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Attalla RA, Helmy IM, Nassar IA, Elbarbary AA, Elshafey KE. CMR parameters and CMR-FT in repaired tetralogy of Fallot. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Repaired tetralogy of Fallot patients develops postoperative complications that are in need for follow-up and re-intervention in some circumstances. CMR myocardial feature tracking is a novel method that allows quantification of bi-atrial and bi-ventricular mechanics of deformation. So our aim is to assess the added value of cardiac magnetic resonance imaging and its advanced feature tracking analysis in evaluation of repaired tetralogy of Fallot patients.
Results
CMR was done with feature tracking post-processing analysis for 56 patients with repaired tetralogy of Fallot and 56 healthy volunteers. The commonest postoperative complications in patients with repaired tetralogy of Fallot are in the following order: pulmonary regurgitation with subsequent right ventricular dilatation and tricuspid regurgitation followed by pulmonary stenosis, right ventricular dysfunction, right ventricular outflow tract dilatation, left ventricular dysfunction, aortic and mitral regurgitation and residual ventricular septal defect. All right ventricular volumes were found to be significantly increased compared to those of the healthy volunteers (p value < 0.001) also left ventricular end-diastolic and end-systolic volumes indexed were found to be increased in those patients compared to healthy volunteers (p value < 0.001). Right and left ventricular function were significantly lower in those patients compared to controls. Bi-ventricular CMR-FT indices and right atrial global longitudinal strain were found to be significantly lower in patients with repaired tetralogy of Fallot compared to controls. Right atrium global longitudinal strain was found to be significantly correlated with right ventricular global longitudinal strain and did not correlate with right ventricular ejection fraction and end-diastolic volume indexed; p value < 0.001, 0.109 and 0.565, respectively. Right ventricular global circumferential strain was found to be significantly increased in patients with right ventricular outflow tract obstruction compared to those without obstruction (− 16.26 ± 4.27% vs. − 12.2 ± 3.78%, respectively). Pulmonary regurgitant volume indexed was found to be significantly related to right ventricle longitudinal strain (p value 0.027).
Conclusion
Biventricular volumetric measures are increased in patients with repaired tetralogy of Fallot compared to controls; however, feature tracking parameters for both ventricles and right atrium are lower in those patients compared to controls.
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Shah TR, Beig JR, Choh NA, Rather FA, Yaqoob I, Jan VM. Phase contrast cardiac magnetic resonance imaging versus transoesophageal echocardiography for the evaluation of feasibility for transcatheter closure of atrial septal defects. Egypt Heart J 2022; 74:27. [PMID: 35416569 PMCID: PMC9008100 DOI: 10.1186/s43044-022-00269-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 04/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background This prospective study was aimed at comparing phase contrast cardiac magnetic resonance imaging (PC-CMR) with 2D transoesophageal echocardiography (TEE) for determining potential candidature for transcatheter closure in ostium secundum ASD (OS-ASD) patients. We included consecutive adult patients with OS-ASD for the evaluation of feasibility for transcatheter closure using 2D-TEE and PC-CMR over a period of 2 years. Patients who fulfilled the conventional criteria for transcatheter closure, i.e. maximum ASD diameter ≤ 34 mm, adequate rims (≥ 5 mm, except for anterosuperior rim), and normal pulmonary venous drainage on both imaging modalities, were taken for device closure. In patients where there was discrepancy in the measurements of ASD diameter or rim size, making them eligible for device closure on one imaging modality and ineligible on the other hand, provisional device closure was attempted. All patients who underwent transcatheter closure were followed up to 6 months to rule out any complications. Results A total of 58 patients (mean age 35.93 ± 10.59 years) were enrolled in the study. Overall, there was significant positive correlation between 2D-TEE and CMR measurements of maximal ASD diameter and rim size (p < 0.001). However, TEE significantly underestimated maximal ASD diameter and posteroinferior rim size in comparison with CMR (p = 0.013 and p = 0.023, respectively). 46 (79.3%) patients were suitable for transcatheter closure on CMR, while 44 (75.9%) were eligible on TEE. Transcatheter closure was attempted in 48 patients based on imaging findings and was successful in 46 (95.8%) patients. Device closure was unsuccessful in 2 patients with defect size < 34 mm on TEE but > 34 mm on CMR. Among 7 patients with deficient posteroinferior rim on TEE, 5 had sufficient rim on CMR and underwent successful transcatheter closure. CMR detected anomalous pulmonary venous drainage in one patient which was missed on TEE, hence excluding the patient from transcatheter closure. Mean device size was 28.3 ± 7.4 mm and correlated more strongly with the defect dimensions on PC-CMR (r = 0.85, p < 0.001) compared to TEE (r = 0.71, p = 0.02). Conclusions PC-CMR may to be superior to 2D-TEE for the preprocedural planning and feasibility assessment for transcatheter closure in adult patients with ostium secundum ASD.
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Affiliation(s)
| | - Jahangir Rashid Beig
- Department of Cardiology, Super Speciality Hospital, Government Medical College, Srinagar, Jammu and Kashmir, 190010, India.
| | | | | | - Irfan Yaqoob
- Department of Cardiology, SKIMS, Srinagar, J&K, India
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Tamanini G, Cominardi A, Brighi N, Fusaroli P, Lisotti A. Endoscopic ultrasound assessment and tissue acquisition of mediastinal and abdominal lymph nodes. World J Gastrointest Oncol 2021; 13:1475-1491. [PMID: 34721779 PMCID: PMC8529915 DOI: 10.4251/wjgo.v13.i10.1475] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/16/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
The differential diagnosis between benign and malignant lymph nodes (LNs) has a fundamental role in the characterization and staging of malignant conditions, as well as in subsequent patients’ management. All imaging modalities (i.e. computed tomography and magnetic resonance imaging) rely mainly on size; endoscopic ultrasound (EUS) criteria based on B-mode evaluation and Doppler features fail to adequately characterize with high specificity LNs nature. The introduction of EUS-elastography and contrast-enhanced harmonic EUS are useful techniques to increase the diagnostic yield in identifying metastatic LNs, to identify which suspicious LN should require pathological characterization and, finally, to target tissue acquisition. EUS-guided tissue acquisition (EUS-TA) is increasingly being used for diagnosing lymphadenopathy whenever the characterization modifies patients’ subsequent management and when no superficial LN is accessible. Since target therapy are currently available (i.e. lung cancer, breast cancer), EUS-TA of malignant LNs could be required to identify tumor biology. In this field, both fine needle aspiration and biopsy needles are able to guarantee accurate results with almost perfect specificity and sub-optimal sensitivity. We finally propose a diagnostic algorithm based on most recent, high-level evidence for the diagnostic approach to suspected LNs assessment.
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Affiliation(s)
- Giacomo Tamanini
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Anna Cominardi
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Nicole Brighi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola 47014, FC, Italy
| | - Pietro Fusaroli
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
| | - Andrea Lisotti
- Department of Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola 40026, BO, Italy
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Ojha V, Pandey NN, Sharma A, Ganga KP. Spectrum of changes on cardiac magnetic resonance in repaired tetralogy of Fallot: Imaging according to surgical considerations. Clin Imaging 2020; 69:102-114. [PMID: 32717537 DOI: 10.1016/j.clinimag.2020.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 06/10/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
Imaging of repaired tetralogy of Fallot (TOF) is one of the common indications for cardiac magnetic resonance (CMR) examinations. With advances in CMR imaging techniques like phase contrast imaging and functional imaging, it has superseded investigations like echocardiography for anatomical and functional assessment of the pathophysiological changes in repaired TOF. Common repair procedures for TOF include infundibulectomy, transannular patch repair and right ventricle to pulmonary artery (RV-PA) conduit. While each of these procedures cause dynamic changes in heart and pulmonary arteries resulting in some expected imaging findings, CMR also helps in diagnosing the complications associated with these repair procedures like pulmonary stenosis, right ventricular outflow tract aneurysm, pulmonary regurgitation, RV-PA conduit stenosis, tricuspid regurgitation, right ventricular failure, and residual ventricular septal defects. Hence, it is imperative for a radiologist to be familiar with the expected changes on CMR in repaired TOF along with some of the common complications that may be encountered on imaging in such patients.
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Affiliation(s)
- Vineeta Ojha
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Arun Sharma
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Kartik P Ganga
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110029, India
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Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner SC, Sekarski N, Di Bernardo S, Bouchardy J, Stuber M, Schwitter J. Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease. J Cardiovasc Magn Reson 2015; 17:55. [PMID: 26156377 PMCID: PMC4496886 DOI: 10.1186/s12968-015-0156-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 06/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality. METHODS CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression. RESULTS Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults. CONCLUSION In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.
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Affiliation(s)
- Pierre Monney
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Davide Piccini
- Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland.
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Tobias Rutz
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Gabriella Vincenti
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Simone Coppo
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Simon C Koestner
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Nicole Sekarski
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Stefano Di Bernardo
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Judith Bouchardy
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Matthias Stuber
- Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
- Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland.
| | - Juerg Schwitter
- Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
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Ordovas KG, Muzzarelli S, Hope MD, Naeger DM, Karl T, Reddy GP, Marchiori E, Higgins CB. Cardiovascular MR Imaging after Surgical Correction of Tetralogy of Fallot: Approach Based on Understanding of Surgical Procedures. Radiographics 2013; 33:1037-52. [DOI: 10.1148/rg.334115084] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Collateral Flow Measurement by Phase-contrast Magnetic Resonance Imaging for the Assessment of Systemic Venous Baffle Patency After Atrial Switch Repair for Transposition of the Great Arteries. J Thorac Imaging 2012; 27:175-8. [DOI: 10.1097/rti.0b013e31823fb9a0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Transthoracic echocardiography is the first-line modality for cardiovascular imaging in adults with congenital heart disease (ACHD). The windows of access that are possible with transthoracic echocardiography are, however, rarely adequate for all regions of interest. The choice of further imaging depends on the clinical questions that remain to be addressed. The strengths of MRI include comprehensive access and coverage, providing imaging of all parts of the right ventricle, the pulmonary arteries, pulmonary veins and aorta. Cine images and velocity maps are acquired in specifically aligned planes, with stacks of cines or dynamic contrast angiography providing more comprehensive coverage. Tissues can be characterised if necessary, and MRI provides relatively accurate measurements of biventricular function and volume flow. These parameters are important in the assessment and follow-up of adults after repairs for tetralogy of Fallot or transposition of the great arteries and after Fontan operations. The superior spatial resolution and rapid acquisition of CT are invaluable in selected situations, including the visualisation of anomalous coronary or aortopulmonary collateral arteries, the assessment of luminal patency after stenting and imaging in patients with pacemakers. Ionising radiation is, however, a concern in younger patients who may need repeated investigation. Adults with relatively complex conditions should ideally be imaged in a specialist ACHD centre, where dedicated echocardiographic and cardiovascular MRI services are a necessary facility. General radiologists should be aware of the nature and pathophysiology of congenital heart disease, and should be alert for previously undiagnosed cases presenting in adulthood, including cases of atrial septal defect, aortic coarctation, patent ductus arteriosus, double-chambered right ventricle and congenitally corrected transposition.
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Affiliation(s)
- P J Kilner
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
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Muzzarelli S, Ordovas KG, Cannavale G, Meadows AK, Higgins CB. Tetralogy of Fallot: Impact of the Excursion of the Interventricular Septum on Left Ventricular Systolic Function and Fibrosis after Surgical Repair. Radiology 2011; 259:375-83. [PMID: 21248236 DOI: 10.1148/radiol.10100895] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Stefano Muzzarelli
- Department of Radiology, University Hospital of California-San Francisco, 505 Parnassus Ave, Box 0628, Room L-325A, San Francisco, CA 94143-0628, USA
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