Journal of cardiovascular computed tomography
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Septal defects are common congenital cardiac anomalies that may present in adulthood. Although echocardiography and magnetic resonance imaging are most frequently used to assess for and evaluate septal defects, multidetector computed tomography (CT), with its high spatial and temporal resolutions, multiplanar reconstruction capabilities, and wide field of view, is an excellent tool for detection and characterization of septal defects and for identification of associated anomalies of the heart and pulmonary vasculature. Knowledge of the CT appearances of septal defects and their respective associated abnormalities is critical for accurate reporting as well as for providing information for planning of surgical or percutaneous therapy. In this pictorial review, the CT appearances of various atrial and ventricular septal defects and associated shunts are described and illustrated.
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We report a case of young male with a penetrating chest trauma due to a gunshot. The bullet was detected by conventional X-ray and localized within the lateral wall of the left ventricle by CT. During surgery the bullet was not found. Thereafter conventional X-ray showed migration of the bullet within the lung parenchyma.
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J Cardiovasc Comput Tomogr · Jul 2009
Randomized Controlled TrialRationale and design of a randomized controlled trial comparing stress myocardial perfusion imaging with coronary CT angiography as the initial imaging study for intermediate-risk patients admitted with chest pain.
Noninvasive cardiac imaging plays an important role in the diagnosis and management of coronary artery disease (CAD). Prior studies have focused on the diagnostic performance of noninvasive modalities using angiographically significant stenoses as the reference standard. Recent trends in evidence-based medicine and increasing imaging utilization call for validation of diagnostic algorithms with well-designed, controlled trials with clinical outcome endpoints. ⋯ The results of this trial will further our understanding of the relative appropriateness of CTA and MPI in evaluating intermediate-risk patients hospitalized with chest pain. It will also have implications for the design and probability of success of multicentered trials that are currently being planned.
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J Cardiovasc Comput Tomogr · Mar 2009
ReviewIs the "triple rule-out" study an appropriate indication for cardiovascular CT?
There is interest in using the fast volume coverage of 64-slice cardiovascular CT angiography (CCTA) in patients presenting with undifferentiated acute chest pain to simultaneously evaluate the coronary arteries, thoracic aorta, and pulmonary arteries during a single breathhold, the so-called "triple rule-out." However, it is not clear whether the triple rule-out study is an appropriate indication for cardiovascular CCTA. Initial studies suggest that performing a triple rule-out protocol to comprehensively evaluate patients with acute chest pain presenting to the emergency department (ED) is feasible and that quantitative parameters of image quality may be comparable to the conventional, dedicated coronary and pulmonary CTA protocols. ⋯ In addition, new scanner technology has also reduced the contrast and radiation doses necessary for such an examination. However, despite these early encouraging results, randomized control trials designed to determine whether this protocol is safe, cost-effective, and improves clinical decision making are necessary before routine implementation of such an examination can be justified.