Seiya Matsuyama

Evaluation of pericardial effusion with computed tomography.

Evaluation of pericardial effusion was attempted with computed tomography in 11 patients. The volume and distribution of pericardial fluid were assessed with satisfactory resolution and the nature of the fluid was estimated by the difference in x-ray transparency (CT numbers). The volume of pericardial fluid calculated by tomographic methods ranged from 25 ml. to 585 ml. and agreed well with the surgically drained fluid volume. The CT numbers of the pericardial effusion due to renal or heart failure, acute viral pericarditis, hypothyroidism, and hemopericardium were +12 to +13, +20, +28 to +30, and +26 to +40, respectively. Therefore the volume and gross nature of the pericardial fluid could be estimated noninvasively with computed tomography.

Evaluation of intracardiac thrombus with computed tomography

Left atrial (LA) and left ventricular (LV) thrombus was evaluated by computed tomography in 56 patients. The patients were divided into 2 groups: Group I, 28 patients with mitral valve disease, and Group II, 28 patients with myocardial infarction. Computed tomography and 2-dimensional echocardiography were performed in all the patients studied. Cineangiocardiography was performed in all Group I and in 13 Group II patients. Open heart surgery or autopsy was performed in all Group I and 4 Group II patients. The sensitivity in detecting LA thrombus was 100% with computed tomography, 70% with angiocardiography, and 60% with 2-dimensional echocardiography. The specificity in detecting LA thrombus was 91% with computed tomography, 86% with 2-dimensional echocardiography, and 88% with angiocardiography. Thrombi located at the LA appendage were associated with great difficulties in detection by other methods, but were well delineated with computed tomography. LV thrombus was also visualized by computed tomography with similar or greater accuracy than other diagnostic methods, although the sensitivity and specificity were not ascertained because surgery or autopsy was performed in only a minority of Group II patients. Therefore, as far as the detection of intracardiac thrombus is concerned, computed tomography has the advantage of offering uniform slices of the heart in an attempt to detect thrombi in unknown areas of cardiac chambers, including the LA appendage or LV apex, without being disturbed by the surrounding cardiac and noncardiac structures. Thus, computed tomography has excellent accuracy in the detection of intracardiac thrombus.

Evaluation of left atrial thrombus with computed tomography

Left atrial thrombi were evaluated with computed tomography in 23 patients with mitral valvular diseases. In three of the patients, left atrial thrombi were delineated with computed tomography and were confirmed by cardiac surgery or autopsy. The minimum size of the thrombi detected tomographically was 3.5 gm. There were no false-positive or false-negative results with computed tomography in 13 patients who subsequently underwent cardiac surgery. Computed tomography is essentially noninvasive and appears to be one of the best methods to evaluate left atrial thrombus.

Evaluation of left ventricular thrombus with computed tomography

Abstract In 21 patients with myocardial infarction left ventricular thrombi were evaluated with a third generation computed tomographic system. In three patients, thrombus was delineated with computed tomography and confirmed with the conventional echocardiographic and angiographic methods. In one patient the thrombus was not detected with two dimensional echocardiography. This experience indicates that identification of left ventricular thrombus with computed tomography is possible.

Disappearing False Aneurysm of the Ventricular Septum Without Rupture: A Complication of Acute Inferior Myocardial Infarction—A Case Report

An interseptal false aneurysm of the left ventricle due to the dissection of the septum in a patient with acute inferior myocardial infarction is described. The aneurysm was demonstrated as a cystic bulge of the left ventricular cavity into the inferoposterior interventricular septum with a small orifice from the left ventricle without any protrusion or rupture into the right ventricular cavity. Two-dimensional echocardiography, magnetic resonance imaging, and dy namic computed tomography were the most useful and reliable noninvasive di agnostic modalities. Repeated examinations demonstrated a significant reduction of the aneu rysm in six months.

Application and validation of three-dimensional data sets from a phase contrast MR angiography for preoperative computer simulation of brain tumors.

We applied a three‐dimensional (3D) phase contrast magnetic resonance angiography as the source for generating integrated 3D images for surgical planning of brain tumors. In the 3D model, we defined the Cingulomarginal sulcus and subsequently the central sulcus in the interhemispheric plane. This method solved the misregistration problem caused by the combination of multi‐sequence data sets and can be feasible for surgical planning.J. Magn. Reson. Imaging 1999;10:102–106.

Nonsurgical retrieval of an accidentally dislodged vent catheter retention ring

During open mitral commissurotomy in a patient with mitral stenosis, a vent catheter retention ring was accidentally slipped off into the left atrium and lodged near the orifice of the right renal artery. Nonsurgical retrieval of this intraarterial foreign body was performed successfully under fluoroscopic guidance in the operating room using a combined approach of angiographic catheters and guidewire, these being inserted via the arteriotomy site of the right femoral artery created for cardiopulmonary bypass.