scholarly journals High-resolution analysis with multiphase computed tomography of the left atrio-ventricular junction in mitral annular disjunction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jouan ◽  
I Masari ◽  
V Bliah ◽  
G Soulat ◽  
D Craiem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Cardiac Cycle ◽  
Morphological Changes ◽  
Cardiac Computed Tomography ◽  
Mitral Annulus ◽  
Data Sets ◽  
Vertical Deformation ◽  
Imaging Data ◽  
Eccentricity Index

Abstract Background Mitral annular disjunction (MAD) has been associated with myxomatous mitral valve disease (MMVD) but functional analyses of the mitral annulus (MA) and the entire left atrio-ventricular junction (LAVJ) are lacking from high-resolution imaging to understand MAD physiopathology. Purpose Using multiphase cardiac computed tomography imaging (4D-MCCTI), we aimed at characterizing the morphological changes of MA and LAVJ throughout the cardiac cycle. Methods Volume imaging data sets through time were obtained from 4D-MCCTI of 2 groups of 10 patients as defined by echocardiographic diagnosis of MMVD and/or MAD: MMVD+MAD+, MMVD+MAD− and 20 case-controls without mitral regurgitation (MMVD−). Data were implemented in a custom software for 3D semi-automated delineation of 18 points around MA perimeter. Coordinates of these points in each of the 10 time-phases within an RR interval were used for MA reconstruction and calculation of areas, perimeters, 360°-diameters and parameters of planar/vertical deformation. Subsequently, left ventricle (LV) and left atrium (LA) inner contours were delineated. Results Groups were similar for age, body surface area and LV ejection fraction. Compared to the 2 other groups, MA expansion in MMVD+MAD+ started early after end-diastole, following LA expansion, and reached a maximum at end-systole (ES): 3D-area ES: 13.9±4.0cm2/m2, 3D-perimeterE S: 10.4±1.6cm/m2 versus respectively 8.8±3.0cm2/m2, 7.9±1.4cm/m2 in MMVD+MAD− (p<0.001) and 6.1±1.3cm2/m2, 7.0±1.1cm/m2 in MVVD− (p<0.001). However throughout the cardiac cycle, MA perimeter reduction was not altered in MMVD+MAD+: −14.0±6.3%, compared to MMVD+MAD−: −10.1±5.6% and MMVD−: −8.7±2.3% (p=0.09). MA shape modification was different in MMVD+MAD+ group, MA becoming more elliptical during systole, whereas MA reached a minimal eccentricity index (EcI) at ES in both MMVD+MAD− and MMVD− groups: EcIES = 0.63±0.09 versus 0.52±0.15 and 0.49±0.13 (p=0.04), respectively (Figure). Surprisingly, vertical deformation of MA increased during early systole in MMVD+MAD+ group when MA became more planar in the MMVD+MAD− and MMVD− groups. Conclusions MA function was globally preserved in MAD but was desynchronized with respect to LV contraction. Eccentricity index of mitral annulus Funding Acknowledgement Type of funding source: None

Dynamics of the right atrio-ventricular junction in human: a spatial high-resolution study with multiphase computed tomography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jouan ◽  
I Masari ◽  
V Bliah ◽  
G Soulat ◽  
D Craiem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Cycle ◽  
Cardiac Computed Tomography ◽  
Reconstruction Method ◽  
Imaging Data ◽  
High Definition ◽  
Vertical Projection ◽  
Horizontal Projection ◽  
Cross Sectional ◽  
The Right

Abstract Introduction In order to improve knowledge of the tricuspid valve (TV) function and its coupling with the right atrio-ventricular junction (RAVJ) and right ventricle (RV), new four-dimensional high-definition imagery methods are mandatory (3D+t). Purpose Using an innovative reconstruction method based on multiphase cardiac computed tomography imaging (4D-MCCTI), we finely analyzed the morphological & dynamical features of tricuspid annulus (TA) and RAVJ components in order to assess new functional parameters of TV and RV functions. Methods Volume imaging data sets through time were obtained from 4D-MCCTI of 30 subjects (sex ratio 1, mean age 57±11y.) with no rhythm, valvular or ventricular abnormalities on echocardiography and implemented in a custom software for 3D semi-automated delineation of 18 points around TA perimeter. Coordinates of these points in each of the 10 time-phases within an RR interval were used to calculate specific geometrical features of TA such as 3D/2D areas, perimeters, 360°-diameters and vertical deformation. Subsequently, RV and Right Atrium (RA) inner contours were also delineated (Figure). Results TA shape was elliptical in horizontal projection with a mean eccentricity index (EcI) of 0.58±0.12; and saddle-shapped in vertical projection with a horn nearby the antero-septal commissure. This feature remained throughout the cardiac cycle but TA was more planar (minimal TA-height: 4.47±1.04 mm) and circular (minimal EcI=0.44±0.14) in mid-diastole when TA-3Darea and TA-3Dperimeter reached a maximum of 6.98±1.21 cm2/m2 and 7.41±0.91 cm, respectively. Correlation between TA-3Darea, TA-2Darea and latero-septal diameter (LSD) were R2=0.99 and R2=0.73, respectively. LSD was minimal in early-systole (18.83±3.04 mm/m2) and maximal in mid-diastole (20.04±3.05 mm/m2). Correlation of TA-3Darea with RV and RA cross-sectional areas were R2=0.82 and R2=0.71, respectively. Conversely, there was no significant correlation between TA, RV and RA concentric contractions. Conclusions Our method for 4D-MTCCI analysis has allowed confirming the shape and dynamics function of RAVJ throughout the cardiac cycle in healthy subjects, and giving new reference parameters for TV and RV evaluation. Software multiplanar view of TA Funding Acknowledgement Type of funding source: None

scholarly journals Cardiac computed tomography: beyond ischemic heart disease and preTAVI studies. Experience during a year in a second level hospital

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
I Sanz Ortega ◽  
M Sadaba Sagredo ◽  
K Armendariz Tellitu ◽  
S Velasco Del Castillo ◽  
O Quintana Raczka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Radiation Exposure ◽  
Spatial Resolution ◽  
Retrospective Studies ◽  
Imaging Techniques ◽  
Cardiac Computed Tomography ◽  
Mitral Annulus ◽  
Diagnostic Purpose ◽  
Cardiac Procedures

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac disease is generally evaluated by non-ionizing imaging exams, as echocardiogram or magnetic resonance (MRI) and cardiac computed tomography (cCT) is seldom performed due to radiation concerns, but this exam has some advantages as better spatial resolution or better assessment of calcifications. Depending on different cardiac procedures, radiation exposure to the patients varies. Published values ranged from 4 mSv approx. for coronary angiography alone to 15 mSv approx. if stenting and ventriculography are added. Apart from coronary angiography, cCT is usually performed to plan transaortic valve implantation (TAVI) but other indications exit. Methods we reviewed cCT performed during a year and selected those not performed to assess coronary stenosis or previous to TAVI procedure. Results There were 18 exams, 50% women, mean age 62.8 years (range 17 to 82). There were no inconclusive exams. There were 10 exams with diagnostic purpose, not for measuring different structures. Among them, suspected diagnosis was confirmed in 2 cases. Reasons to choose cCT were: better assessment of calcium (6 cases), better spatial resolution (11), contraindications to MRI (3: 1 due to claustrophobia, 2 due to intracardiac device). 3 exams had 2 reasons (better spatial resolution+ assessment of calcium). 4 exams were performed without contrast, only to assess calcification: 1 case the pericardium, 3 cases the aortic valve. In the rest, contrast was used, assessing coronary anatomy as well in 5 of them. Among them, calcification was also assessed in other 2 cases (pericardium in constrictive pericarditis and mitral annulus in a woman with previous coronary artery by-pass grafting in whom a new mitral intervention was planned). Mean Radiation exposure was 5.5 mSv (range 0.3 to 15.3). There were 9 prospective cases (4 women), with a mean age of 61.6 years (17 to 82 years). Radiation exposure was 1.9 mSv (0.3 to 5.9). Mean age in retrospective studies was 63.8 years (53 to 81). 5 women underwent a retrospective study. Radiation exposure in retrospective studies was 8.7 mSv (3.9 to 15.3). There were no complications. We can see images from the prospective and retrospective studies in figures 1 and 2 respectively. Conclusions Although is seldom performed, cCT can be used safely to assess different cardiac structures. In different cases in which other imaging techniques is not enough, cCT is a good option to evaluate different structures or ventricular function. Several structures can be assessed in the same exploration.

scholarly journals Phenotyping of Chronic Obstructive Pulmonary Disease Using the Modified Bhalla Scoring System for High-Resolution Computed Tomography

2013 ◽  
Vol 20 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Baykal Tulek ◽  
Ali Sami Kivrak ◽  
Seda Ozbek ◽  
Fikret Kanat ◽  
Mecit Suerdem
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Scoring System ◽  
Morphological Changes ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease

BACKGROUND: Identifying different phenotypes of chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease.OBJECTIVE: To characterize the phenotypes of COPD according to high-resolution computed tomography (HRCT) findings; and to correlate HRCT scores obtained using the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.METHODS: The present study included 80 consecutive patients with stable COPD. HRCT scans were evaluated by two independent radiologists according to the modified Bhalla scoring system.RESULTS: Fifty-four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements and higher levels of inflammation, and reported more exacerbations in the previous year compared with patients with no findings on HRCT. Patients with morphological changes were classified into one of three groups according to their HRCT phenotype(s): emphysema (E) only, E + bronchiectasis (B)/peribronchial thickening (PBT) or B/PBT only. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, C-reactive protein (CRP) levels and the number of exacerbations among the groups were significantly different. Pairwise comparisons between the E only and E+B/PBT groups showed significantly lower FVC, FEV1and FEV1/FVC values, and higher CRP levels and number of exacerbations compared with the B/PBT group. No significant differences were found between the E+B/PBT and the B/PBT groups. An inverse correlation was found between the total HRCT score and FVC, FEV1and FEV1/FVC; the correlation was positive with CRP level, erythrocyte sedimentation rate and number of exacerbations.CONCLUSION: The present study exposed the intimate relationship between phenotype(s) characterized by HRCT and scoring for morphological abnormalities; and clinical and functional parameters and inflammatory markers. The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in the management and prognosis of COPD patients.

scholarly journals Acute Effect of Mitral Valve Repair on Mitral Valve Geometry

2018 ◽  
Vol 67 (07) ◽  
pp. 516-523 ◽  
Author(s):  
Thilo Noack ◽  
Kathleen Wittgen ◽  
Philipp Kiefer ◽  
Fabian Emrich ◽  
Matthias Raschpichler ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Cardiac Cycle ◽  
Morphological Changes ◽  
Three Dimensional ◽  
Mitral Annulus ◽  
Acute Effect ◽  
Dynamic Changes ◽  
4D Imaging ◽  
Ring Annuloplasty ◽  
Before And After

Background The aim of this study was to quantify acute mitral valve (MV) geometry dynamic changes throughout the cardiac cycle using three-dimensional transesophageal echocardiography (3D TEE) in patients undergoing surgical MV repair (MVR) with ring annuloplasty and optional neochord implantation. Methods Twenty-nine patients (63 ± 10 years) with severe primary mitral regurgitation underwent surgical MVR using ring annuloplasty with or without neochord implantation. We recorded 3D TEE data throughout the cardiac cycle before and after MVR. Dynamic changes (4D) in the MV annulus geometry and anatomical MV orifice area (AMVOA) were measured using a novel semiautomated software (Auto Valve, Siemens Healthcare). Results MVR significantly reduces the anteroposterior diameter by up to 38% at end-systole (36.8–22.7 mm; p < 0.001) and the lateromedial diameter by up to 31% (42.7–30.3 mm; p < 0.001). Moreover, the annular circumference was reduced by up to 31% at end-systole (129.6–87.6 mm, p < 0.001), and the annular area was significantly decreased by up to 52% (12.8–5.7 cm2; p < 0.001). Finally, the AMVOA experienced the largest change, decreasing from 1.1 to 0.2 cm2 during systole (at midsystole; p < 0.001) and from 4.1 to 3.2 cm2 (p < 0.001) during diastole. Conclusions MVR reduces the annular dimension and the AMVOA, contributing to mitral competency, but the use of annuloplasty rings reduces annular contractility after the procedure. Surgeons can use 4D imaging technology to assess MV function dynamically, detecting the acute morphological changes of the mitral annulus and leaflets before and after the procedure.

Micro-computed tomography high resolution evaluation of dimensional and morphological changes of 3 root-end filling materials in simulated physiological conditions

2020 ◽  
Vol 31 (2) ◽  
Author(s):  
Fernanda Ferrrari Esteves Torres ◽  
Reinhilde Jacobs ◽  
Mostafa EzEldeen ◽  
Juliane Maria Guerreiro-Tanomaru ◽  
Bernardo Camargo dos Santos ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Morphological Changes ◽  
Micro Computed Tomography ◽  
Physiological Conditions ◽  
Filling Materials

scholarly journals Optical Projection Tomography

2002 ◽  
Vol 10 (5) ◽  
pp. 3-4
Author(s):  
Stephen W. Carmichael ◽  
Stephen A. Boppart
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Three Dimensional ◽  
Data Sets ◽  
Optical Technique ◽  
Optical Projection Tomography ◽  
X Ray ◽  
Optical Projection ◽  
High Resolution Images ◽  
Optical Pathway

There are many approaches to obtaining high-resolution images and three dimensional volumetric data sets, but all have limitations. Many techniques involve reconstructing volumes of information from sections, either physical sections or optical sections. Recently, James Sharpe, Ulf Ahlgren, Paul Perry, Bill Hill, Allyson Ross, Jacob Hecksher-Sørensen, Richard Baldock, and Duncan Davidson have developed an optical technique that is analogous to computed tomography (CT). Whereas clinical CT involves an X-ray source and detector rotating around the patient, optical projection tomography (OPT) has the specimen rotating within an optical pathway.

scholarly journals Caseous Necrosis of Mitral Annulus

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Sinan Balci ◽  
Selcuk Akkaya ◽  
Selin Ardali ◽  
Tuncay Hazirolan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cardiac Magnetic Resonance ◽  
Cardiac Computed Tomography ◽  
Mitral Annulus ◽  
Resonance Imaging ◽  
Caseous Necrosis ◽  
First Choice ◽  
Wide Range ◽  
Magnetic Resonance Imaging Mri

Masses or mass-like lesions located in proximity to mitral valve encompass a wide range of differential diagnoses including neoplasias, abscesses, thrombi, and rarely caseous calcification of mitral annulus. Due to asymptomatic presentation, its diagnosis is usually incidental. Echocardiography is the first choice of imaging in evaluation. Cardiac computed tomography (CT) is helpful in establishing diagnosis by showing dense calcifications while cardiac magnetic resonance imaging (MRI) is used primarily as a problem solving tool. Imaging in evaluation of mitral annulus caseous calcification is essential in order to prevent unnecessary operations.

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