TL;DR: The aim was to assess the feasibility of performing a fetal cardiac study in pregnancies referred for nuchal translucency (NT) screening, using high‐frequency linear transabdominal transducers with a specific ultrasound preset.
Abstract: Objective The fetal heart is not studied routinely in the first trimester because of technical and time limitations. Our aim was to assess the feasibility of performing a fetal cardiac study in pregnancies referred for nuchal translucency (NT) screening, using high-frequency linear transabdominal transducers with a specific ultrasound preset. Methods A single trained operator assessed the fetal heart in pregnancies with a fetal crown‐rump length (CRL) of 60‐84 mm that had been referred for NT screening. A 15- or 6-MHz transabdominal linear transducer with a specific preset suitable mainly for color-flow mapping was used to confirm or refute normal cardiac anatomy rather than to establish a specific diagnosis. Fetuses having an increased risk for congenital heart disease were referred to a tertiary center for a further examination within 1 week. This group consisted of all fetuses with NT >95 th centile and those in which a family history or the initial heart scan increased the risk. Results A total of 608 fetuses with a median CRL of 65 mm was examined between 2003 and 2005. A cardiac scan was performed successfully in 456 (75%) using a 15-MHz linear transducer alone, and the additional use of a 6-MHz transducer allowed diagnostic images to be obtained in a further 152. Normal cardiac anatomy was assessed confidently within 10 min in 517/608 (85%) pregnancies; in 85 (14%) a longer time was needed and six patients were rescheduled within 2 weeks because of non-diagnostic images at the initial scan. In 571/608 (94%) the risk for congenital heart disease (CHD) was not increased and the heart was considered normal at initialechocardiography;this wasconfirmed bylaterscans and at postnatal follow-up. In 37/608 (6%) fetuses the risk for CHD was increased (35 for NT >95 th centile and two for family history). In this group normal heart anatomy was described in 34 fetuses and confirmed by subsequent specialist echocardiography. Cardiac defects were suspected in three fetuses (all with increased NT) and confirmed by a fetal cardiologist in each case. Conclusions A trained operator can perform a fetal heart study during the NT screening test using transabdominal high-resolution transducers in an acceptable length of time. Copyright 2007 ISUOG. Published by John Wiley & Sons, Ltd.
TL;DR: Results of multislice computed tomography (MSCT) using retrospective electrocardiograph gating is presented, which is a new modality in cardiac imaging and allows functional imaging with evaluation of impaired systolic and diastolic left ventricular wall motion.
Abstract: We report a case of a 43-year-old male patient with an atypical nonobstructive hypertrophic cardiomyopathy and a calcified left ventricular thrombus, and present results of multislice computed tomography (MSCT) using retrospective electrocardiograph gating, which is a new modality in cardiac imaging Obtaining virtually motion-free images with a temporal resolution of 250 ms in an optimized heart scan MSCT allows functional imaging with evaluation of impaired systolic and diastolic left ventricular wall motion
TL;DR: The authors suggest that patients with primary angiosarcoma of the heart undergo nuclear heart scan as a noninvasive screening test to visualize the cardiac chambers and evaluate cardiac function.
Abstract: Patients with primary angiosarcoma of the heart typically have the signs of right-sided congestive heart failure pericardial chest pain and pericardial effusion. The diagnosis of this uncommon tumor can be confirmed by nuclear cardiac scan to demonstrate any filling defect. The authors suggest that patients with this clinical presentation undergo nuclear heart scan as a noninvasive screening test to visualize the cardiac chambers and evaluate cardiac function.
TL;DR: In this article, the most accurate means of diagnosis of pericardial effusion was found to be the ratio of the maximum transverse cardiac diameters on scan and roentgenogram.
Abstract: Summary In 23 patients undergoing open-heart surgery in whom the pericardial contents were accurately measured, and in 11 additional patients examined at autopsy or by pericardiocentesis, isotopic photoscans of the heart were made and the results were correlated. The most accurate means of diagnosis of pericardial effusion was found to be the ratio of the maximum transverse cardiac diameters on scan and roentgenogram. In patients with less than 100 cc of pericardial fluid this ratio was greater than 0.80, and it was less than this in cases of effusion of 200 cc or more. Measurement of the difference of these diameters, and visible separation of the cardiac blood pool from the pulmonary vasculature and liver aided in the diagnosis. Pericardial effusions of 200–300 cc or greater can be detected by isotopic photoscanning. Although cardiac dilatation and/or hypertrophy decrease the sensitivity of the technique somewhat, a definite diagnosis of pericardial effusion can be made even when cardiomegaly exists.
TL;DR: It is concluded that pyrophosphate heart scintigraphy may detect myocardial impairment in some cases of systemic sclerosis before it is manifested by heart failure.
Abstract: Scintigraphic examination of the myocardium, using 99mTc-labelled pyrophosphate, was carried out in 17 patients suffering from systemic sclerosis. This connective tissue disorder very often affects the myocardium secondarily. The results of the cardiac scan were compared with the information obtained from the electrocardiogram of systolic time intervals. In addition, spirometry was undertaken to detect a potential relation between cardiac and pulmonary involvement. The scan was found to be positive in seven patients and electrocardiographic findings were pathological in five patients only. The systolic time intervals were abnormal in three patients only. A ventilation disturbance was recorded in 10 patients. No clear relation was found between the results of the individual examinations. It is concluded that pyrophosphate heart scintigraphy may detect myocardial impairment in some cases of systemic sclerosis before it is manifested by heart failure. Examination of systolic time intervals is of little importance.