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Epidemiology and reporting of osteoporotic vertebral fractures in patients with long-term hospital records based on routine clinical CT imaging.

UNLABELLED: Osteoporotic vertebral fractures signify an increased risk of future fractures and mortality and can manifest the diagnosis of osteoporosis. We investigated the prevalence of vertebral fractures in routine CT of patients with long-term hospital records. Three out of ten patients showed osteoporotic vertebral fractures (VFs) corresponding to the highest rates reported in European population-based studies. INTRODUCTION: VFs are a common manifestation of osteoporosis, which influences future fracture risk. Their epidemiology has been investigated in population-based studies. However,

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… Underdiagnosis of vertebral collapse on routine multidetector computed tomography scan of the abdomen. Acta Radiol. 2008;49:795–800. doi: 10.1080/02841850802165776. 42. Carberry GA, Pooler BD, Binkley N, et al. Unreported vertebral body compression fractures at abdominal multidetector CT. …

Improved prediction of permanent pacemaker implantation in TAVR for aortic regurgitation: integrating Self-expanding valve implants with 3D printed Patient-specific aortic root models and sensors.

The aim of this study is to develop a comprehensive predictive model for PPMI after transcatheter aortic valve replacement (TAVR) in patients with aortic regurgitation by reflecting pressure changes in the critical region post-TAVR using 3D-printed root models equipped with pressure sensors, in conjunction with clinical baseline characteristics, MDCT findings, procedural factors. A retrospective analysis was performed on seventy-two patients with aortic regurgitation who performed pre-TAVR CT evaluation using self-expandable valves. The study excluded patients with a pre-existing PPMI or those

Multicenter Comparison of Novel Self-Expanding Versus Balloon-Expandable Transcatheter Heart Valves.

OBJECTIVES: This study sought to compare 2 next-generation transcatheter heart valves (THV), the self-expanding ACURATE neo (NEO) and the balloon-expandable SAPIEN 3 (S3), in terms of device failure and early safety at 30 days. BACKGROUND: Deployment of these THV showed promising initial clinical results. However, no comparative data are available. METHODS: Of 1,121 treated patients at 3 centers, a 1-to-2 nearest neighbor matching was performed to identify 2 patients treated with S3 (n = 622) for each patient treated with NEO (n = 311). RESULTS: In-hospital complications were comparable bet

Alcohol Use and Cardiovascular Disease Risk in Patients With Nonalcoholic Fatty Liver Disease.

BACKGROUND & AIMS: Cardiovascular disease (CVD) is the leading cause of death among patients with nonalcoholic fatty liver disease (NAFLD). Moderate drinking (vs abstinence) is associated with lower risk of CVD in the general population. We assessed whether alcohol use is associated with CVD risk in patients with NAFLD. METHODS: We analyzed data from participants in the Coronary Artery Risk Development in Young Adults longitudinal cohort study of 5115 black and white young adults, 18-30 years old, recruited from 4 cities in the United States from 1985 through 1986. Participants self-reported

Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI.

Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81 ± 6 years) undergoing TAVI were enrolled. Vascular path

Current trends in patients with chronic total occlusions undergoing coronary CT angiography.

OBJECTIVE: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment strategies of CTO identified by CCTA. METHODS: We identified 23 745 patients who underwent CCTA for suspected coronary artery disease (CAD) from the prospective international CCTA registry. Baseline clinical data were collected, and allocation to early coronary revascularisation performed within 90 days of CCTA w

Early triage of emergency department patients with acute coronary syndrome: contribution of 64-slice computed tomography angiography.

BACKGROUND: Multislice computed tomography coronary angiography (MSCT-CA) is feasible in the emergency department (ED) for ruling out obstructive coronary artery disease (CAD). AIM: To investigate a diagnostic strategy using MSCT-CA for the early triage of patients presenting to the ED with acute chest pain suggestive of acute coronary syndrome (ACS), according to the medium-term incidence of clinical events. METHODS: We conducted a single-centre, prospective, observational cohort study in 123 patients with low-risk to intermediate-risk acute chest pain suggestive of ACS. MSCT-CA was perform

Coronary CT and the coronary calcium score, the future of ED risk stratification?

Accurate and efficient evaluation of acute chest pain remains clinically challenging because traditional diagnostic modalities have many limitations. Recent improvement in non-invasive imaging technologies could potentially improve both diagnostic efficiency and clinical outcomes of patients with acute chest pain while reducing unnecessary hospitalizations. However, there is still controversy regarding much of the evidence for these technologies. This article reviews the role of coronary artery calcium score and the coronary computed tomography in the assessment of individual coronary risk and

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… Circulation 2010 10.1016/j.jcct.2010.11.001 21232696 44 Stillman AE Oudkerk M Ackerman M Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology Eur Radiol 2007 … computed tomography as an initial diagnostic approach in patients with acute chest pain Am Heart J 2008 156 375 83 18657674 10.1016/j.ahj.2008.03.016 59 May JM Shuman WP Strote JN Low-risk patients with chest pain in the emergency department: negative 64-MDCT coronary angiography may reduce length …

Computed tomography with low-dose radiation versus standard-dose radiation for diagnosing fractures: systematic review and meta-analysis.

BackgroundComputed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT.ObjectiveTo determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures.Design and settingSystematic review of

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… Multidetector computed tomography in acute joint fractures. Acta Radiol. 2005;46(6):587–98. doi: 10.1080/02841850510021634. 27. Konda SR, Goch AM, Haglin J, Egol KA. … Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists. PLoS One. 2016;11(10):e0164859. doi: 10.1371/journal.pone.0164859. 43. …

Whole-body magnetic resonance imaging (WBMRI) versus whole-body computed tomography (WBCT) for myeloma imaging and staging.

Myeloma-associated bone disease (MBD) develops in about 80-90% of patients and severely affects their quality of life, as it accounts for the majority of mortality and morbidity. Imaging in multiple myeloma (MM) and MBD is of utmost importance in order to detect bone and bone marrow lesions as well as extraosseous soft-tissue masses and complications before the initiation of treatment. It is required for determination of the stage of disease and aids in the assessment of treatment response. Whole-body low-dose computed tomography (WBLDCT) is the key modality to establish the initial diagnosis

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… Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma. Blood Cancer J. 2015;5:e329. doi: 10.1038/bcj.2015.57. 28. … Image quality in low-dose multidetector computed tomography: a pilot study to assess feasibility and dose optimization in whole-body bone imaging. Can Assoc Radiol J. 2010;61(5):258–264. doi: 10.1016/j.carj.2010.01.003. 38. …

Effects of dose reduction on bone strength prediction using finite element analysis.

This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests w

Systemic inflammation is related to coronary microvascular dysfunction in obese patients without obstructive coronary disease.

BACKGROUND AND AIMS: Obesity, systemic inflammation and changes in the heart functions are associated with increased cardiovascular risk. This study aimed to investigate coronary microvascular dysfunction as an early marker of atherosclerosis in obese patients without any evidence of cardiovascular disease. METHODS AND RESULTS: 86 obese subjects (aged 44 ± 12 years, body mass index (BMI) 41 ± 8 kg m(-2)), without evidence of heart disease, and 48 lean controls were studied using transthoracic Doppler echocardiography for detecting coronary flow reserve (CFR). A value of CFR ≤ 2.5 was consider

Continuous multiple vertebral compression fractures in multiple myeloma patient.

Multiple myeloma is a B-cell origin tumor characterized by hypercalcemia, osteolytic bony lesions, and pathologic fractures. Back pain is one of the most common presenting symptoms of multiple myeloma and about 60% of patients have vertebral involvement at the time of diagnosis7). Minimally invasive surgeries such as vertebroplasty and kyphoplasty are effective to relieve pain and improve the quality of life when a compression fracture occurs in multiple myeloma patients. We report a case of continuous multiple compression fractures associated with multiple myeloma. We should check for the pos

Computed tomography for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease.

BACKGROUND: Hepatocellular carcinoma occurs mostly in people with chronic liver disease and ranks sixth in terms of global incidence of cancer, and fourth in terms of cancer deaths. In clinical practice, computed tomography (CT) is used as a second-line diagnostic imaging modality to confirm the presence of focal liver lesions suspected as hepatocellular carcinoma on prior diagnostic test such as abdominal ultrasound or alpha-foetoprotein, or both, either in surveillance programmes or in clinical settings. According to current guidelines, a single contrast-enhanced imaging study CT or magnetic

Imaging for Plasma Cell Dyscrasias: What, When, and How?

Imaging plays a vital role in the diagnosis, response assessment, and follow-up of patients with plasma cell bone disease. The radiologic diagnostic paradigm has thus far evolved with developing technology and availability of better imaging platforms; however, the skewed availability of these imaging modalities in developed vis-à-vis the developing countries along with the lack of uniformity in reporting has led to a consensus on the imaging criteria for diagnosing and response assessment in plasma cell dyscrasia. Therefore, it is imperative for not only the radiologists but also the treating

An Approach to Working Up Cases of Embolic Stroke of Undetermined Source.

BACKGROUND: From a therapeutic viewpoint, it is important to differentiate the underlying causes of embolism in patients with cryptogenic stroke, such as aortic arch atheroma, patent foramen ovale, and paroxysmal atrial fibrillation. We investigated the clinical and radiological characteristics of these 3 common causes of cryptogenic embolism to develop models for decision making in etiologic workups. METHODS AND RESULTS: A total of 321 consecutive patients with acute infarcts from cryptogenic embolism were included. Patients were divided into 3 groups-aortic arch atheroma (n=40), patent fora

Computed tomography-derived cardiovascular risk markers, incident cardiovascular events, and all-cause mortality in nondiabetics: the Multi-Ethnic Study of Atherosclerosis.

AIM: We assess the improvement in discrimination afforded by the addition of the computed tomography risk markers thoracic aorta calcium (TAC), aortic valve calcification (AVC), mitral annular calcification (MAC), pericardial adipose tissue volume (PAT), and liver attenuation (LA) to the Framingham risk score (FRS) + coronary artery calcium (CAC) for incident coronary heart disease (CHD) and incident cerebrovascular disease (CVD) in a multiethnic cohort. METHODS AND RESULTS: A total of 5745 participants were enrolled, with 2710 at intermediate Framingham risk, 210 CVD events, and 155 CHD even

Clinical significance of flow-mediated dilation, brachial intima-media thickness and pulse wave velocity in patients with and without coronary artery disease.

BACKGROUND: Little is known about the interrelationships among brachial flow-mediated vasodilatation (bFMD), brachial-ankle pulse wave velocity (baPWV) and brachial intima-media thickness (bIMT) in patients with and without coronary artery disease (CAD). METHODS AND RESULTS: Two-hundred consecutive patients with stable angina pectoris (SAP) were enrolled as the CAD group and 50 age-, sex- and body mass index-matched patients without CAD were selected as the non-CAD group. bFMD, diastolic blood pressure (DBP) and high-density lipoprotein cholesterol (HDL-C) in the CAD group were significantly

Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel.

Solitary plasmacytoma is an infrequent form of plasma cell dyscrasia that presents as a single mass of monoclonal plasma cells, located either extramedullary or intraosseous. In some patients, a bone marrow aspiration can detect a low monoclonal plasma cell infiltration which indicates a high risk of early progression to an overt myeloma disease. Before treatment initiation, whole body positron emission tomography-computed tomography or magnetic resonance imaging should be performed to exclude the presence of additional malignant lesions. For decades, treatment has been based on high-dose radi

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… Kropil P Fenk R Fritz LB Blondin D Kobbe G Modder U Cohnen M Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma Eur Radiol 2008 18 51 58 10.1007/s00330-007-0738-3 17924119 21. …

IgM Myeloma: Всеобъемлющий обзор и практический подход к хемапаевому управлению.

IgM mieloma — редкий подтип множественной миэломы (MM). 0.5% из всех его дел. Она характеризуется нерегулируемым распространением плазменных клеток ИгМ в костном мозге. Фундаментальный патогенез предполагает регулирование изотипной рекомбинации переключателей, что приводит к различным транслокациям хромосом, таким, как 11q13 и 4p16. Обычно у пациентов возникают симптомы гипервизорного синдрома, инфильтрации костного мозга и органомегалия. Диагностика включает в себя клиническую оценку, лабораторные тесты (электропорез, биопсия костного мозга, цитогенетика, иммунохимия) и съемку. Варианты лечен

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… However, skeletal bone surveys have their own limitations; in order for it to detect osteolytic lesions, 30% of the bone cortex should have been destroyed by the time of diagnosis [ 40 ]. 18 F-FDG-PET/CT, multidetector computed tomography (MDCT), and low-dose computed tomography (LDCT) have shown to …