atrial fibrillation and the detection of LAA thrombi by MDCT. Heart Vessels 2016; 31:2014-2024. [PMID: 26936451 DOI: 10.1007/s00380-016-0819-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/19/2016] [Indexed: 01/08/2023]
Abstract
Filling defects of the left atrial appendage (LAA) on multidetector computed tomography (MDCT) are known to occur, not only due to LAA thrombi formation, but also due to the disturbance of blood flow in the LAA of patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of the maintenance of sinus rhythm via ablation on the incidence of LAA filling defects on MDCT in patients with AF. A total of 459 consecutive patients were included in the present study. Prior to ablation, MDCT and transesophageal echocardiography (TEE) were performed. AF ablation was performed in patients without LAA thrombi confirmed on TEE. The LAA filling defects were evaluated on MDCT at 3 months after ablation. LAA filling defects were detected on MDCT in 51 patients (11.1 %), among whom the absence of LAA thrombi was confirmed in 42 patients using TEE. The LAA Doppler velocity in patients with LAA filling defects was lower than that of patients without filling defects (0.61 ± 0.19 vs. 0.47 ± 0.21 m/s; P < 0.0001). The sensitivity, specificity and negative predictive value of MDCT in the detection of thrombi were 100, 91 and 100 %, respectively. No LAA filling defects were observed on MDCT at 3 months after ablation in any of the patients, including the patients in whom filling defects were noted prior to the procedure. MDCT is useful for evaluating the presence of LAA thrombi and the blood flow of the LAA. The catheter ablation of AF not only suppresses AF, but also eliminates LAA filling defect on MDCT suggesting the improvement of LAA blood flow.
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Affiliation(s)
- Mika Hioki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Ito
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ikuko Anan
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Sakuma
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ken-Ichi Sugimoto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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IWAYAMA TADATERU, ARIMOTO TAKANORI, ISHIGAKI DAISUKE, HASHIMOTO NAOAKI, KUMAGAI YU, KOYAMA YO, KIRIBAYASHI NOBUYUKI, NETSU SHUNSUKE, NISHIYAMA SATOSHI, TAKAHASHI HIROKI, SHISHIDO TETSURO, MIYAMOTO TAKUYA, SATO TOSHIMITSU, WATANABE TETSU, KUBOTA ISAO. The Clinical Value of Nongated Dual-Source Computed Tomography in Atrial Fibrillation Catheter Ablation. J Cardiovasc Electrophysiol 2015; 27:34-40. [DOI: 10.1111/jce.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/15/2015] [Accepted: 08/25/2015] [Indexed: 11/27/2022]
Affiliation(s)
- TADATERU IWAYAMA
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - TAKANORI ARIMOTO
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - DAISUKE ISHIGAKI
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - NAOAKI HASHIMOTO
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - YU KUMAGAI
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - YO KOYAMA
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - NOBUYUKI KIRIBAYASHI
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - SHUNSUKE NETSU
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - SATOSHI NISHIYAMA
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - HIROKI TAKAHASHI
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - TETSURO SHISHIDO
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - TAKUYA MIYAMOTO
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - TOSHIMITSU SATO
- Division of Radiology; Yamagata University School of Medicine; Yamagata Japan
| | - TETSU WATANABE
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
| | - ISAO KUBOTA
- Department of Cardiology, Pulmonology, and Nephrology; Yamagata University School of Medicine; Yamagata Japan
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Determination of left atrium volume by fast anatomical mapping and intracardiac echocardiography. The contribution of respiratory gating. J Interv Card Electrophysiol 2015; 42:129-34. [DOI: 10.1007/s10840-014-9968-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/22/2014] [Indexed: 01/22/2023]
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14
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Multimodality imaging for patient evaluation and guidance of catheter ablation for atrial fibrillation — Current status and future perspective. Int J Cardiol 2014; 175:400-8. [DOI: 10.1016/j.ijcard.2014.06.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/12/2014] [Accepted: 06/24/2014] [Indexed: 11/17/2022]
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15
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Mlynarski R, Mlynarska A, Sosnowski M. Coronary venous system in cardiac computer tomography: Visualization, classification and role. World J Radiol 2014; 6:399-408. [PMID: 25071880 PMCID: PMC4109091 DOI: 10.4329/wjr.v6.i7.399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 02/28/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023] Open
Abstract
The role of the coronary venous system was underestimated for many years. In the last 20 years, a few percutaneous cardiology techniques in which the anatomy of the coronary venous system was significant were developed and are in use. The most important seems to be cardiac resynchronization therapy, which is an invasive method for the treatment of heart failure. Unfortunately, one of the major problems is the significant anatomical variability of the coronary venous system. The description of the selected anatomical structures is only useful in selected cases such as, for example, the obstruction of selected vessels, a huge Thebesian valve, etc. The 3D images can add significant value; however, their usefulness is limited due to the different points of view that are obtained during intra-operational fluoroscopy. After summarizing all of the articles and guidelines, it can be recommended that the visualization of the coronary venous system be performed in certain patients before cardiac resynchronization. The best option is to use tomography with retrospective gating with the optimal reconstruction of cardiac veins that occurs during the diastolic phases.
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Beitzke D, Nolz R, Unterhumer S, Plank C, Weber M, Schernthaner R, Schöpf V, Wolf F, Loewe C. Low-dose high-pitch CT angiography of the supraaortic arteries using sinogram-affirmed iterative reconstruction. PLoS One 2014; 9:e99832. [PMID: 24919195 PMCID: PMC4053523 DOI: 10.1371/journal.pone.0099832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/19/2014] [Indexed: 11/18/2022] Open
Abstract
Objective To prospectively evaluate image quality and radiation dose using a low-dose computed tomography angiography protocol and iterative image reconstruction for high-pitch dual-source CT-angiography (DSCTA) of the supraaortic arteries. Material and Methods DSCTA was performed in 42 patients, using either 120 kVp tube voltage, 120 mAS tube current, 2.4 pitch and filtered back projection, or 100 kVp tube voltage, 100 mAs tube current, 3.2 pitch, and sinogram affirmed iterative reconstruction. Measurements of vessel attenuation, of the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were performed to objectively evaluate image quality. Two readers evaluated subjective image quality and image noise, using a four-point scale. Effective dose was used to compare the differences in radiation dose. Results Low-dose protocol application showed significantly higher vessel opacification (p = 0.013), and non-significantly higher CNR and SNR values. There was no difference in the subjective image quality and image noise reading between the protocols. Effective dose was significantly lower using the low-dose protocol (1.29±0.21 mSv vs. 2.92±0.72 mSv; p<0.001). Conclusion The combined use of reduced tube voltage, reduced tube current, and iterative reconstruction reduces radiation dose by 55.4% in high-pitch DSCTA of the supraaortic arteries without impairment of image quality.
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Affiliation(s)
- Dietrich Beitzke
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
- * E-mail:
| | - Richard Nolz
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Sylvia Unterhumer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Christina Plank
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Rüdiger Schernthaner
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Veronika Schöpf
- Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Vienna, Austria
| | - Florian Wolf
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
| | - Christian Loewe
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University Vienna, Vienna, Austria
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Teshima H, Akasu K, Arinaga K, Aoyagi S, Tanaka H. Diagnosis of Structural Deterioration in an Aortic Bioprosthetic Valve by Multidetector Row Computed Tomography: Report of a Case. Ann Thorac Cardiovasc Surg 2014; 20 Suppl:697-701. [DOI: 10.5761/atcs.cr.12.01988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hideki Teshima
- Cardiovascular Surgery, Chikamori Hospital Heart Center, Kochi, Japan
| | - Koji Akasu
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kouichi Arinaga
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shigeaki Aoyagi
- Cardiovascular Surgery, Munakata Suikokai General Hospital, Fukuoka, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Belgrano M, Bregant P, Djoguela MF, Toscano W, Marchese E, Cova MA. 256-slice CT coronary angiography: in vivo dosimetry and technique optimization. LA RADIOLOGIA MEDICA 2013; 119:249-56. [PMID: 24337756 DOI: 10.1007/s11547-013-0334-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 01/23/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE This study was undertaken to compare the different acquisition protocols available in a last-generation multislice computed tomography scanner used for cardiovascular studies, with particular attention to dosimetric aspects. MATERIALS AND METHODS Our study compared prospective and retrospective electrocardiographic-gating techniques for cardiac imaging. For each patient, we performed in vivo dose measurements, using Gafchromic film. We compared the effective dose values estimated from the experimental measurements and the dose data reported on the CT console. Image quality was also assessed. RESULTS Prospective acquisition allows for major dose savings compared to retrospective acquisition (mean effective dose, 4.5 mSv with prospective acquisition versus 27.5 mSv with retrospective acquisition). The agreement between the experimental and software-based dose estimates was excellent and showed below 10% of variation of the measured dose. CONCLUSION In patients with regular rhythm and a heart rate lower than 75 bpm, the prospective acquisition technique ensures adequate diagnostic results and allows for significant patient dose savings.
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Affiliation(s)
- Manuel Belgrano
- UCO di Radiologia, Dipartimento di Scienze Mediche, Chirurgiche e della Salute, Azienda Ospedaliero-Universitaria di Trieste, Ospedale di Cattinara, strada di Fiume 447, Trieste, Italy,
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Circulation: Cardiovascular Imaging
Editors’ Picks. Circ Cardiovasc Imaging 2013. [DOI: 10.1161/circimaging.113.001335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aljaroudi WA, Saliba WS, Wazni OM, Jaber WA. Role of cardiac computed tomography and cardiovascular magnetic resonance imaging in guiding management and treatment of patients with atrial fibrillation: state of the art review. J Nucl Cardiol 2013; 20:426-42. [PMID: 23400559 DOI: 10.1007/s12350-013-9689-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 01/28/2013] [Indexed: 11/29/2022]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is associated with high morbidity and mortality. In view of an aging population, the prevalence and incidence of AF are on the rise and are expected to double in the coming decades, posing a huge economic burden on already strained resources. New innovative therapies such as pulmonary vein isolation and percutaneous closure of the left atrial appendage have emerged. The current applications of such therapies would not have been possible without the pivotal role of multimodality cardiovascular imaging. The role of echocardiography in guiding therapy has been extensively reviewed. However, there are new data in support of other complementary imaging modalities, mainly cardiac computed tomography and cardiovascular magnetic resonance imaging, which will be the focus of this review.
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Affiliation(s)
- Wael A Aljaroudi
- Division of Cardiovascular Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Cao LX, Zhang H, Liu B, Yang WJ, Zhang YY, Pan ZL, Yan FH, Chen KM. Evaluation of high-pitch flash scan for pulmonary venous CTA on a 128-slice dual source CT: compared with prospective ECG-triggered sequence scan. Int J Cardiovasc Imaging 2013; 29:1557-64. [PMID: 23645131 DOI: 10.1007/s10554-013-0227-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 04/19/2013] [Indexed: 11/30/2022]
Abstract
To compare the image quality (IQ) and radiation dose of high-pitch scan and prospective ECG-triggered sequence scan on a 128-slice DSCT system for patients with atrial fibrillation (AF). Pulmonary venous (PV) CTA was performed with two protocols, including high-pitch scan and prospective ECG-triggered sequence scan. For each protocol, 20 sex, age and body-mass-index (mean 24.2 kg/m(2)) matched patients were identified. Two experienced radiologists, who were blinded to the scan protocols, independently graded the CT images of the two groups by a 5-point scale for subjective IQ assessment. Measured CT attenuation (Hounsfield units ± standard deviation), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) at various anatomic locations were also recorded for objective IQ evaluation. Radiation exposure parameters [dose length product (DLP) and effective radiation dose (ERD)] were compared. Twenty-three patients (57.5 %) showed an ECG pattern of AF in total. Subjective IQ was rated excellent in 100 % for the high-pitch scan group, while minor step artifacts were observed in two patients (10 %) with arrhythmia for the prospective ECG-triggered sequence group. There was no significant difference on IQ, neither by subjective, nor by objective measures (SNR, CNR) between the two groups. The ERD of high-pitch flash scan and prospective ECG-triggered sequence scan were 0.9 (± 0.25) and 2.9 (± 0.69) mSv, respectively. Significantly lower radiation was achieved by using high-pitch flash scan (P < 0.05). High-pitch flash scan can provide similar subjective and objective IQ compared with prospective ECG-triggered sequence scan for PV CTA, while radiation exposure was significantly reduced.
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Affiliation(s)
- Li Xiu Cao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
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Abstract
Various electrophysiological procedures and device implantation has been shown to improve morbidity and mortality in patients with atrial fibrillation (AF) and patients with heart failure (HF). Noninvasive cardiac imaging is used extensively in the preprocedural patient selection and for procedural guidance. In this review, we will discuss the application of preprocedural cardiac imaging in patients with AF prior to pulmonary vein and left atrial ablation as well as insertion of left atrial occluder device. We also discuss the role of noninvasive cardiac imaging in the selection of appropriate HF patients for device therapy as well as their use in guiding implantation of biventricular pacemaker for cardiac resynchronization therapy by assessing left ventricular ejection fraction, coronary venous anatomy, mechanical dyssynchrony and myocardial scar. We describe new research associated with preprocedural imaging in these patient cohorts.
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