Coronary angiography using spectral detector dual-energy CT:is it the time to assess myocardial first-pass perfusion?

Coronary computed tomography angiography (CCTA) represents a common approach to the diagnostic workup of patients with suspected coronary artery disease. Technological development has recently allowed the integration of conventional CCTA information with spectral data. Spectral CCTA used in clinical routine may allow for improving CCTA diagnostic performance by measuring myocardial iodine distribution as a marker of first-pass perfusion, thus providing additional functional information about coronary artery disease

Spectral CT Imaging of Prosthetic Valve Embolization after Transcatheter Aortic Valve Implantation

Transcatheter heart valve (THV) embolization is a rare complication of transcatheter aortic valve implantation (TAVI) generally caused by malpositioning, sizing inaccuracies and pacing failures. The consequences are related to the site of embolization, ranging from a silent clinical picture when the device is stably anchored in the descending aorta to potentially fatal outcomes (e.g., obstruction of flow to vital organs, aortic dissection, thrombosis, etc.). Here, we present the case of a 65-year-old severely obese woman affected by severe aortic valve stenosis who underwent TAVI complicated by embolization of the device. The patient underwent spectral CT angiography that allowed for improved image quality by means of virtual monoenergetic reconstructions, permitting optimal pre-procedural planning. She was successfully re-treated with implantation of a second prosthetic valve a few weeks later.</p

Anomalous venoatrial connections – CT and MRI assessment

Abnormal venous atrial (VA) connections present a congenital heart disease (CHD) challenge for pediatric cardiologists. Fully anatomical evaluation is very difficult in prenatal and perinatal follow-up, but it has a profound impact on surgical correction and outcome. The echocardiogram is first-line imaging and represents the gold standard tool for simple abnormal VA connection. CT and MRI are mandatory for more complex heart disease and “nightmare cases”. 3D post-processing of volumetric CT and MRI acquisition helps to clarify anatomical relationships and allows for the creation of 3D printing models that can become crucial in customizing surgical strategy. Our article describes a ten-year (2013–2022) tertiary referral CHD center of abnormal AV connections investigated with CT and MRI, illustrating most of these complex diseases with the help of volume rendering (VR) or multiplanar reconstructions (MPR). The nightmarish cases will also be addressed due to the complex cardiovascular arrangement that requires a challenging surgical solution for correction along with the post-surgical complications.</p

Il Dentascan

IX, 47 pagg.online resource

Orthopantomography

VII, 202 p. 252 illus., 35 illus. in color.onlin