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AbstractObjectiveTo evaluate the utility of cardiac magnetic resonance feature tracking-derived left ventricular strain in assessing cardiac dysfunction and investigate the correlation between left ventricular strain and myocardial T2* in patients with beta-thalassaemia major.MethodsForty-two patients with beta-thalassaemia major, having a mean age of 22.49 ± 8.48 years, and age-matched healthy controls were enrolled in the study. The observer drew regions of interest on the interventricular septum, and T2* decay curves were calculated accordingly. The short-axis cine images were used to derive left ventricular circumferential and radial strains, and the long-axis four-chamber and two-chamber images were used to assess left ventricular longitudinal strain.ResultsThe mean global left ventricular strains were lower in beta-thalassaemia major patients than the controls (p < 0.05). Left ventricular strains of beta-thalassaemia major patients with cardiac T2* values of > 20 ms were also significantly reduced compared with the controls (p < 0.05); there was no difference between the mean left ventricular ejection fractions of the two groups (p = 0.84). Cardiac T2* showed a weak correlation with left ventricular ejection fraction (r = 0.33, p = 0.03), while the left ventricular circumferential strain showed a good positive correlation with cardiac T2* (r = 0.6, p < 0.0001).ConclusionCompared with healthy controls, patients with beta-thalassaemia major, including those with myocardial T2* values of >20 ms, showed reduced global left ventricular strains. Left ventricular circumferential strain was positively correlated with myocardial T2*. Left ventricular strain analysis using cardiac magnetic resonance feature tracking may have utility in beta-thalassaemia major assessment.Key FindingsPatients with beta-thalassaemia major, including those with myocardial T2* values of >20 ms, had reduced global left ventricular strains.Cardiac T2* showed a weak correlation with left ventricular ejection fraction, while the left ventricular circumferential strain showed a good positive correlation with cardiac T2*.ImportanceLeft ventricular strain using cardiac magnetic resonance feature tracking might be used as an adjunct in assessing cardiac functions in beta-thalassaemia major.

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Background Distal pancreatectomy (DP) is the main surgical treatment of benign and malignant lesions located in pancreatic body and tail. Postoperative pancreatic fistula (POPF) following DP is still a considerable cause of morbidity. Identification of risk factors for POPF after DP might provide some preventive applications. We aimed to evaluate the factors affecting POPF after DP and to present a new and easy radiological predictive factor.Materials and Methods Thirty-four patients underwent DP with stapler closure were included. Several risk factors for clinically relevant POPF (CR-POPF) were analyzed. Additionally, computed tomography findings of pancreatic thickness (PT), main pancreatic duct diameter (MPDD), and PT/MPDD ratio were evaluated for POPF.Results CR-POPF was observed in 10 patients (29.4%). Univariate and multivariate analyses showed that previous abdominal surgery and PT/MPDD ratio were predictive factors for CR-POPF after DP (P= 0.040, P= 0.034, respectively). The cutoff value for the PT/MPDD ratio was 8.Conclusion A PT/MPDD ratio greater than 8 (a wide pancreas with a narrow duct) is a significant predictive factor for CR-POPF following DP.

Introduction:Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement.