Computation of FFRQCA is a novel method that allows the assessment of the functional significance of intermediate stenosis. It may emerge as a safe, efficient, and cost-reducing tool for evaluation of coronary stenosis severity during diagnostic angiography.
Summary:Left ventricular wall rupture after myocardial infarction is a mechanical complication that may result in a pseudoaneurysm. Between January 1994 and October 1996, false or pseudoaneurysms were detected in 6 (0.0026%) of 2,600 consecutive patients (4 women, 2 men; mean age 59.4 years) undergoing cardiac catheterization at University Medical School, Debrecen, Hungary. All patients had a history of cardiovascular disease, with diagnosis of pseudoaneurysm confirmed by echocardiography. The average time from the occurrence of acute infarction to diagnosis was 37.0 days (range 3-80 days). All patients were in New York Heart Association functional class IV congestive heart failure; in four patients cardiogenic shock was present. Five patients underwent coronary angiography, which demonstrated multivessel disease and occlusion of the infarct-related artery (TIMI 0) without adequate collateral circulation (grade 0-1). Five patients had surgical repair of the false aneurysm, and, in three patients, concomitant coronary bypass grafting was performed. The 2-year mortality rate for all patients was 50%. Early diagnosis of false aneurysm is facilitated by echocardiography, and coronary angiography is required before surgery. Early surgical correction with coronary revascularization is advised.
Contrast material-enhanced magnetic resonance (MR) imaging of the breast has variable specificity for differentiation of breast cancer from other enhancing conditions. Two principal strategies to improve its specificity are rapid dynamic MR imaging and high-spatial-resolution MR imaging. A method was developed of combining contemporaneously acquired dynamic and high-spatial-resolution MR imaging data into a single integrated display. Whole-breast rapid dynamic data were condensed into a color map by using pharmacokinetic analysis. The pharmacokinetic results were combined with the high-spatial-resolution images with a new technique that preserves underlying morphologic details. This new method was evaluated by five radiologists for eight breast lesions, and the results were compared with those of the standard method of overlaying parametric map data. The radiologists' ratings showed a statistically significant preference for the intensity-modulated parametric map display method over the overlaid parametric display method for 10 of the 12 evaluation criteria. The new method enabled simultaneous visualization of pharmacokinetic and morphologic information, facilitated assessment of lesion extent, and improved the suppression of noise in the pharmacokinetic data. The ability to simultaneously assess both dynamic and high-spatial-resolution features may ultimately improve the specificity of breast MR imaging.
Desmoplastic small round cell tumour (DSRCT) belongs to the histological descriptive category of small round blue cell tumours. DSRCT primarily occurs in adolescents and young adults between the ages of 15 and 25 years and has a male predominance. DSRCT is an aggressive disease with a poor prognosis; timely diagnosis is therefore critical to the management of these patients. Although their radiographic appearances overlap with other aggressive malignancies, there are certain imaging features that can suggest the diagnosis and expedite the initiation of appropriate therapy. The aim of our pictorial review is to describe the imaging findings of primary and metastatic DSRCT in adults.
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