Background: We have shown that coronary high-intensity plaques (HIPs) on non-contrast T1-weighted imaging (T1WI) represent plaque vulnerability. However, it remains unclear whether HIPs are associated with vulnerable plaque features detected by optical coherence tomography (OCT) such as thin-cap fibroatheroma (TCFA), plaque rupture, or intra-coronary thrombus. Recently, healed ruptured plaques, comprised of a layered pattern underlying poor signaled region with diffuse border, is a novel feature for predicting plaque vulnerability. Method: Twenty-one patients with stable coronary artery disease (CAD) underwent non-contrast T1WI within 2 days prior to elective percutaneous coronary intervention (PCI) with OCT study to calculate the plaque-to-myocardium signal intensity ratio (PMR). CAD patients were categorized as HIP positive if any lesion identified plaque had a PMR>1.4. Results: Of the 22 lesions studied, 11 (50%) lesions were positive for HIP and 11 (50%) were negative for HIP (non-HIP). Figure shows a representative case having left anterior descending artery lesion (A, arrow) that was positive for HIP with 2.27 of PMR (B) and was characterized as healed ruptured plaque by OCT (C). There were no significant differences in age, male gender, and history of diabetes mellitus, hypertension, dyslipidemia, and current smoking. On OCT analysis, in the HIP group, the prevalence of healed rupture plaque was significantly higher (HIP, 82% vs. non-HIP, 27%, p=0.03) and the degree of lipid-arc was greater than non-HIP group (HIP, 201.0 ± 26.7° vs non-HIP, 171.5 ± 35.3°, p=0.034). However, no significant differences were observed in the prevalence of TCFA, lipid-rich plaque, ruptured plaque, thrombus, and calcification between the 2 groups (Table). Conclusions: The present OCT analysis showed that prevalence of healed ruptured plaque and degree of lipid-arc were high in plaques with HIPs, which are therefore associated with plaque vulnerability.
PURPOSE: To describe the features of twisted ovarian tumors on computed tomographic (CT) scans and magnetic resonance (MR) images. MATERIALS AND METHODS: The CT scans, MR images, clinical records, and histopathologic findings in 10 patients with surgical proof of a twisted adnexal tumor were retrospectively evaluated. RESULTS: The most common findings on MR images were nonspecific: deviation of the uterus to the twisted side (n = 9), engorged blood vessels on the twisted side (n = 6), a small amount of ascites (n = 5), and obliteration of fat (n = 4). The following characteristics were seen only in the five patients with hemorrhagic infarction: (a) a protrusion of the lesion on the twisted side to which the uterus was continuous or engorged blood vessels converged (n = 5); (b) thick, straight blood vessels that draped around the lesion (n = 2); (c) distinct hematoma (n = 2); and (d) complete absence of enhancement (n = 3). CONCLUSION: Three findings (a, b, and d) seem to be diagnostic of the twisted adnexal tumor and may facilitate prompt surgical intervention at examination with MR imaging or CT.
The American Heart Association (AHA) Scientific Sessions 2016 were held on November 12-16 at the Ernest N. Morial Convention Center, New Orleans, LA. This 5-day event featured cardiovascular clinical practice covering all aspects of basic, clinical, population, and translational content. One of the hot topics at AHA 2016 was precision medicine. The key presentations and highlights from the AHA Scientific Sessions 2016, including "precision medicine" as one of the hot topics, are herein reported.
Background: To stratify the patients with later fatal arrhythmia event (FAE) following acute myocardial infarction (AMI), its determinants in the reperfusion era still remain uncertain. Methods: Am...
