Cardiac MRI

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The inaugural CVI Philadelphia dinner symposium on cardiovascular imaging, held in early August, was deemed a success by organizer Dr. Jeffrey Hellinger, director of cardiovascular imaging and the 3D laboratory at Children’s Hospital of Philadelphia.

The first substantive clinical trials of dual-source CT suggest it will deliver on a promise to improve the detection of coronary artery disease. A Dutch study published in the August 21 issue of the Journal of the American College of Cardiology found it is 95% sensitive and 95% specific on a per-segment basis for diagnosing significant stenoses.

One of the promises of dual-source CT coronary angiography is the ability to scan patients without administering beta blockers. It was reported in the March issue of Diagnostic Imaging, however, that some imagers continue to use beta blockers, albeit with an improved workflow because they don't need to check for optimal heart rate. But several studies recently published and presented at conferences attest to the viability of scanning patients without beta blockers in a variety of cardiac situations.

Though the latest generation of 64-slice CT scanners often excels, the technology is still not good enough for practitioners to confidently assess in-stent restenosis, according to Dr. Stephan Achenbach, a professor of medicine at the University of Erlangen in Germany.

Not all those who suffer heart attacks have typical symptoms. Many people, including the elderly, those with renal disease, and women, are at risk of having a silent myocardial infarction. People with diabetes, in particular, are among those at highest risk of experiencing a silent MI. Now there is a clinical MRI technique that can identify abnormal myocardium, which signifies a high-risk profile, in diabetic patients.

An analysis of available data on ionizing radiation effects suggests that 64-slice coronary CT angiography scans put young women at a greater risk of developing cancer later in life than any other patient, according to a study in the July 18 issue of the Journal of the American Medical Association.

Echocardiography is already widely accepted as a diagnostic test for infective endocarditis, but now researchers have proven it’s also a cost-effective option. Making decisions about early surgery for patients with significant stroke risk based on echocardiographic findings is ultimately more economical than standard care.

Because of the great potential of cardiac CT angiography for the future of cardiovascular disease diagnosis and management, many physicians have shown an interest in developing expertise in cardiac CT. A number of radiologists and cardiologists have received training in cardiac CT, and many more are planning to obtain such training.

If ever a generation has been obsessed with aging, it's the baby-boom generation. Thirty years' worth of fads in exercise, diets, fashion, and personal grooming have all been directed at slowing the aging process or hiding its effects. Well, boomers can run (or jog, or bike, or yoga), but they won't be able to hide from what radiologists may soon be able to tell about the age of their insides.

A review of the current literature reveals a difference of opinion regarding whether to screen diabetic patients with CT and an inherent flaw with hybrid SPECT/CT scanners resulting in misregistered images. Researchers also optimized a contrast protocol for the triple rule-out procedure and advise echo studies when mitral valve calcification is found on chest CT.

The advent of 64-slice and dual-source CT has undoubtedly been welcomed by cardiovascular imaging experts. The systems' rapid rotation speeds and high-volume coverage have made it far easier to attain quality images of the beating heart and coronary arteries.