Faculty Bibliography

PURPOSE: To conduct a pilot study to determine the feasibility of evaluating aortic valve morphology and motion on electrocardiogram-gated 64-slice cardiac MDCT. METHODS: Four-dimensional images of the aortic valve were reviewed in 20 consecutive patients who underwent computed tomography (CT) coronary angiography. A consensus reading of 3 readers was performed of valve visibility, number of leaflets, valve motion, and calcification. Visibility of the valve leaflets and visualization of opening and closing of the valve leaflets were graded as well seen or suboptimally seen. The number of valve leaflets (3 or 2) and presence of valvular calcification were noted. RESULTS: The aortic valve was well seen in all 20 patients. Three leaflets were identified in all cases, and no calcifications were seen. Valve movement with opening and closure of the leaflets during the cardiac cycle was also well seen in all cases. CONCLUSIONS: Visualization of the aortic valve and valvular motion during the cardiac cycle is feasible on CT studies performed for coronary angiography. CT has a potential role in the assessment of aortic valvular pathology

OBJECTIVE. The objective of our study was to evaluate the image quality of 64-MDCT coronary angiography. SUBJECTS AND METHODS. Fifty consecutive CT coronary angiograms obtained on a scanner were independently reviewed by two reviewers. Segments were scored as no motion (score of 1), minimal motion (2), moderate motion (3), respiratory motion (4), vessel blurting (5). Opacification was graded as good (score of 1) or limited (2). Segments < 2 were graded as well seen; or as poorly seen or not seen. The scores for motion artifact, opacification, and visibility were combined for overall vessel assessment. Segments with a motion of 1 or 2 that had good opacification and were well seen were judged to be assessable. RESULTS. A total of 714 segments were analyzed in 50 patients. Seven hundred segments assessed in all patients (segments 1-3, 11-20, 4, or 27), and a ramus intermedius segment evaluated in 14 patients. Combining the scores for both reviewers, the average motion score I for 619 segments (86.7%), the average motion score for all segments in an individual patient 1.14 (range, 1-3.35), and the average opacification score for all segments in a patient was (range, 1-1.38). A total of 374 segments were less than 2 min in diameter. Combining the for both reviewers, an average of 36 segments (5.0% of 714) could not be identified by the 319.5 segments (85.4%) were well seen, and 18.5 segments (4.9%) were poorly seen. an average of 637 segments (89.2%) were judged assessable by the reviewers. On a per-patient basis, 10 or more vessel segments werejudged assessable in 47 patients (94%). CONCLUSION. On 64-MDCT, 89% of coronary artery segments are assessable. Ten or vessel segments are assessable in 94% of patients

Cardiac multidetector helical computed tomography angiogram (MDCTA) findings of a quadricuspid aortic valve are presented. MDCTA enabled evaluation of the aortic valve and its function, the coronary arteries, and left ventricular function. This case is, to our knowledge, the first description of the MDCTA imaging appearance of quadricuspid aortic valve

Cardiac computed tomography (CT) is an evolving modality that includes a variety of examinations to assess the anatomy and pathology of the cardiac chambers, valves, myocardium, coronary arteries and veins, pericardium, aortic root, and central great vessels. The development of multidetector CT scanners with increasing numbers of detector rows, narrow section thicknesses, increasing scanner speeds, the ability for electrocardiographic gating, and radiation dose modulation allows the performance of CT coronary arteriography. Computed tomography coronary arteriography enables the assessment of multiple types of cardiac pathology, including intraluminal coronary arterial plaque formation, coronary artery stenosis, congenital anomalies, coronary artery aneurysms, sequelae of cardiac ischemia, and the assessment of prior vascular interventions, while providing information about cardiac and valvular function. Noncardiac structures included in cardiac CT examinations must also be evaluated. This guideline attempts to maximize the probability of detecting cardiac abnormalities with cardiac CT. American College of Radiology requirements for physicians and personnel performing examinations are also addressed and will become applicable by July 1, 2008

Traumatic bowel and mesenteric injuries are notoriously difficult to diagnose. CT has become the modality of choice for evaluating stable trauma patients for the presence of intra-abdominal injury. This article will summarize the CT findings useful for detecting bowel and mesenteric injury

OBJECTIVE: The purpose of our study was to reassess the CT finding of pneumatosis in intestinal ischemia to determine whether it indicates transmural necrosis versus partial mural ischemia and also to determine whether other CT findings can be used to predict which patients with pneumatosis are likely to have viable bowel. CONCLUSION: The CT finding of pneumatosis does not always indicate transmural infarction of the bowel in intestinal ischemia. Patients with associated portomesenteric venous gas are more likely to have transmural infarction than those with pneumatosis alone.