Ricardo Duarte

Diagnostic and Interventional Radiology

There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features.

The aim of this study was to evaluate the radiation dose, image quality and acquisition time of coronary computed tomography angiography (CCTA) using a 128-slice dual source scanner with prospective ECG-triggered high-pitch spiral acquisition (Flash Spiral). A series of 20 consecutive patients in sinus rhythm, with no contraindications to administration of iodinated contrast media and beta-blockers and no history of coronary revascularization, underwent CCTA either to rule out coronary artery disease (CAD) or to evaluate known or suspected CAD. Image quality was evaluated using a four-point scale (1 excellent, 4 poor). Data on acquisition time and radiation dose were recorded. Mean acquisition time was 292 +/- 21 milliseconds. The mean effective radiation dose was 0.99 mSv +/- 0.34 mSv. All of the 266 coronary artery segments analyzed were of diagnostic image quality. CCTA using a 128-slice dual source scanner with prospective ECG-triggered high-pitch spiral acquisition provides single cardiac cycle acquisition with high image quality at mean effective radiation doses of approximately 1 mSv.