Educational Sessions Spread Knowledge, Clinical Insight

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Computed tomography was again the talk of the 94th Scientific Assembly and Annual Meeting of Radiological Society of North America (RSNA) educational and scientific sessions and posters—noteably cardiac CT angiography, CT radiation dose safety (namely in cardiac and pediatric studies) and CT colonography. But sharing the spotlight were sessions on IT informatics and integration and breast imaging such as breast MRI, sonoelastography and positron emission tomography. Altogether, some 1,803 scientific papers and 729 scientific posters were presented, while 1,606 abstracts offered insight for education exhibits. Some of the notable presentations are summarized here. For full-length stories of these presentations and more, visit


Researchers outline expanded role for cardiac CT

Cardiac CT continues to demonstrate its clinical utility and is likely to replace TEE in a number of indications; however, additional research is necessary to more adequately define their roles. Xiao-Chun Zhang, MD, of Sichuan University in Chengdu, China, reported that 64-slice CT can assess right ventricular systolic and left ventricular diastolic function to quantify the severity of pure rheumatoid mitral stenosis. Zhang also said that in patients with mitral regurgitation, CT measurements agreed and correlated with 3D echo and MR, and CT produced highly accurate and reproducible results for patients with pure rheumatoid mitral stenosis.

Jin Hur, MD, of Yonsei University in Seoul, South Korea, said that cardiac CT angiography offers a non-invasive and sensitive modality for detecting left atrial appendage thrombus and differentiating between thrombus and spontaneous echo contrast in stroke patients.   

Troy LaBounty, MD, of Weill Cornell Medical College in New York City, reported high intraobserver agreement on CT studies and concluded that CT may be useful in evaluating valve functioning in patients with Medtronic Hall and St. Jude valves and concluded that CT may provide useful prognostic information in patients with aortic stenosis.

Another clinical cardiac application where CT could replace TEE is pre-operative characterization of aortic valve features in patients with aortic stenosis. Baskaran Sundaram, MD, of University of Michigan in Ann Arbor, and colleagues said that aortic valve assessment using dynamic CT is feasible and determines leaflet morphology precisely.

Myocardial bridging could be risk factor for arteriosclerosis?

“Myocardial bridging in the middle left anterior descending coronary artery (LAD) may be a significant risk factor for atherosclerosis in the proximal LAD,” said Takeshi Nakaura MD, from the Kumamoto University School of Medicine in Kumamoto, Japan.  By multivariate analysis, age, sex, the presence of hypertension and myocardial bridging were “statistically significantly associated with proximal LAD atherosclerosis.” Nakaura added that  middle LAD bridging represented the highest risk for the development of coronary plaques in the proximal segment of the LAD.

Contrast-enhanced cardiac MDCT, stress MRI help detect perfusion abnormalities

Adenosine stress multidetector CT (MDCT) myocardial perfusion imaging can be successfully performed in patients with coronary artery disease (CAD) with good agreement with stress myocardial perfusion MRI. The “ability of MDCT to perform both stress perfusion imaging and coronary angiography will significantly enhance the value of cardiac MDCT study in the diagnosis and treatment of patients with CAD,” said Shingo Kato, MD, of the National Institute of Radiological Sciences in Chiba, Japan.

Quantity of intracranial calcification is not an independent predictor of stroke

Philip Homburg, MD, from Erasmus Medical Center, University Medical Center in Rotterdam, the Netherlands, said that intracranial calcification in the symptomatic artery found on a multidetector CT angiography is not independently associated with infarcts in the symptomatic hemisphere. He said that the quantity of intracranial calcification was significantly higher in the symptomatic carotid artery of patients with infarcts in the symptomatic hemisphere than in patients without infarcts in the symptomatic hemisphere. However, he noted that in a multivariate analysis after adjustment for age and sex, no independent relationship was found between the quantity of intracranial calcification in the symptomatic artery and infarcts in the symptomatic hemisphere.