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To assess differences in aortic and endoleak enhancement in patients after endovascular aneurysm repair (EVAR) with dynamic computed tomography (CT) angiography.Twenty-one consecutive patients (mean age, 74.5 y ± 6; range, 61-88 y) with endoleaks after EVAR of the abdominal aorta were examined on a second-generation dual-source CT unit with 10 unidirectional scan phases (temporal resolution, 5 s; 80 kV; 120 reference-mAs; z-axis field of view, 283 mm), followed by a venous scan phase. Enhancement was assessed in aorta and endoleaks for all phases by density measurements. The diagnostic reliability of endoleak detection was assessed on a five-point confidence scale.In total, 26 endoleaks (type I, n = 1; type II, n = 25) were detected. The highest detection rate was found in phase 5 (22 s after threshold; P.01 vs other dynamic phases). Mean peak aortic enhancement (560 HU ± 96) was present in an early arterial phase (phase 3, 12 s after threshold), whereas the mean peak endoleak enhancement (398 HU ± 174) for type II endoleaks was present later, in phase 4 (17 s after threshold). Despite perceived high diagnostic confidence in phases 1 and 2 (ie, typical arterial phase of biphasic CT protocol), only 23% and 62% of endoleaks were detected, respectively, whereas peak diagnostic confidence (phases 4 and 5) corresponded well with the maximum endoleak detection rate but decreased significantly in later phases (ie, 6-10).Preliminary dynamic CT angiography results in post-EVAR follow-up revealed notably different peaks of endoleak and aortic enhancement, which are not covered sufficiently by conventional biphasic CT protocols. Phase 5 demonstrated the highest type II endoleak detection rate, with high diagnostic confidence.

Coronary artery fistulas are rare acquired or congenital abnormalities leading to a shunt between a coronary artery and one of the cardiac cavities, a main artery, or a vein. This case report describes the combined use of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the precise anatomical and functional assessment of a right coronary artery (RCA) fistula shunting to the coronary sinus. The RCA itself showed a massively elongated deformation and a maximal aneurysmatic dilatation of 41 mm on MDCT and MRI. The absolute shunt volume calculated by MRI flow measurements at the RCA was 40 ml, which means 37% in relation to the measured LV stroke volume of 109 ml.

A short run-time in separation of lipoproteins by preparative ultracentrifugation is desirable for several reasons. Recently, a method was described that needs only 100 min for one run in a centrifugal field of 625,000 x g. It is assumed that lipoprotein separation depends on the rotor speed but this has not been systematically studied in centrifugal fields of this order. We performed such a study. Rotor speeds of 120, 90, 60 and 30 x 10(3) rev./min and run-times of 100 min, 3 h, 6.7 h and 27 h were selected in such a way that the product of centrifugal field and run-time remained constant. The first conditions correspond to the 'very fast ultracentrifugation' (VFU) procedure with a centrifugal field of 625,000 x g. The Optima tabletop ultracentrifuge, the rotor TLA-120.2 and thick wall open tubes for 1 ml were used. Thirteen different plasma samples covering a wide range of cholesterol and triglyceride concentrations were separated into VLDL, LDL and HDL in the course of two centrifugal runs at densities of 1.006 and 1.063. The constituents of the lipoproteins were calculated considering the mass of the tube contents after slicing. Recoveries of cholesterol, triglycerides and protein were 97%, 98% and 90%, respectively. The influence of the rotor speed on the apparent composition of the lipoproteins was small. With increasing rotor speed, VLDL-cholesterol became higher (by 14%, P < 0.001), VLDL-triglyceride became lower (by 6%, P < 0.012), LDL-cholesterol became lower (by 9%, P < 0.000). The effects on LDL-triglyceride and on HDL-cholesterol and HDL-triglyceride, did not reach statistical significance. Protein in VLDL and in LDL decreased and increased in 'HDL' (the subnatant of the LDL run). As checked by SDS-PAGE the protein effects were due to complete disappearance of albumin from VLDL and LDL while the apolipoproteins B-100, E and C-I to C-III remained unaffected. It is concluded that the main advantages of VFU are the short run-time and the disappearance of albumin from VLDL and LDL. The other compositional changes need to be further investigated.

ObjectiveSurgical ventricular reconstruction is a treatment option for patients with apical akinesia or dyskinesia. The Surgical Treatment for Ischemic Heart Failure trial recently demonstrated its safety but no added benefit to bypass surgery, although the trial’s inclusion criteria did not contain shape or viability parameters. However, we evaluated cardiac magnetic resonance-derived parameters as potential predictors of function after surgical ventricular reconstruction.MethodsIn 24 patients with cardiac magnetic resonance before and after surgical ventricular reconstruction, we assessed cardiac volumes, function, scar, and geometry (sphericity index, short to long axis; apical conicity index, apical to short axis; apical volume index, apical to basal volume).ResultsSurgical ventricular reconstruction significantly reduced ventricular volumes (−64.2%) and increased global ejection fraction by 12% (P