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Purpose: Preoperative assessment of patients with pectus excavatum (PE) demands evaluation of malformation indexes, generally with chest computed tomography (CT). In addition, assessment of the cardiac impact of sternal depression has become a rule in high referral centers, thus requiring two independent imaging modalities and use ionizing radiation in a very young population. The objective of this study was to explore the agreement between chest CT and standard cardiac MR (CMR) for the evaluation of chest wall malformation indexes., Methods: We included consecutive patients with PE referred to undergo chest CT and CMR to establish surgical candidacy and/or to define treatment strategies. Both CT and CMR were performed at full-expiration. In both modalities, the Haller index (HI) and the Correction index (CI) were calculated by two independent observers. In CMR, only scout images were used. Agreement was evaluated using intra-class correlation coefficients (ICC)., Results: Fifty patients comprised the study population (median age 19.0 years) and underwent chest CT and CMR within the same month. CMR assessment of chest malformation indexes was reproducible, with a very good inter-observer agreement for HI [ICC 0.93 (0.88-0.96), p < 0.0001] and CI [ICC 0.91 (0.83-0.95), p < 0.0001]. CMR also had a very good agreement with chest CT for HI [ICC 0.90 (0.82-0.94), p < 0.0001] and CI measurements [ICC 0.93 (95% CI 0.88-0.96), p < 0.0001]., Conclusions: We demonstrated an excellent agreement between chest CT and standard CMR for the assessment of chest wall malformations, thus potentially enabling preoperative assessment of PE severity and cardiac involvement with a single diagnostic tool., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: To explore the relationship between coronary and extra-coronary atherosclerotic plaque burden with total and regional fat depots among patients undergoing ECG-gated aortic computed tomography angiography (CTA)., Methods: The subjects of this study comprised a cohort of consecutive patients who underwent ECG-gated thoracoabdominal CTA. We assessed the number of coronary segments with plaques (segment-involvement score, SIS); and the extra-coronary atherosclerotic plaque burden, comprising the aorta and supra-aortic trunks, iliofemoral arteries, and visceral arteries (extra-coronary SS). Total and regional fat volume (FV) were calculated., Results: A total of 2700 vascular segments were evaluated in 90 patients. Obese patients (n = 31, 34%) showed similar coronary SIS (p = 0.41) and extra-coronary SS (p = 0.22) than non-obese patients. General body fat measurements were not related to atherosclerotic plaque burden scores, without associations between coronary or extra-coronary plaque burden and BMI (p = 0.68, and p = 0.91), abdominal circumference (p = 0.13, p = 0.89), total body FV (p = 0.50, p = 0.98), or abdominal FV (p = 0.51, p = 0.99). Pericardial FV was related to coronary SIS (p < 0.0001) and extra-coronary SS (p = 0.008), and visceral FV was related to the coronary SIS (p = 0.006) and extra-coronary SS (p = 0.056). Abdominal subcutaneous fat was inversely related to coronary SIS (p = 0.038) and extra-coronary SS (p = 0.010). Pericardial FV was identified as the only independent predictor of extensive coronary [OR 1.020 (95% CI 1.001-1.039), p = 0.036] and extra-coronary [OR 1.018 (95% CI 1.001-1.036), p = 0.035] plaque burden., Conclusions: In the present study, pericardial and visceral fat were associated with an increased atherosclerotic burden, whereas we identified an inverse relationship between subcutaneous abdominal fat and plaque burden., (Copyright © 2018 Elsevier B.V. All rights reserved.)

We explored whether intracycle motion correction algorithms (MCAs) might be applicable to dual energy computed tomography coronary angiography in patients with intermediate to high likelihood of coronary artery disease. MCA reconstructions were associated with higher interpretability rates (96.7% vs. 87.9%, P<.001), image quality scores (4.12 ± 0.9 vs. 3.76 ± 1.0; P<.0001), and diagnostic performance [area under the curve of 0.95 (95% confidence interval [CI] 0.92-0.97) vs. 0.89 (95% CI 0.86-0.92); P<.0001] compared to conventional reconstructions. In conclusion, application of intracycle MCA reconstructions to dual energy computed tomography acquisitions was feasible and resulted in significantly higher image quality scores, interpretability, and diagnostic performance., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The assessment of myocardial perfusion using single-energy (SE) imaging is influenced by beam-hardening artifacts (BHA). We sought to explore the ability of dual-energy (DE) imaging to attenuate the presence of BHA. Myocardial signal density (SD) was evaluated in 2240 myocardial segments (112 for each energy level) and in 320 American Heart Association segments among the SE group. Compared to DE reconstructions at the best energy level, SE acquisitions showed no significant differences overall regarding myocardial SD or signal-to-noise ratio. The segments most commonly affected by BHA showed significantly lower myocardial SD at the lowest energy levels, progressively normalizing at higher energy levels., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objectives: We sought to explore the relationship between established parameters of reperfusion and the extent of myocardial damage measured by the delayed enhancement (DE) of iodinated contrast by multidetector computed tomography (MDCT) immediately after primary percutaneous coronary intervention (PCI)., Background: Early detection of myocardial viability should be valuable for risk stratification of patients with reperfused acute myocardial infarction (AMI)., Methods: Consecutive patients without a history of previous AMI who underwent primary PCI for an ST-segment elevation AMI were examined by DE-MDCT without an additional contrast injection immediately after completion of PCI. No medication was administrated to lower the heart rate. Dose modulation lead to an approximate mean radiation dose of 5.5 mSv., Results: Thirty patients constituted the study population. Mean age was 61.4 +/- 15.6 years, 24 (80%) were men, and 4 (13%) were diabetic. Although post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 was achieved in all patients, DE was detected in 14 (47%) patients. Age, sex, hypertension, diabetes, smoking history, serum creatinine levels, and pain duration were not associated with the presence of DE. Door-to-balloon time (DE 70.3 +/- 33.6 min vs. non-DE 98.3 +/- 70.7 min, p = 0.19) and lesion crossing time (DE 18.6 +/- 11.4 min vs. non-DE 16.4 +/- 9.6 min, p = 0.58) did not differ between groups. The TIMI myocardial perfusion grade (0 to 1 vs. 2 to 3) after stent implantation and electrocardiogram ST-segment resolution (<50% or >/=50%) were associated with the presence of DE (p = 0.001 and p = 0.02, respectively). Pre-discharge left ventricular ejection fraction was lower in DE than in non-DE patients (44.6 +/- 12.4% vs. 54.1 +/- 10.3%, respectively, p = 0.05). Hospitalization days (DE 5.6 +/- 3.8 vs. non-DE 4.8 +/- 1.0, p = 0.41) and 6-month cardiac events (DE 3 of 14 vs. non-DE 1 of 16, p = 0.22) did not differ between groups., Conclusions: Early detection of myocardial viability immediately after primary PCI by the use of DE-MDCT is related to clinical and angiographic parameters of myocardial reperfusion.