Background Morbid obesity is a worldwide epidemic and is increasingly treated by bariatric surgery. Fatty liver is a common finding; almost half of all patients with non-alcoholic steatohepatitis develop steatohepatitis. Bariatric surgery improves steatohepatitis documented by liver biopsy and single voxel magnetic resonance imaging (MRI) techniques. Objective To investigate changes before and after bariatric surgery using whole organ MRI quantification of liver, visceral, and subcutaneous fat. Setting University of Basel Hospital and St. Clara Research Ltd, Basel, Switzerland. Methods Sixteen morbidly obese patients were evaluated by abdominal MRI-scanning before and 3, 6, 12, and 24 months after bariatric surgery to measure percentage liver fat (%-LF), total liver volume (TLV) and visceral and subcutaneous adipose tissues (VAT and SAT). Fasting plasma samples were taken for measurement of glucose, insulin, blood lipids, and liver biomarkers. In a control group of 12 healthy lean volunteers, the liver biomarker was also measured. Results The reproducibility of fat quantification by use of MRI was excellent. LF decreased significantly faster than VAT and SAT (%-LF vs. VAT p < 0.001 and %-LF vs. SAT p < 0.001). At certain time points, %-LF, VAT, and SAT were associated with changes in blood lipids and insulin. Conclusions MRI quantification offers excellently reproducible results in measurement of liver fat and visceral and subcutaneous adipose tissues. Liver fat decreased significantly faster than visceral or subcutaneous adipose tissue. Decrease in %-LF and VAT is associated with decrease in total cholesterol, LDL, and plasma insulin. Electronic supplementary material The online version of this article (10.1007/s11695-019-03897-2) contains supplementary material, which is available to authorized users.

A 28-year-old man presented to the emergency department with progressive shortness of breath complicated by large hemoptysis. At 3 months of age, he had been diagnosed with a "hole in his heart" in the Ukraine and had undergone 3 coronary catheterizations (2 in Russia, 1 in India; results unavailable). His parents had declined options for treatment. After stabilization in the emergency department, he was transferred to coronary care, where echocardiography demonstrated a persistent ductus arteriosus (PDA) measuring 0.9ϫ2.0 cm with a right-to-left shunt consistent with Eisenmenger syndrome. Left ventricular function was severely impaired (ejection fractionϭ21%).Cardiac 64-slice multidetector computed tomography (MDCT) was undertaken to provide optimal depiction of the PDA and main pulmonary artery (PA) and confirmed a widely patent PDA measuring 2.0 cm in largest diameter ( Figure 1A). Functional MDCT cine multiphase reconstructions of the PDA revealed a bidirectional shunt (Movie I). Main, left, and right PAs were markedly enlarged ( Figure 1B). Coronary MDCT evaluation demonstrated severe left main coronary artery (LM) compression Ͼ90% between the aortic sinus and the enlarged PA ( Figure 1C). Additionally, coronary MDCT demonstrated a downward angulation of the LM with the left sinus of Valsalva of 11°( Figure 1D). Functional MDCT cine multiphase reconstructions demonstrated dynamic compression of the LM between the aortic sinus and the PA during systole (Movie II and III) and confirmed severe global left and right ventricular dysfunction (Movie IV). Noncardiac findings included pulmonary hemorrhage and pulmonary parenchymal peripheral vascular pruning that were consistent with severe pulmonary hypertension and Eisenmenger syndrome ( Figure 1E).Coronary angiography confirmed LM stenosis (Figure 2; Movie V), and hemodynamic evaluation revealed a Qp/Qs of 1.05. Three days after catheterization, the patient suffered a cardiac arrest and underwent percutaneous transcatheter intervention with stent placement across the LM. The patient declined heart-lung transplantation and was discharged in stable condition. The patient remains event free at 4-month follow-up.Left coronary artery compression syndrome was first described in 1957 and is characterized by compression of the LM between the aorta and an enlarged main PA. 1 It is usually seen with a congenital cardiac defect, most commonly an atrial septal defect, ventricular septal defect, or tetralogy of Fallot. 2 The association between an isolated PDA and left coronary artery compression is rare. 3 Both the degree of LM compression and its angle with the left sinus of Valsalva Ͻ30°are thought to increase the likelihood of significant myocardial ischemia. A main PA/aorta diameter ratio Ͼ2 is considered an additional risk factor. Cardiac 64-slice MDCT provides a noninvasive method for evaluating the degree of dynamic LM compression throughout the cardiac cycle, angulation of the LM relative to the left sinus of Valsalva, evaluation of left and right ventricular functi...