• Title/Summary/Keyword: Contrast echocardiography

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Cardiac Papillary Fibroelastoma in Left Ventricular Trabeculation as a Potential Cause of Cerebral Infarction: A Case Report (뇌경색의 원인으로 생각되는 좌심실 섬유주에 생긴 심장 섬유탄력종: 증례 보고)

  • JunYong Im;Dong Su Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.988-993
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    • 2021
  • Cardiac papillary fibroelastoma (CPF) is the second or third most common primary cardiac tumor. Although histologically benign, it can cause serious symptoms depending on its location of occurrence, size, and motility. Herein, we report CPF in the left ventricular trabeculation as a potential cause of cerebral infarction.

Atypical loculated pericardial effusion with infectious pericarditis mimicking a cardiac mass in a dog: a case report

  • Ji-Yun Lee;Seulgi Bae;Jin-Kyu Park;Min Jang;Kija Lee;Sang-Kwon Lee
    • Korean Journal of Veterinary Research
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    • v.64 no.2
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    • pp.15.1-15.5
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    • 2024
  • A 13-year-old, Maltese dog presented with syncope and lethargy. Abdominal ultrasonography demonstrated anechoic peritoneal effusion and hepatic congestion. A focal echogenic round mass compressing the right ventricle and atrium was observed on echocardiography. Cardiac tamponade and right ventricular outflow tract obstruction occurred. On computed tomography, a homogeneous soft-tissue structure compressing the right chamber without contrast enhancement, suspected to be loculated pericardial effusion. During pericardiocentesis, cardiac tamponade was resolved, and irregular pericardial thickening was noted. Pericardial effusion was exudate and gram-positive bacterial colonies were observed on cytology. A diagnosis of fibrinous pericarditis secondary to bacterial infection was established.

Right-to-left Shunting Ventricular Septal Defect in a Dog (개에서 발생한 우-좌 단락 심실 중격 결손 증례)

  • Yun, Sookyung;Kim, Boeun;Youn, Hwayoung;Choi, Mincheol;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.343-346
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    • 2015
  • A 4-year-old castrated male Dachshund was presented with a chronic history of dyspnea and cyanosis. Complete blood count revealed marked polycythemia with a hematocrit of 79.7%. Thoracic radiographs showed mild right-sided cardiac enlargement. Echocardiography showed a large ventricular septal defect in the left ventricular outflow tract region just proximal to the aortic valve. On Doppler echocardiography, right-to-left shunt flow through the defect was found and confirmed by contrast echocardiography. Based on these diagnostic findings and clinical signs, the dog was diagnosed as right-to-left shunting ventricular septal defect. Phlebotomy and oxygen supplement were performed, but the dog died the day after presentation.

Left Atrial Myxoma (좌심방 점액종 1례 보고)

  • 오세웅
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.809-814
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    • 1987
  • Myxoma is a benign growth constituting nearly 50% of all primary cardiac tumors. It is important because in can be abolished by surgical therapy and is usually fatal if unrecognized and untreated. Primary cardiac tumors are uncommon in all age group. In contrast, tumors metastatic to the heart are significantly more common. The diagnosis is made by echocardiography and cardiac angiography. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We report the two cases of left atrial myxomas which were removed successfully by surgery in the thoracic and cardiovascular surgery department, Marryknoll Hospital.

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Diaphragmatic deformity in a cat mimicking a cardiac mass

  • Choi, Ran;Lee, Seung-Gon;Moon, Hyeong-Sun;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.48 no.2
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    • pp.209-213
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    • 2008
  • A four-month-old intact femlae Abyssinian cat was present for routine health evaluation, because her littermate was recently died of ventricular septal defect. Diagnostic imaging studies showed a large caudal paracardiac mass in thoracic radiography and homogenous mass adjacent to heart in the echocardiography. Further echographic study revealed that the mass was liver and the diaphragmatic line was intact. The positive contrast celiogram revealed that no extravasation of the contrast media across the diaphragm and the prolapse of diaphragm into the pleural cavity. Based on our diagnostic imaging studies, the case was diagnosed as diaphragmatic deformity in a cat mimicking a cardiac mass.

Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

A Case of Hepatopulmonary Syndrome Diagnosed by $^{99m}Tc-MAA$ Perfusion Lung Scan ($^{99m}Tc-MAA$ 폐관류스캔으로 진단한 간폐증후군)

  • Oh, Hyung-Tae;Lee, Moo-Yong;Song, Il-Han;Park, Seok-Gun
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.203-208
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    • 2002
  • In patients with chronic liver disease, hepatopulmonary syndrome, the right to left shunt without previous pulmonary and cardiac disease, can develope and cause respiratory distress. Tools to prove shunt are contrast echocardiography, pulmonary angiography, and $^{99m}Tc-MAA$ perfusion lung scan. Among them, $^{99m}Tc-MAA$ scan is a simple and safe method detecting the right to left shunt. At the same time, quantitation of shunt amount is possible by this method. We report a case of hepatopulmonary syndrome confirmed by $^{99m}Tc-MAA$ scan and contrast echocardiography with review of literlatures.

Paradoxical Response of Giant Left Atrial Appendage Aneurysm after Catheter Ablation of Atrial Fibrillation

  • Chung, Jee Won;Shim, Jaemin;Shim, Wan Joo;Kim, Young-Hoon;Hwang, Sung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.132-135
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    • 2016
  • We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

Distribution of Aortic Root Calcium in Relation to Frame Expansion and Paravalvular Leakage After Transcatheter Aortic Valve Implantation (TAVI): An Observational Study Using a Patient-specific Contrast Attenuation Coefficient for Calcium Definition and Independent Core Lab Analysis of Paravalvular Leakage

  • Nahid El Faquir;Quinten Wolff;Rafi Sakhi;Ben Ren;Zouhair Rahhab;Sander van Weenen;Patrick Geeve;Ricardo P J Budde;Eric Boersma;Joost Daemen;Nicolas M van Mieghem;Peter P de Jaegere
    • Journal of Cardiovascular Imaging
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    • v.30 no.4
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    • pp.292-304
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    • 2022
  • BACKGROUND: Calcium is a determinant of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI). This is based on a fixed contrast attenuation value while X-ray attenuation is patient-dependent and without considering frame expansion and PVL location. We examined the role of calcium in (site-specific) PVL after TAVI using a patient-specific contrast attenuation coefficient combined with frame expansion. METHODS: 57 patients were included with baseline CT, post-TAVI transthoracic echocardiography and rotational angiography (R-angio). Calcium load was assessed using a patient-specific contrast attenuation coefficient. Baseline CT and post-TAVI R-angio were fused to assess frame expansion. PVL was assessed by a core lab. RESULTS: Overall, the highest calcium load was at the non-coronary-cusp-region (NCR, 436 mm3) vs. the right-coronary-cusp-region (RCR, 233 mm3) and the left-coronary-cusp-region (LCR, 244 mm3), p < 0.001. Calcium load was higher in patients with vs. without PVL (1,137 vs. 742 mm3, p = 0.012) and was an independent predictor of PVL (odds ratio, 4.83, p = 0.004). PVL was seen most often in the LCR (39% vs. 21% [RCR] and 19% [NCR]). The degree of frame expansion was 71% at the NCR, 70% at the RCR and 74% at the LCR without difference between patients with or without PVL. CONCLUSIONS: Calcium load was higher in patients with PVL and was an independent predictor of PVL. While calcium was predominantly seen at the NCR, PVL was most often at the LCR. These findings indicate that in addition to calcium, specific anatomic features play a role in PVL after TAVI.

Low Contrast and Low kV CTA Before Transcatheter Aortic Valve Replacement: A Systematic Review

  • Spencer C. Lacy;Mina M. Benjamin;Mohammed Osman;Mushabbar A. Syed;Menhel Kinno
    • Journal of Cardiovascular Imaging
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    • v.31 no.2
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    • pp.108-115
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    • 2023
  • BACKGROUND: Minimizing contrast dose and radiation exposure while maintaining image quality during computed tomography angiography (CTA) for transcatheter aortic valve replacement (TAVR) is desirable, but not well established. This systematic review compares image quality for low contrast and low kV CTA versus conventional CTA in patients with aortic stenosis undergoing TAVR planning. METHODS: We performed a systematic literature review to identify clinical studies comparing imaging strategies for patients with aortic stenosis undergoing TAVR planning. The primary outcomes of image quality as assessed by the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were reported as random effects mean difference with 95% confidence interval (CI). RESULTS: We included 6 studies reporting on 353 patients. There was no difference in cardiac SNR (mean difference, -1.42; 95% CI, -5.71 to 2.88; p = 0.52), cardiac CNR (mean difference, -3.83; 95% CI, -9.98 to 2.32; p = 0.22), aortic SNR (mean difference, -0.23; 95% CI, -7.83 to 7.37; p = 0.95), aortic CNR (mean difference, -3.95; 95% CI, -12.03 to 4.13; p = 0.34), and ileofemoral SNR (mean difference, -6.09; 95% CI, -13.80 to 1.62; p = 0.12) between the low dose and conventional protocols. There was a difference in ileofemoral CNR between the low dose and conventional protocols with a mean difference of -9.26 (95% CI, -15.06 to -3.46; p = 0.002). Overall, subjective image quality was similar between the 2 protocols. CONCLUSIONS: This systematic review suggests that low contrast and low kV CTA for TAVR planning provides similar image quality to conventional CTA.