Myocardial bridging as evaluated by 16 row MDCT

Purpose

The purpose of this study is to find out the prevalence, appearance and clinical symptoms of myocardial bridging (MB) by MDCT coronary angiography (CTA).

Materials and methods

A total of 280 (50 females) consecutive patients followed with coronary artery disease or postoperative stent and bypass control, underwent CTA performed by 16-MDCT scanner between January 2006 and April 2006. Short axis multiplanar reformatted images were evaluated. MBs were classified as complete and incomplete bridges with respect to continuity of the myocardium over the tunneled segment of left anterior descending artery (LAD) in interventricular groove and the cut-off value is 1.3 mm. Patients diagnosed with MB on CTA who had prior catheter angiography studies were re-evaluated for the presence of MB.

Results

One hundred and twenty MBs [98 (81.6%) on LAD, 2 (1.6%) on diagonal branch, 11 (9.1%) on obtuse marginal, 4 (3.3%) on right coronary artery, 5 (4.1%) on ramus intermedius artery] were detected in 108 (38.5%) patients. Eighty-five (70.8%) of bridged segments in 79 (28.2%) patients were complete and the rest [35 (29.2%) in 34 (12.1%) patients] were incomplete. In 12 patients two MBs (either on different arteries or on the same artery) were detected. The length of bridged segments in patients with complete and incomplete MBs varied between 4–50.9 mm (mean 18 mm) and 4–37.3 mm (mean 13.6 mm), respectively, and the depth of myocardium over the artery ranged between 1–6.4 mm (mean 2.3 mm) and 1–1.2 mm (mean 1 mm), respectively. Thirty (27.7%) out of 108 patients, in whom MB was detected on CTA, were found to have correlative catheter angiography studies, retrospectively and MB was detected only in 4 (13.3%) out of 30 patients.

Conclusion

MDCT coronary angiography is a non-invasive, efficient method in the diagnosis of MB avoiding the procedural risks that catheter angiography carries. MDCT coronary angiography allows direct visualization of the bridge itself and may thus give the opportunity to differentiate between complete and incomplete myocardial bridges.     

Non-invasive imaging of aberrant right subclavian artery pathologies and aberrant right vertebral artery

Here, we review the CT and MR angiography findings of aberrant right subclavian and right vertebral arteries, with emphasis on the differences between these structures. In addition, non-invasive imaging findings of aberrant right subclavian artery pathologies, including arteritis, aneurysm and dissection, are discussed.     

An unusual growth of ovarian cystic teratoma with multiple floating balls during pregnancy: A case report

We report a case of ovarian cystic teratoma with an important growth during pregnancy and the sonographic appearance of intracystic multiple, mobile, polygonal structures called intracystic “fat balls.” Due to the rapid growth of the lesion, which exceeded 15 cm in diameter, a right oophorectomy was performed. Histopathologic diagnosis confirmed the mature cystic teratoma. The presence of floating balls composed of keratin and fat is rarely seen but is pathognomonic of mature cystic teratomas. Growth of a teratoma during pregnancy is a rare condition. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010     

Four- and Eight-Channel Aortoiliac CT Angiography: A Comparative Study

Purpose To compare performance parameters, contrast material load and radiation dose in a patient cohort having aortoiliac CT angiography using 4- and 8-channel multidetector CT (MDCT) systems.Methods Eighteen patients with abdominal aortic aneurysms underwent initial 4-channel and follow-up 8-channel MDCT angiography. Both the 4- and 8-channel MDCT systems utilized a matrix detector of 16 × 1.25 mm rows. Scan coverage included the abdominal aorta and iliac arteries to the level of the proximal femoral arteries. For 4-channel MDCT, nominal slice thickness and beam pitch were 1.25 mm and 1.5, respectively, and for 8-channel MDCT they were 1.25 mm and 1.35 or 1.65 respectively. Scan duration, iodinated contrast material load and mean aortoiliac attenuation were compared retrospectively. Comparative radiation dose measurements for 4- and 8-channel MDCT were obtained using a multiple scan average dose technique on an abdominal phantom.Results Compared with 4-channel MDCT, 8-channel MDCT aortoiliac angiography was performed with equivalent collimation, decreased contrast load (mean 45% decrease: 144 ml versus 83 ml of 300 mg iodine/ml contrast material) and decreased acquisition time (mean 51% shorter: 34.4 sec versus 16.9 sec) without a significant change in mean aortic enhancement (299 HU versus 300 HU, p > 0.05). Radiation dose was 2 rad for the 4-channel system and 2/1.5 rad for the 8-channel system at 1.35/1.65 pitch respectively.Conclusion Compared with 4-channel MDCT, aortoiliac CT angiography with 8-channel MDCT produces equivalent z-axis resolution with decreased contrast load and acquisition time without increased radiation exposure.     

Diaphragmatic mesothelial cysts in children: radiologic findings and percutaneous ethanol sclerotherapy

OBJECTIVE: We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of percutaneous treatment with ethanol. All cysts were bilobulate and showed extrahepatic location between the right liver lobe and diaphragm. CONCLUSION: Radiologic findings are helpful in diagnosing diaphragmatic mesothelial cysts, which should be managed conservatively. Percutaneous ethanol sclerotherapy should be the first choice of treatment if necessary.     

Bilateral scrotal extraperitoneal herniation of ureters: computed tomography urographic findings and review of the literature

Scrotal herniation of the ureter is an extremely rare and often misdiagnosed condition with possible serious surgical complications. Most reported cases occur in obese men during the fifth and sixth decades of life. Two types of ureteroinguinal hernias are defined: paraperitoneal (more frequent and acquired form with a peritoneal hernia sac in which other abdominal structures are found) and extraperitoneal (uncommon and congenital form without a peritoneal sac that is almost always composed of the ureter and fat tissue). A case of scrotal extraperitoneal ureteral hernia with exquisite computed tomography urographic and ultrasound findings is presented.     

Bilateral ovarian fibromatosis presenting with ascites and hirsutism

BACKGROUND: Ovarian fibromatosis is a very rare nonneoplastic disease. Due to the rarity and atypical clinical presentations, they may give rise to a misdiagnosis of malignancy and unnecessary extensive surgical interventions. Literature lacks definitive data about this rare disease and its preoperative evaluations. MRI together with the intraoperative frozen section may help us to define the benign nature of the disease. In this report, we aimed to review the literature and give a highlight to the gynecologic oncologists about this rare disease. CASE HISTORY: A 19-year-old female patient admitted to our hospital with the complaints of menstrual irregularity, hirsutism, and increased abdominal girth. Physical examination revealed bilateral ovarian mass, hirsutism, and ascites. Serum CA-125 levels were slightly elevated. Preoperative MRI study showed bilateral hypointense lobulated ovarian masses. With the initial diagnosis of ovarian tumor, we performed explorative laparotomy and excised both masses. Final pathology was reported as bilateral ovarian fibromatosis. CONCLUSION: Ovarian fibromatosis commonly presents with ascites and solid pelvic mass and can be misdiagnosed as a malignant ovarian tumor. In young patients, clinicians should consider ovarian fibromatosis in differential diagnosis of pelvic mass. Preoperative MRI findings and intraoperative frozen examination may be used to avoid unnecessary aggressive surgical management.     

Magnetic resonance venography of double inferior vena cava

Duplication of the inferior vena cava IVC is the most common anomaly affecting the vena cava. Variations of the IVC are diagnosed in routine dissection studies, in retroperitoneal surgeries, or in radiological studies for various reasons. In this paper, we present a case of double IVC with its magnetic resonance imaging findings.