Myocardial infarction with huge mural thrombus due to spontaneous coronary artery dissection detected by 64-multidetector computed tomography

Park, Sang Min; Koh, Kwang Kon; Kim, Jeong-Ho; Yoon, Kyu Hyun; Chung, Wook‐Jin; Kang, Woong Chol

doi:10.1016/j.ijcard.2007.06.082

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…When it affects the coronary arteries, it may cause life-threatening myocardial infarction, and therefore, it requires urgent diagnosis and treatment. Spontaneous coronary artery dissection predominantly affects young women, and while very rare, its effects are often severe (39). Spontaneous coronary artery dissection can lead to acute coronary syndrome or ischemic coronary events (40)(41)(42).…”

Section: Coronary Artery Dissectionmentioning

confidence: 99%

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

Kantarcı

Doğanay

Karçaaltıncaba

et al. 2011

Diagn Interv Radiol

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261C oronary artery disease is responsible for millions of deaths per year in developed countries (1, 2). Early recognition of coronary artery disease is important for the prevention of its related complications and improving prognosis (3). Catheter angiography has been considered the gold standard imaging method for evaluating the coronary tree. The major advantages of conventional coronary angiography (CCA) are its high spatial and temporal resolutions and the option of directly performing interventions, such as balloon dilation or coronary stent placement (4). However, CCA is an invasive procedure that carries the risk of morbidity and mortality (3). In addition, CCA provides only luminal data and is limited in revealing changes in the vessel wall and the adjacent soft tissues. Conversely, multidetector computed tomography coronary angiography (MDCT-CA) not only provides visualization of the vessel lumen but also displays the vessel wall and surrounding soft tissues, allowing for the detection of various congenital or acquired abnormalities of the coronary arteries that may not be evident with CCA (3).In this article, on the basis of our experience with more than 15 000 MDCT-CA from seven different centers, we reviewed clinical conditions in which MDCT-CA may be more helpful compared with CCA. Coronary CT techniqueWith the advent of technological refinements in the last decade, MDCT-CA has gained widespread use for the evaluation of coronary artery diseases. Currently, state-of-the-art computed tomography (CT) systems can simultaneously acquire 64 or more submillimeter sections with a gantry rotation time of less than half a second. Previous limitations of CT for evaluating the vascular system, associated with older generation scanners, have now been eliminated. Presently, a thinner section thickness allows for isotropic voxels, which is essential for optimum high-resolution, three-dimensional (3D) reconstruction and other postprocessing displays, such as maximum projection reformatting (MPR) in any selected plane. Faster scanners have resulted in shorter scans and shorter contrast bolus durations, allowing for the use of less contrast agent at a higher flow rate to achieve greater luminal enhancement. Motion artifacts from breathing are no longer a problem since highresolution imaging of the entire heart can be obtained in a single breath hold. Electrocardiography (ECG) gating techniques improve temporal resolution and minimize imaging artifacts caused by cardiac motion. With more recent technological advances, a reduction in radiation dose, for example, by the utilization of prospective gating, has occurred without any deterioration in diagnostic image quality (5).In our centers, images were acquired using either 16-or 64-MDCT scanners. Eighty-five to one hundred milliliters of iodinated contrast medium (Ultravist 370, Schering, Berlin, Germany) was intravenously ABSTRACT In this review, we aimed to outline the clinical and pathological conditions for which multidetector computed tomography coronary angiogr...

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Section: Coronary Artery Dissectionmentioning

confidence: 99%

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

Kantarcı

Doğanay

Karçaaltıncaba

et al. 2011

Diagn Interv Radiol

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“…CT as having a typical arterial dissection type appearance with intimal flaps and true and false lumina (28,29).…”

Section: Ischemic Heart Diseasementioning

confidence: 99%

CT and MR Imaging Findings in Patients with Acquired Heart Disease at Risk for Sudden Cardiac Death

Sparrow¹,

Merchant²,

Provost³

et al. 2009

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Noninvasive imaging is an important screening and diagnostic tool in conditions associated with sudden cardiac death. The most common cause of sudden cardiac death is coronary artery disease, with myocarditis, cardiac sarcoidosis, and dilated and infiltrative cardiomyopathies being less common acquired causes. Common risk factors for sudden cardiac death, regardless of the disease process, include severe ventricular dysfunction and the presence of macroscopic scar seen at delayed contrast material-enhanced imaging. Recent advances in electrocardiographically (ECG) gated cardiac magnetic resonance (MR) imaging and multidetector computed tomography (CT) have led to increased referrals for cross-sectional imaging; thus, cardiac radiologists should be familiar with the disease entities associated with sudden cardiac death. Inflammatory processes and cardiomyopathies are best depicted with cardiac MR imaging. Steady-state free precession cine sequences coupled with inversion-recovery prepared gradient-echo T1-weighted sequences performed after the intravenous administration of gadolinium-based contrast material should form the basis of cardiac MR imaging protocols for cardiomyopathy. A clinical history that is suggestive of myocardial ischemia, specific requests to exclude coronary artery disease, or contraindications for MR imaging may imply that multidetector CT would be more appropriate. Nevertheless, both cardiac MR imaging and ECG-gated multidetector CT offer robust diagnosis and risk stratification for individual disease processes associated with sudden cardiac death.

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Spontaneous coronary artery dissection

Giacoppo

Capodanno

Dangas

et al. 2014

International Journal of Cardiology

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Myocardial infarction with huge mural thrombus due to spontaneous coronary artery dissection detected by 64-multidetector computed tomography

Cited by 4 publications

References 4 publications

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

CT and MR Imaging Findings in Patients with Acquired Heart Disease at Risk for Sudden Cardiac Death

Spontaneous coronary artery dissection

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