فهرست مطالب

Archives Of Cardiovascular Imaging - Volume:4 Issue: 3, 2016
  • Volume:4 Issue: 3, 2016
  • تاریخ انتشار: 1395/07/08
  • تعداد عناوین: 7
|
  • Mona Yadollahi, Azin Alizadehasl * Page 1
  • Farah Naghashzadeh, Neda Behzadnia *, Babak Sharif Kashani, Zargham Hossein Ahmadi, Alireza Jahangirifard, Samira Chaibakhsh Page 2
    Background
    Endomyocardial biopsy (EMB) is currently the method of choice for the definite diagnosis of acute allograft heart rejection after transplantation. But, it is somewhat invasive and expensive and, on occasion, gives rise to serious complications. To find a non-invasive method for the identification of acute allograft rejection, we compared the results between EMB according to the criteria of the international society of heart and lung transplantation (ISHLT) and myocardial deformation indices (color-coded tissue Doppler imaging (TDI)-derived strain and strain rate (SR) imaging)..
    Methods
    In 31 heart transplantation recipients followed up in our transplant clinic, EMB was achieved with a time lapse of 3 to 12 months after heart transplantation and color-coded TDI was performed during a 24-hour period after the biopsy procedure. The peak values of systolic strain and SR were determined in all 12 segments of the left ventricle (LV) except the apical segments..
    Results
    All the 31 heart transplantation patients were included in the study. According to the ISHLT’s criteria, 13 EMB samples revealed grade IR rejection and only 1 biopsy sample revealed grade IIR. ROC curve analysis was used for all the 12 LV segments. There were no meaningful correlations between the TDI-derived mean strain and SR values and the EMB results. The only meaningful correlation was between the SR of the infero-basal segment and the pathology result. The area under the curve was 0.73 (P = 0.024)..
    Conclusions
    Our results did not reveal a meaningful correlation between TDI-derived strain and SR and EMB results, but color-coded TDI-derived strain and SR imaging might have a complementary role for the identification of higher grades of acute allograft rejection in heart transplantation recipients. In our study, 1 EMB sample revealed grade IIR and no biopsy sample revealed grade IIIR; thus, a better assessment of the role of strain and SR imaging in predicting rejection requires further research with higher numbers of patients including higher grades of acute allograft rejection and novel techniques of stain rate imaging like speckle-tracking 2D strain imaging..
    Keywords: Strain Rate Imaging, Rejection, Heart Transplantation
  • Hossein Yousefi Banaem, Saeed Kermani *, Omid Srrafzadeh Page 3
    Background
    Obtaining accurate left ventricular (LV) endocardium segmentation requires the exclusion of the papillary muscles from the cardiac wall, which is a significant, albeit challenging, step in cardiac image analysis. Most medical imaging systems suffer from noise in that it affects the processing procedure. We herein introduce a segmentation algorithm, which improves segmentation accuracy by excluding the papillary muscles and suppressing noise effects..
    Methods
    We proposed a hybrid fuzzy-based level set method (LSM) to segment the cardiac wall in magnetic resonance imaging image series. In this approach, we applied improved spatial fuzzy c-means (FCM) on the given image and then utilized the obtained result as the initial contour for the LSM method to obtain more accurate segmentation results..
    Results
    We compared the obtained results with those obtained via manual segmentation as the gold standard vis-à-vis accuracy, Jaccard coefficient, dice coefficient, and false positive ratio. Also, the robustness of the proposed method to the noise was tested by adding the Gaussian noise with different variances to the original image. The obtained results showed 96 ± 1.3% accuracy in normal images and 89 ± 4% accuracy in noisy images with a signal-to-noise ratio of -2.2 to -1..
    Conclusions
    Our results demonstrated that our proposed method was able to exclude the papillary muscles from the cardiac wall. Moreover, our hybrid method showed better accuracy than the 2 methods of FCM and LSM alone..
    Keywords: Improved Spatial FCM, Endocardium Segmentation, Level Set
  • Hedieh Alimi, Masumeh Alvandi * Page 4
    Primary malignant cardiac tumors are rare tumors of the heart with a very poor prognosis. Complete excision is the treatment of choice, but it is dependent on the stage and extension of the tumor. We describe an old man with the initial presenting symptoms of progressive dyspnea. Our assessment revealed moderate pericardial effusion and a large infiltrative right ventricular mass. The initial differential diagnosis included malignant sarcoma, lymphoma, or melanoma. The patient underwent palliative excision of the tumor and chemotherapy. After biopsy, cardiac lymphoma was confirmed..
    Keywords: Cardiac Lymphoma, Pericardial Effusion, Echocardiography
  • Mehmet Onur Omaygenc *, Ibrahim Oguz Karaca, Beytullah Cakal, Haci Murat Gunes, Filiz Kizilirmak, Bilal Boztosun Page 5
    Introduction
    Pericardial cysts are rare abnormalities of the mediastinum and generally have a benign course. Patients are mostly asymptomatic, and diagnosis is established incidentally in a majority of cases. The management of this asymptomatic population is also controversial..
    Case Report: We report a huge pericardial cyst, located at the right cardiophrenic angle impairing ventricular filling properties without causing evident symptoms. The cyst was almost 13 cm in the largest diameter. Echocardiography and computed tomography scan were utilized not only to confirm the diagnosis, but also to determine the treatment strategy..
    Conclusions
    Surgical or percutaneous interventional treatment for pericardial cysts might be occasionally necessary, depending on the location of the cyst and its relationship with the adjacent structures. Unfortunately, our patient refused any kind of treatment option. Based on this report, the course of the disease, diagnostic modalities, and treatment strategies in general manner were additionally discussed..
    Keywords: Mediastinal Cyst, Pericardial Cyst, Pericardial Fluid
  • Rienzi Diaz Navarro *, Petros Nihoyannopoulos Page 6
    Postpartum Takotsubo cardiomyopathy is mainly induced by drugs that enhance sympathetic nervous activity. We report a novel case of postpartum inverted Takotsubo cardiomyopathy triggered by intravenous atropine administration resulting in acute pulmonary edema. Cardiac troponin I and beta-type natriuretic peptide were elevated. Transthoracic color Doppler echocardiography demonstrated a nondilated left ventricle with mid-basal akinesis, a hyperdynamic apex, and moderate-to-severe mitral regurgitation likely linked to papillary muscle dysfunction. Coronary computed tomography angiography revealed normal coronary arteries. Atropine inhibits the parasympathetic nervous system, alters the autonomic system balance, and, thus, leads to increased sympathetic nervous activity, which seems to have been the cause of Takotsubo cardiomyopathy in this patient. Atropine should be listed among the drugs triggering Takotsubo cardiomyopathy..
    Keywords: Takotsubo Cardiomyopathy, Cardiomyopathies, Echocardiography Doppler Color, Atropine
  • Fatemeh Mirrazeghi, Mohammad Esmaeil Rezaei *, Anita Sadeghpour, Alireza Alizadeh Ghavidel, Kambiz Mozaffari Page 7
    Myxomas are the most common primary cardiac tumors. They are mostly located in the left atrium, but 15% to 20% of them arise from the right atrium (RA). We herein describe a 22-year-old man with a giant RA mass and simultaneous pulmonary embolism. The mass was detected accidentally on transthoracic echocardiography in preoperative workup for an elective noncardiac surgery and was confirmed with multimodality imaging. The patient underwent surgical removal of the mass and concomitant pulmonary artery embolectomy. Histopathological examination confirmed the diagnosis of an RA myxoma. He had an uneventful recovery and was asymptomatic after 24 months of follow-up. This case is a villous RA myxoma, which is a very rare subtype with a high tendency to pulmonary embolism. We report this case as an unusual location of a very large myxoma and emphasize the role of multimodality imaging in the preoperative management of this patient as cardiac computed tomography angiography confirmed the associated pulmonary embolism..
    Keywords: Echocardiography, Cardiac Mass, Cardiac CT, Cardiac MR