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Morey AGN, Karnia JJ, Wiggen KE. The utility of cardiac-gated computed tomography in diagnosing a reverse patent ductus arteriosus in a dog with a concurrent intracardiac right-to-left shunt. J Vet Cardiol 2024; 52:90-95. [PMID: 38296713 DOI: 10.1016/j.jvc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024]
Abstract
A five-month-old male intact Goldendoodle presented for evaluation for peripheral cyanosis following exercise. Transthoracic echocardiography demonstrated severe right ventricular wall thickening and right atrial dilation secondary to pulmonary hypertension. An agitated saline contrast study demonstrated an interatrial right-to-left shunt. Cardiac-gated computed tomography confirmed a reverse patent ductus arteriosus. This case report highlights the utility of cardiac-gated computed tomography in identifying multi-level intra- and extra-cardiac shunts.
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Affiliation(s)
- A G N Morey
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA
| | - J J Karnia
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA
| | - K E Wiggen
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA.
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2
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Dirrichs T, Tietz E, Rüffer A, Hanten J, Nguyen TD, Dethlefsen E, Kuhl CK. Photon-counting versus Dual-Source CT of Congenital Heart Defects in Neonates and Infants: Initial Experience. Radiology 2023; 307:e223088. [PMID: 37219443 DOI: 10.1148/radiol.223088] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background Photon-counting CT (PCCT) has been shown to improve cardiovascular CT imaging in adults. Data in neonates, infants, and young children under the age of 3 years are missing. Purpose To compare image quality and radiation dose of ultrahigh-pitch PCCT with that of ultrahigh-pitch dual-source CT (DSCT) in children suspected of having congenital heart defects. Materials and Methods This is a prospective analysis of existing clinical CT studies in children suspected of having congenital heart defects who underwent contrast-enhanced PCCT or DSCT in the heart and thoracic aorta between January 2019 and October 2022. CT dose index and dose-length product were used to calculate effective radiation dose. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated by standardized region-of-interest analysis. SNR and CNR dose ratios were calculated. Visual image quality was assessed by four independent readers on a five-point scale: 5, excellent or absent; 4, good or minimal; 3, moderate; 2, limited or substantial; and 1, poor or massive. Results Contrast-enhanced PCCT (n = 30) or DSCT (n = 84) was performed in 113 children (55 female and 58 male participants; median age, 66 days [IQR, 15-270]; median height, 56 cm [IQR, 52-67]; and median weight, 4.5 kg [IQR, 3.4-7.1]). A diagnostic image quality score of at least 3 was obtained in 29 of 30 (97%) with PCCT versus 65 of 84 (77%) with DSCT. Mean overall image quality ratings were higher for PCCT versus DSCT (4.17 vs 3.16, respectively; P < .001). SNR and CNR were higher for PCCT versus DSCT with SNR (46.3 ± 16.3 vs 29.9 ± 15.3, respectively; P = .007) and CNR (62.0 ± 50.3 vs 37.2 ± 20.8, respectively; P = .001). Mean effective radiation doses were similar for PCCT and DSCT (0.50 mSv vs 0.52 mSv; P = .47). Conclusion At a similar radiation dose, PCCT offers a higher SNR and CNR and thus better cardiovascular imaging quality than DSCT in children suspected of having cardiac heart defects. © RSNA, 2023.
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Affiliation(s)
- Timm Dirrichs
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - Eric Tietz
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - André Rüffer
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - Jens Hanten
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - Thai Duy Nguyen
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - Ebba Dethlefsen
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
| | - Christiane K Kuhl
- From the Department of Diagnostic and Interventional Radiology (T.D., E.T., E.D., C.K.K.), Department of Pediatric Heart Surgery (A.R., T.D.N.), and Department of Pediatric Cardiology (J.H.), RWTH Aachen University Hospital, Pauwelsstr 30, 52074 Aachen, Germany
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3
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Feng P, Yu L, Liang P. Application of CECT, CEMRI, and contrast-enhanced ultrasonography in the evaluation of renal cystic lesions: a systematic review and meta-analysis of retrospective studies. Biotechnol Genet Eng Rev 2023:1-14. [PMID: 37243577 DOI: 10.1080/02648725.2023.2215640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
The purpose of this meta-analysis was to investigate the role and effect of CECT, CEMRI and CEUS in the detection of renal cystic lesions, and to provide evidence-based basis for clinical examination and treatment. The Cochrane Library, EMBASE, and PUBMED databases were searched from January 2012 to December 2022 for article retrieval. The articles on the treatment of cystic renal disease were searched. According to the inclusion criteria, the included articles were evaluated with the Jad scale and Cochrane manual version 5.1, and the included articles was analyzed by Review Manager 5.4.1. A total of ten relevant articles were included in this meta-analysis. The results of this meta-analysis indicated that CEUS had high sensitivity and specificity in diagnosing renal cystic lesions, which was statistically significant.
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Affiliation(s)
- Peipei Feng
- Department of Imaging, Yantaishan Hospital, Yantai, China
| | - Libo Yu
- Department of Imaging, Yantaishan Hospital, Yantai, China
| | - Peng Liang
- Department of Imaging, Yantaishan Hospital, Yantai, China
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4
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Caro-Domínguez P, Secinaro A, Valverde I, Fouilloux V. Imaging and surgical management of congenital heart diseases. Pediatr Radiol 2023; 53:677-694. [PMID: 36334120 DOI: 10.1007/s00247-022-05536-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/01/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
Abstract
Congenital heart disease affects approximately 1% of live births per year. In recent years, there has been a decrease in the morbidity and mortality of these cases due to advances in medical and surgical care. Imaging plays a key role in the management of these children, with chest radiography, echocardiography and chest ultrasound the first diagnostic tools, and cardiac computed tomography, catheterization and magnetic resonance imaging reserved to assess better the anatomy and physiology of the most complex cases. This article is a beginner's guide to the anatomy of the most frequent congenital heart diseases (atrial and ventricular septal defects, abnormal pulmonary venous connections, univentricular heart, tetralogy of Fallot, transposition of the great arteries and coarctation of the aorta), their surgical management, the most common postsurgical complications, deciding which imaging modality is needed, and when and how to image gently.
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Affiliation(s)
- Pablo Caro-Domínguez
- Pediatric Radiology Unit, Department of Radiology, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, Seville, Spain.
| | - Aurelio Secinaro
- Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Israel Valverde
- Pediatric Cardiology Unit and Cardiovascular Pathology Unit, Hospital Universitario Virgen del Rocio and Institute of Biomedicine of Seville, Seville, Spain
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Virginie Fouilloux
- Department of Congenital and Pediatric Cardiac Surgery, Timone Children Hospital, Marseille, France
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5
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Kellenberger CJ, Lovrenski J, Semple T, Caro-Domínguez P. Neonatal cardiorespiratory imaging-a multimodality state-of-the-art review. Pediatr Radiol 2023; 53:660-676. [PMID: 36138217 DOI: 10.1007/s00247-022-05504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/02/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
Abstract
Advanced cardiorespiratory imaging of the chest with ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) plays an important role in diagnosing respiratory and cardiac conditions in neonates when radiography and echocardiography alone are not sufficient. This pictorial essay highlights the particularities, clinical indications and technical aspects of applying chest US, cardiac CT and cardiorespiratory MRI techniques specifically to neonates, summarising the first session of the European Society of Paediatric Radiology's cardiothoracic task force.
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Affiliation(s)
- Christian J Kellenberger
- Department of Diagnostic Imaging, University Children's Hospital Zürich, Zurich, Switzerland
- Children's Research Centre, University Children's Hospital Zürich, Zurich, Switzerland
| | - Jovan Lovrenski
- Radiology Department, Faculty of Medicine, University of Novi Sad and Institute for Children and Adolescents Health Care of Vojvodina, Novi Sad, Serbia
| | - Thomas Semple
- Radiology Department, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
- Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Pablo Caro-Domínguez
- Pediatric Radiology Unit, Radiology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, Seville, Spain.
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Panayiotou HR, Mills LK, Broadbent DA, Shelley D, Scheffczik J, Olaru AM, Jin N, Greenwood JP, Michael H, Plein S, Bissell MM. Comprehensive Neonatal Cardiac, Feed and Wrap, Non-contrast, Non-sedated, Free-breathing Compressed Sensing 4D Flow MRI Assessment. J Magn Reson Imaging 2023; 57:789-799. [PMID: 35792484 DOI: 10.1002/jmri.28325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cardiac MRI is an important imaging tool in congenital cardiac disease, but its use has been limited in the neonatal population as general anesthesia has been needed for breath-holding. Technological advances in four-dimensional (4D) flow MRI have now made nonsedated free-breathing acquisition protocols a viable clinical option, but the method requires prospective validation in neonates. PURPOSE To test the feasibility of compressed sensing (CS) 4D flow MRI in the neonatal population and to compare with standard previously validated two-dimensional (2D) phase-contrast (PC) flow MRI. STUDY TYPE Prospective, cohort, image quality. POPULATION A total of 14 healthy neonates (median [range] age: 2.5 [0-80] days; 8 male). FIELD STRENGTH AND SEQUENCE Noncontrast 2D cine gradient echo sequence with through-plane velocity encoding (PC) sequence and compressed sensing (CS) three-dimensional (3D), time-resolved, cine phase-contrast MRI with 3D velocity-encoding (4D flow MRI) at 3 T. ASSESSMENT Aortic 2D PC, and aortic, pulmonary trunk and superior vena cava CS 4D flow MRI were acquired using the feed and wrap technique (nonsedated) and quantified using commercially available software. Aortic flow and peak velocity were compared between methods. Internal consistency of 4D flow MRI was determined by comparing mean forward flow of the main pulmonary artery (MPA) vs. the sum of left and right pulmonary artery flows (LPA and RPA) and by comparing mean ascending aorta forward flow (AAo) vs. the sum of superior vena cava (SVC) and descending aorta flows (DAo). STATISTICAL TESTS Flow and peak-velocity comparisons were assessed using paired t-tests, with P < 0.05 considered significant, and Bland-Altman analysis. Interobserver and intraobserver agreement and internal consistency were analyzed by intraclass correlation co-efficient (ICC). RESULTS There was no statistically significant difference between ascending aortic forward flow between 2D PC and CS 4D Flow MRI (P = 0.26) with a bias of 0.11 mL (-0.59 to 0.82 mL) nor peak velocity (P = 0.11), with a bias of -5 cm/sec and (-26 to 16 cm/sec). There was excellent interobserver and intraobserver agreement for each vessel (interobserver ICC: AAo 1.00; DAo 0.94, SVC 0.90, MPA 0.99, RPA 0.98, LPA 0.96; intraobserver ICC: AAo 1.00; DAo 0.99, SVC 0.98, MPA 1.00, RPA 1.00, LPA 0.99). Internal consistency measures showed excellent agreement for both mean forward flow of main pulmonary artery vs. the sum of left and right pulmonary arteries (ICC: 0.95) and mean ascending aorta forward flow vs. the sum of superior vena cava and descending aorta flows (ICC: 1.00). CONCLUSION Sedation-free neonatal feed and wrap MRI is well tolerated and feasible. CS 4D flow MRI quantification is similar to validated 2D PC free-breathing imaging with excellent interobserver and intraobserver agreement. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
| | - Lily K Mills
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK
| | - David A Broadbent
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK.,Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - David Shelley
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK
| | - Jutta Scheffczik
- Department of Anaesthesiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Ning Jin
- Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - John P Greenwood
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK
| | - Helen Michael
- Department of Paediatric Cardiology, Leeds Teaching Hospitals NHS Trust, UK
| | - Sven Plein
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK
| | - Malenka M Bissell
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK.,Department of Paediatric Cardiology, Leeds Teaching Hospitals NHS Trust, UK
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7
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Ramirez-Suarez KI, Tierradentro-García LO, Biko DM, Otero HJ, White AM, Dori Y, Smith CL, Vatsky S, Rapp JB. Lymphatic anomalies in congenital heart disease. Pediatr Radiol 2022; 52:1862-1876. [PMID: 35840695 DOI: 10.1007/s00247-022-05449-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/16/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
Congenital heart disease can lead to various lymphatic complications including traumatic leaks, lymphatic overproduction, conduction abnormalities or lymphedema. Advancements in the imaging of central lymphatics and guided interventions have improved outcomes in these children. Dynamic contrast-enhanced magnetic resonance (MR) lymphangiography allows for the assessment of abnormal lymphatic drainage. This technique is preferred for evaluating lymphatic conditions such as plastic bronchitis, chylothorax, chyloptysis, chylopericardium, protein-losing enteropathy and chylous ascites, among other lymphatic disorders. In this review, we discuss lymphatic abnormalities encountered on MRI in children with congenital heart disease. We also briefly review treatment options.
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Affiliation(s)
- Karen I Ramirez-Suarez
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | | | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ammie M White
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yoav Dori
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christopher L Smith
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Seth Vatsky
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jordan B Rapp
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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