Kyung Sup Song

Anomalous right coronary artery originated from left coronary sinus with interarterial course: evaluation of the proximal segment on multidetector row computed tomography with clinical correlation.

Purpose: Anomalous origin of the right coronary artery (RCA) with an interarterial course is a potentially life-threatening anomaly. Clinical significance could depend on its orifice and interarterial course. We evaluated the anomalous RCA on multidetector row computed tomography (MDCT) with clinical correlation. Materials and Methods: Twenty-five electrocardiography-gated MDCT cases of 24 patients (mean [SD] age, 58.2 [12.3] years; 12 men and 12 women) with anomalous origin of RCA from left coronary sinus with an interarterial course were retrospectively reviewed in 3 hospitals. The cases were evaluated for the location of orifice, a takeoff angle from coronary sinus, mean diameters of RCA (orifice, interarterial, and reference), and the ratio of the diameters of RCA (orifice-reference and interarterial-reference) on MDCT with clinical correlation. Results: The orifice and the interarterial course of all anomalous RCAs were well visualized on MDCT. The narrowest portion of RCA was more frequent in the orifice (16/25 cases) than the interarterial course (6 cases). Three cases revealed the same diameter between the orifice and the interarterial course. The location of the orifice was not correlated with the diameters of anomalous RCA. Takeoff angles were correlated with the relative narrowing of the orifice of anomalous RCA (P = 0.001) and the relative narrowing of the interarterial course (P = 0.007). Only 1 patient showed significant luminal narrowing (>50% stenosis), and this patient showed a minimal takeoff angle and a persistent symptom. The symptom of this patient had disappeared after operation, and postoperative MDCT revealed an increased takeoff angle and no significant luminal narrowing. The other patients showed no significant luminal narrowing. Symptoms were not correlated with the takeoff angle and relative luminal narrowing (orifice-reference and interarterial-reference; P = 0.923, P = 0.915, and P = 0.703). Conclusions: The takeoff angles of anomalous RCA with an interarterial course are correlated with the relative narrowing of luminal diameters at the orifice and the interarterial course. Most cases show a benign nature. Evaluation of the proximal structure of anomalous RCA with an interarterial course could be important in a treatment plan.

Myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging

We present a case of myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging. Reninoma is a rare and curable cause of secondary hypertension. Currently developed multi-detector computed tomography (MDCT) has permitted better evaluation of myocardial infarction and myocardial bridging. Myocardial infarction associated with reninoma and myocardial bridging has not been reported, and we report this interesting case.

TU-AB-BRA-04: An Investigation of Metal Artifact Effects in Multi-Modalities: Development of MRI-CT Heterogeneous Head and Neck Phantom for MRI-CT Registration

PURPOSE The purpose of this investigation was to develop an CT-MR head and neck phantom which can investigate dose calculation differences between density-assigned MRI and CT, and to compare non-implant inserted registered MR-CT registered image with artifact reduced image of MR-CT registered image. It is to identify potential limitations related to dental implants of MR image and CT image and maximize the advantages to find interactive method to use registered image. METHODS The phantom comprises half-circled shape which shaped to simulated the anatomical structures of a human head and neck. Through applying various clinical cases, the developed phantom is closely allied to human. Developed phantom can be verified in to opened-mouth and closed-mouth phantom. The case of the phantom was made of acrylic, which introduces a 0.003 parts per million (ppm) phase shift, whereas the Teflon results in a 0.03 ppm shift measured at 3T which represents human bone. Both materials are considered acceptable for MR field measurements. The phantom was filled with a solution of nickel chloride and sodium chloride. The implants and teeth were imaged by means of 3T MRI system. RESULTS In MRI image, the metal artifact reduced and the results in improved image quality and reduction of susceptibility artifacts originate in MR images. CT and MR artifact correction method resulted in substantial artifact reduction, both quantitatively and qualitatively. On head and neck CT images, it remained anatomical conformation but it has reduced streak and dark artifact which appeared around the dental restoration. The artifact reduced MR-CT image improved image quality and calculation accuracy for patients with severe CT artifacts. CONCLUSION By using MRI/CT and the artifact-free slice location of the phantom, we demonstrated that the proposed artifact reduction method can effectively remove streak artifacts from a metal object.