The 3D CT imaging technique is useful in defining the optimal surgical strategy for reoperative cardiac surgery. We found that CTA is superior to CXR and conventional angiography in defining the position of patent grafts and vital structures in relation to the midline and posterior sternum. Preoperative mapping of patent coronary grafts and other vital mediastinal structures reduces the morbidity of the reoperation through modification of surgical approaches.

Fulminant hepatitis due to herpes simplex virus (HSV) is rare in immunocompetent adults. Most reported cases have clearly established pregnancy as a condition that can predispose to disseminated HSV infection. We report a case of a 25-year-old previously healthy pregnant woman who presented with fatigue, fever, and anicteric hepatitis. Triphasic contrast-enhanced computed tomography demonstrated a miliary pattern of multiple, hypovascular, subcentimeter lesions scattered throughout the liver. Familiarity with the clinical findings and computed tomographic appearance may prompt early recognition of fulminant HSV hepatitis and allow differentiation from other hepatic disease during pregnancy.

Purpose MR is a high-cost imaging modality, and an optimized encounter ideally provides high quality care, patient satisfaction and capacity utilization. Our purpose was to assess the effectiveness of team training and its impact on patient show-up and completion rates for their MRI examinations. Methods A total of 97,712 patient visits from 3 tertiary academic medical centers over one-year intervals were evaluated, totaling 49,733 visits at baseline and 47,979 after training. Each centers’ MRI team received team training skill training including advanced communication and team training techniques training. This training included onsite instruction including case simulation with scenarios requiring appropriate behavioral and communicative interventions. Orientation and training also utilized customized online tools, and proctoring. The study completion rate and patient show-up rate during consecutive year-long intervals before and after team training were compared to assess its effectiveness. Two-sided Chi-Square tests for proportions using were applied at a 0.05 significance level. Results Despite differing no-show rates (5–22.2%) and study incompletions rates (0.7–3.7%) at the three academic centers, the combined patients’ data showed significant (p<0.0001) improvement in the patients’ no-show rates (combined decreases from 11.2% to 8.7%) and incompletion rates (combined decreases from 2.3 to 1.4%). Conclusion Our preliminary results suggest training of imaging team can improve the no-show and incompletion rates of the MRI service, positively affecting throughput and utilization. Team training can be readily implemented and may help address the needs of the current cost-conscious and consumer sensitive healthcare environment.

For coronary artery imaging, acquisition protocols that provide the highest temporal resolution are mandatory. The multisector mode is one technique that allows high temporal resolution but may be clinically inappropriate at heart rates below 65 bpm or when heart rate variation is observed during scan time.

Central nervous system involvement in trichinosis is not rare. Brain lesions in trichinosis have been defined on computed tomography and magnetic resonance imaging (MRI) as multifocal small lesions located in the cerebral cortex and white matter. We present a case of trichinosis with multifocal lesions of the brain detected by MRI and diffusion weighted MRI. Evolutions of these lesions from acute through chronic stages on follow up studies are also presented. This is the first report describing sequential MRI findings and diffusion weighted imaging appearance of brain lesions in trichinosis. Sequential evaluation of conventional and diffusion MR data allowed us to conclude that multifocal lesions in the brain were related to multiple infarctions rather than true inflammatory infiltration of the brain parenchyma.