Cardiac Imaging
Figure 3: Reformatted Views for Measuring Valve Diameters
A
Figure 5: Multidetector Computed Tomography Reconstruction of the Right External Iliac Artery in a Patient with a Hip Prosthesis
AB
BC
CD DE
The coronal reformatted view. A: Aortic stenosis. Measurements of the annulus (B) and maximal diameter measurements of the sinus of Vasalva (C), the sinotubular junction (D), and the ascending tubular portion (E) are taken.
Figure 4: Multidetector Computed Tomography of the Anatomy of Different Iliofemoral Arteries in a High-Definition, Maximum-Intensity Projection, 3D Reconstruction
AB C
Lumen view (A) and curved view (B) from ‘quality check’ 140 kVp series; lumen view (C) and curved view (D) from 65 keV-monochromatic series with a metal artifact reduction algorithm. Note the improvement visualization of the arterial segment adjacent to the prosthesis.
A: A small amount of calcification with intermediate sinuosity arteries; B: Mildly calcified vessels with circumferential calcium on short-axis view and severe iliofemoral tortuosity; C: Heavy calcification with small-vessel sinuosity.
(see Figure 2): grade 1, no calcification; grade 2, mild calcification (small isolated spots of calcification); grade 3, moderate calcification (multiple
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larger spots of calcification); and grade 4, heavy calcification (extensive calcification of all aortic valve leaflets). The distance between the annulus and the coronary ostiae is measured, as is the diameter of the annulus, the sinus of Vasalva, the sinotubular junction, and the ascending tubular portion (see Figure 3). Measurement of the systolic aortic valve opening may be possible depending on the imaging quality. This measurement can be taken during systole at the summit of the aortic cone. Even if the severity of the stenosis is assessed from echocardiography and derived from flow measurements, MDCT will be able to measure the maximal valve opening with acceptable accuracy.7 The course and permeability of the coronary artery bypass grafts (frequent in this population) are also analyzed.
US RADIOLOGY
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