Virtual angioscopy in type-A dissection: ascending aortic stent-graft repair.
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Aged, 80 and over↗
Biomedical subjects
Jeffrey C Hellinger
Publications and source records attributed to Jeffrey C Hellinger.
Cardiac CINE imaging with IDEAL water-fat separation and steady-state free precession.
PURPOSE: To decompose multicoil CINE steady-state free precession (SSFP) cardiac images acquired at short echo time (TE) increments into separate water and fat images, using an iterative least-squares "Dixon" (IDEAL) method. MATERIALS AND METHODS: Multicoil CINE IDEAL-SSFP cardiac imaging was performed in three volunteers and 15 patients at 1.5 T. RESULTS: Measurements of signal-to-noise ratio (SNR) matched theoretical expectations and were used to optimize acquisition parameters. TE increments of 0.9-1.0 msec permitted the use of repetition times (TRs) of 5 msec or less, and provided good SNR performance of the water-fat decomposition, while maintaining good image quality with a minimum of banding artifacts. Images from all studies were evaluated for fat separation and image quality by two experienced radiologists. Uniform fat separation and diagnostic image quality was achieved in all images from all studies. Examples from volunteers and patients are shown. CONCLUSION: Multicoil IDEAL-SSFP imaging can produce high quality CINE cardiac images with uniform water-fat separation, insensitive to Bo inhomogeneities. This approach provides a new method for reliable fat-suppression in cardiac imaging.
Adult↗
Detection of endograft fractures with multidetector row computed tomography.
Delayed endograft metallic strut failures detected in vivo with multidetector row computed tomography (MDCT) are reported in two patients who underwent endovascular abdominal aortic aneurysm repair with AneuRx and Talent endografts. In both instances, nitinol fractures were associated with proximal migration and type I endoleak. In both cases, the metallic strut fractures were detected with transverse sections from 16-channel MDCT angiograms and confirmed by using volume rendering. These cases highlight the previously unreported ability of thin-section, high-resolution MDCT angiography to detect endograft strut fractures.
Aged↗
Angiographic imaging of the lower extremities with multidetector CT.
Multidetector CT (MDCT) has improved imaging of the arteries in the lower extremities. The main advantages of this novel technology are the exceptionally fast scan times, high spatial resolution, increased anatomic coverage, and capability to generate high-quality multiplanar reformations and three-dimensional (3-D) renderings from raw data that can be reprocessed easily and quickly. The applications of MDCT in imaging the lower extremities are multiple and varied. They include the evaluation of peripheral arterial occlusive and aneurysmal disease, the patency and integrity of bypass grafts, and arterial injury owing to trauma. This article describes the techniques of lower extremity MDCT angiography and its use in a few clinical applications.
Angiography↗
Endovascular repair of thoracic and abdominal aortic aneurysms: pre- and postprocedural imaging.
Endovascular repair of thoracic and abdominal aortic aneurysms is a safe alternative to conventional open surgical repair. Clinical success, however, is highly dependent on patient selection. Diagnostic vascular imaging has an essential role for this selection process. Following endovascular aneurysm repair (EVAR), patients require long-term surveillance and again vascular imaging serves an integral function. This article reviews EVAR selection criteria and post-EVAR assessment and then discusses the imaging modalities used to evaluate these patients, namely multi-detector-row computed tomographic angiography, magnetic resonance imaging/angiography, duplex ultrasonography, and catheter angiography.
Aortic Aneurysm, Abdominal↗
Evaluating mesenteric ischemia with multidetector-row CT angiography.
Multidetector-row computed tomographic (MDCT) angiography is an established non-invasive imaging modality to evaluate the mesenteric vasculature. It has an important role in diagnostic algorithms for assessment of suspected acute and chronic mesenteric ischemia. Clinical success for synchronizing a MDCT volumetric acquisition with a bolus of contrast medium and also for depicting vascular pathology with high accuracy relies on implementing several key principles. This can be more challenging with advanced generation MDCT scanners. This article reviews the technical principles fundamental to evaluating the mesenteric vasculature with MDCT angiography. An overview of clinical application is also presented.
Angiography↗
Isolated cecal varices as the source of massive lower GI bleeding in a patient with cirrhosis.
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Cecum↗
Iliac artery kinking with endovascular therapies: technical considerations.
Iliac artery tortuosity should be considered when planning endovascular interventions from a femoral approach. Stiff guide wires across tortuous iliac segments can introduce foreshortening and temporary kinking. Recognition of this phenomenon and its implications is important when making anatomic measurements before endovascular device placement, when assessing iliac runoff, and when considering adjunctive procedures after aortoiliac interventions. Two illustrative cases of external iliac artery kinking are presented, one during an abdominal aortic aneurysm endograft procedure and another encountered during stent placement in an external iliac artery dissection. In both cases, the temporary nature of the deformity was recognized, avoiding unnecessary additional intervention.
Aged↗
Computed tomography angiography: state-of-the-art imaging using multidetector-row technology.
Multidetector-row computed tomography (MDCT) is an essential diagnostic modality for many clinical algorithms. This is particularly true with regard to the evaluation of cardiovascular disease. As a result of increased image acquisition speed, improved spatial resolution, and greater scan volume, MDCT angiography (computed tomography angiography [CTA]) has become an excellent noninvasive imaging technique, replacing intra-arterial digital subtraction angiography for most vascular territories. The clinical success of CTA depends on precise synchronization of image acquisition with optimal vascular enhancement. As technology continuously evolves, however, this task can be challenging. It remains important to have a fundamental knowledge of the principles behind technical parameters and contrast medium administration. This article reviews these essential principles, followed by an overview of current clinical applications.
Angiography↗