Congenital left ventricular out-pouching, consisting of left ventricular aneurysms, left ventricle diverticulae, and double-chambered left ventricle, is a rare cardiac malformation. Criteria to differentiate between left ventricular aneurysm and diverticulum are defined. Reports of left ventricular accessory chamber in the medical literature are rare. In this article, we present a case of left ventricular accessory chamber diagnosed during the late prenatal period. Review of the literature, imaging modalities used for differentiation of the nature of this lesion, and management plan are discussed.

Helix system was accurate and safe. Retention of CD34+ cells was confirmed by MRI and immunohistology. Further preclinical studies are needed to characterize retention over time and quantify efficiency. Studies are needed to confirm accuracy, safety, and retention in humans.

Diagnosis and management of inflammatory bowel disease (IBD) requires repeat diagnostic imaging for monitoring of disease activity. Recent evidence has suggested that patients with IBD are at increased risk of radiation exposure from repeat imaging. The aim of this article was to highlight risks associated with increasing radiation exposure and identify alternatives to minimize exposure. The increasing use of computed tomography (CT) in both Crohn's disease and ulcerative colitis has brought additional benefits to guiding management through non-invasive measures. However, the massive increase in use of CT scans poses a risk of exposing patients with IBD to high levels of diagnostic medical radiation. High levels of diagnostic medical radiation are associated with an increased risk of malignancy in several studies. Numerous studies have identified particular risk factors in IBD associated with high levels of diagnostic medical radiation which are also associated with a more severe disease course. Imaging techniques such as magnetic resonance enterography, ultrasound, small bowel follow through, and capsule endoscopy are alternatives to CT scans as they do not utilize radiation. Gastroenterologists managing patients with IBD, particularly Crohn's disease, should be aware of the increased risk of high cumulative doses of radiation exposure, particularly from CT scanning. Alternative forms of imaging should be carefully considered when evaluating patients, in particularly those with identifiable risk factors for an aggressive disease course.

Rationale and Objectives To evaluate clinical and imaging features associated with adequacy of the hepatocyte phase (HP) in gadoxetate disodium–enhanced liver magnetic resonance imaging (MRI) in patients without chronic liver disease (CLD). Materials and Methods This was a retrospective institutional review board–approved study of 97 patients who underwent liver MRI examinations with gadoxetate disodium and had no history of CLD. Available late dynamic and HP sequences (3–20 minutes postinjection) were independently analyzed by four radiologists for perceived image adequacy and level of biliary enhancement. Signal intensity ratios (SIRs) of liver/inferior vena cava (IVC), liver/spleen, and liver/muscle were measured. The Spearman ρ and receiver operating characteristic analyses were performed correlating various factors with HP adequacy. A rule for predicting HP adequacy was also derived and tested to determine whether overall examination time could be shortened. Results A visually adequate HP was observed in 12% of subjects by 10 minutes, 80% by 15 minutes, and 93% by 20 minutes. An SIRliver/ IVC > 1.8 was the imaging feature that had the strongest correlation with an adequate HP (ρ = 0.813, P < .001), and was more predictive of adequacy of the HP than the time postinjection (ρ = 0.5, P < .001). The time at which an adequate HP was first observed did not correlate with any tested demographic or laboratory values. Stopping imaging when an SIRliver/IVC > 1.8 would have successfully reduced mean postcontrast time to 15:39 ± 4:02 from 20:00 (P < .001), although maintaining HP adequacy. Conclusions Most patients without CLD undergoing gadoxetate-enhanced liver MRI achieve adequate HP at 20 minutes. However, a shorter postcontrast stopping time can be used in most patients.

Carotid duplex Doppler ultrasound (CDDU) is increasingly used for the evaluation of internal carotid artery (ICA) stenosis. In CDDU, velocity measurements are used to estimate the degree of ICA stenosis. Traditionally, radiologists have relied on institutional experience and published research when interpreting CDDU. In 2003, a consensus committee of experts convened as the Society of Radiologists in Ultrasound Consensus Committee and proposed standard criteria for grading ICA stenosis including the use of peak systolic velocity (PSV) of greater than 230 cm/s for assigning ICA stenosis of greater than 70%. The purpose of this study was to evaluate the accuracy of the Society of Radiologists in Ultrasound Consensus Criteria in classifying carotid stenoses. This study shows the following: (1) that the criterion of PSV of greater than 230 cm/s for angiographic stenosis of greater than 70% performs as predicted by the consensus committee, with sensitivity of 95.3% (95% confidence interval [CI], 0.89-0.99) and specificity of 84.4% (95% CI, 0.80-0.88); (2) using Pearson correlations, there is no statistical difference found between the correlation of PSV with angiography (0.825 [95% CI, 0.792-0.853]), end diastolic velocity with angiography (0.762 [95% CI, 0.718-0.799]), and the ICA/common carotid artery (CCA) systolic ratio with angiography (0.766 [95% CI, 0.723-0.802]). The correlation of the ICA/CCA diastolic ratio with angiography (0.643 [95% CI, 0.584-0.696]) is less predictive at a 95% confidence interval than the other 3 velocity-based variables, and (3) when the 4 velocity-based variables are taken in pairs (eg, PSV and end diastolic velocity), there is no pair that shows statistically significant improvement in performance. Peak systolic velocity in combination with other variables does show a slight trend toward superior performance.