Christopher J. Francois

The Pulmonary Embolism Reporting and Data System (PE-RADS) provides a standardized framework for reporting acute pulmonary embolism at CT and MR angiography to guide treatment considerations based on clot location and right heart imaging features.

Renovascular hypertension is the most common cause of secondary hypertension, and radiologist awareness of the various imaging appearances and various causes is crucial for accurate diagnosis and guiding treatment.

Background: Gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) may negatively impact idiopathic pulmonary fibrosis (IPF), but data on their concurrent contributions are lacking. We aimed to test the contributions of GERD and sleep‐disordered breathing (SDB) to IPF outcomes. Methods: We performed a cross‐sectional, exploratory study on subjects with IPF. Clinically established GERD diagnosis, questionnaires (Nocturnal GERD Symptom Severity and Impact Questionnaire [N‐GSSIQ], the NIH Patient‐Reported Outcomes Measurement Information System [PROMIS] sleep impairment and fatigue scales, and Short Form‐36 [SF‐36]), full pulmonary function tests (PFT), six‐minute walk test (6MWT), and nocturnal polysomnography (PSG) were obtained. Results: Among n = 24 subjects, 17 (71%) had clinically diagnosed GERD. N‐GSSIQ scores indicated a nocturnal burden, which was adversely related to sleep impairment ( p = 0.010) and daytime fatigue ( p = 0.001), tiredness ( p = 0.026) and SF‐36 social functioning ( p = 0.005), energy/fatigue ( p = 0.015), pain ( p = 0.030), and health change in the prior year ( p = 0.035). From PSG, GERD correlated with worse sleep architecture (GERD diagnosis, all p < 0.05) and periodic leg movements index (PLMI) (N‐GSSIQ, p = 0.02). GERD was not associated with pulmonary or exercise physiology. Overall, apnea–hypopnea index (AHI) was (median [25% quartile, 75% quartile]) 18.2 (8.1, 27.8)/h, and 19 (79%) subjects had OSA (AHI ≥ 5/h), with most (15/19 [79%]) having moderate or severe disease. SDB measures adversely related to gas exchange and distance walked (all p < 0.05). Conclusions: A nocturnal burden of GERD was detected and related to sleep disruption, including PLMs, and to daytime complaints. SDB/OSA, of a severity known to have significant health consequences, was common; it was adversely related to pulmonary diffusion and exercise capacity. These findings call for comprehensive, early evaluation of GERD and OSA for improved IPF outcomes.

Background: The purpose of this study was to describe the correlates and outcomes in adults with unrepaired partial anomalous pulmonary venous return and intact atrial septum (PAPVR‐IAS). Methods and Results: We identified adults with PAPVR‐IAS who received care at the Mayo Clinic, while those with unrepaired PAPVR‐IAS comprised the reference group. Clinical indices (New York Heart Association class, peak oxygen consumption, and NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide]) and echo‐derived right heart indices (right atrial [RA] volume, RA reservoir strain, right ventricular [RV] free wall strain, RV end‐diastolic area, and RV systolic pressure) were assessed at baseline and 3‐year and 5‐year follow‐up. There were 80 patients and 38 patients with unrepaired versus repaired PAPVR‐IAS, respectively. The clinical predictors of surgical repair were the number of anomalous veins, RA volume, and RV end‐diastolic area. The PAPVR‐IAS risk score, derived from these clinical predictors, was associated with surgical repair (adjusted odds ratio, 1.37 [95% CI, 1.24–1.65] per unit increase in risk score; area under the curve, 0.742). Among patients with unrepaired PAPVR‐IAS with 3‐year (n=73) and 5‐year follow‐up (n=36), there was no temporal change in clinical indices (New York Heart Association class, predicted peak oxygen consumption, and NT‐proBNP) and right heart indices (RA volume index, RA reservoir strain, RV end‐diastolic area index, RV free wall strain, and RV systolic pressure). Conclusions: The PAPVR‐IAS risk score can be used to assess the odds of requiring surgical repair. Furthermore, there was no temporal deterioration in clinical and right heart indices during follow‐up in adults with unrepaired PAPVR‐IAS.

This review article focuses on the advancements in non-contrast magnetic resonance angiography (NC-MRA) and its increasing importance in body imaging, especially for patients with renal complications, pregnant women, and children. It highlights the relevance of NC-MRA in chest, abdominal, and pelvis imaging and details various bright-blood NC-MRA techniques like cardiac-gated 3D Fast Spin Echo (FSE), balanced Steady-State Free Precession (bSSFP), Arterial Spin Labeling (ASL), and 4D flow methods. The article explains the operational principles of these techniques, their clinical applications, and their advantages over traditional contrast-enhanced methods. Special attention is given to the utility of these techniques in diverse imaging scenarios, including liver, renal, and pelvic imaging. The article underscores the growing importance of NC-MRA in medical diagnostics, offering insights into current practices and potential future developments. This comprehensive review is a valuable resource for radiologists and clinicians, emphasizing NC-MRA’s role in enhancing patient care and diagnostic accuracy across various medical conditions.

Cor triatriatum sinister is a rare entity characterized by a membrane within the left atrium and posterior to the atrial appendage. This defect may cause obstructive symptoms analogous to mitral stenosis. The authors present a case of an incidentally detected enhancing mass originating from a cor triatriatum sinister membrane, with imaging characteristics most suggestive of myxoma. Keywords: MR Imaging, Cardiac, Left Atrium, Congenital, CT Angiography, Echocardiography Supplemental material is available for this article.