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    April 01, 2013

    The following are highlights from current issues of RSNA’s two peer-reviewed journals.

    Radiology journal logo button for Journal Highlights
    Current and Evolving Clinical Applications of Multidetector Cardiac CT in Assessment of Structural Heart Disease

    While multidetector CT (MDCT) is most commonly performed for assessment of possible coronary artery disease, technologic advances and dose minimization strategies have enabled the technology’s use as a complementary imaging modality to echocardiography and MR imaging for evaluation of noncoronary cardiac structures.

    In an article in the April issue of Radiology (RSNA.org/Radiology), Arthur Nasis, M.B.B.S., of the Monash Cardiovascular Research Centre, Victoria, Australia, and colleagues provide an overview of the noncoronary cardiac structures that can be evaluated on standard MDCT studies and outline the established appropriate clinical uses of MDCT in the assessment of structural heart disease, as well as evolving periprocedural clinical applications. Specifically, the authors discuss assessment of:

    • Pulmonary and cardiac veins prior to electrophysiology procedures
    • Ventricularmorphology and function
    • Valvular morphology and function in selected patients whose images from other noninvasive modalities are inadequate

    “MDCT is being increasingly used for preprocedural evaluation of patient suitability for percutaneous procedures such as transcatheter aortic valve replacement and left atrial appendage device occlusion and for assessment of complications from these procedures,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only. 
    Seroma in a 60-year-old woman with pain and increased volume in the right breast
    Seroma in a 60-year-old woman with pain and increased volume in the right breast immediately after its reconstruction with a DIEP flap. Axial T1-weighted MR images show a fluid collection in the posterior aspect of the reconstructed breast (arrow). (RadioGraphics 2013;33;435–453) ©RSNA, 2013. All rights reserved. Printed with permission.

    Breast Reconstruction: Review of Surgical Methods and Spectrum of Imaging Findings

    Regardless of the reconstruction technique used, breast cancer can recur at the mastectomy site and may be recognized at an earlier stage by radiologists who are familiar with the spectrum of imaging findings.

    According to an article in the March-April issue of RadioGraphics (RSNA.org/RadioGraphics), by Fanny Maud Pinel-Giroux, M.D., of the Centre Hospitalier de l’Université de Montréal, Canada, and colleagues, radiologists must be familiar with the range of normal and abnormal imaging appearances of reconstructed breasts, including features of benign complications as well as those of malignant change. Along with describing breast reconstruction based on the use of prosthetic implants and various kinds of autologous tissue flaps, the authors:

    • Provide detailed descriptions of normal findings, benign changes and recurrent cancers seen at imaging in reconstructed breasts
    • Present data culled from a retrospective analysis of the clinical records of 119 women who underwent a breast examination with MR imaging after mastectomy and breast reconstruction

    Evidence in the existing literature is insufficient to support routine mammographic screening in women after autologous breast reconstruction, the authors write. “Although our patient sample was too small to allow definitive recommendations regarding the most appropriate method for monitoring breast health in women after mastectomy and breast reconstruction, the results of our retrospective analysis suggest that systematic follow-up with breast MR imaging might benefit women with a high risk for breast cancer recurrence due to factors such as a histologically aggressive primary tumor type or a genetic susceptibility,” they write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available in print and online. 
    Three-dimensional multidetector CT volume-rendered reconstruction shows pulmonary vein anatomy
    Three-dimensional multidetector CT volume-rendered reconstruction shows pulmonary vein anatomy. Note additional right-sided middle pulmonary vein. (Radiology 2013;267;1:11–25) ©RSNA, 2013. All rights reserved. Printed with permission.
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