From the Departments of Radiology (T.M., H.T.) and Cardiology (Y.K.),
Ehime-Imabari Hospital; the Department of Radiology, Ehime University School
of Medicine (J.I.); and GE-Yokogawa Medical Systems (Y.S., S.A.), Japan.
Correspondence to Teruhito Mochizuki, MD, Radiology, Ehime-University School of Medicine, Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime-ken 791-0295 Japan. E-mail tmochi{at}m.ehime-u.ac.jp
A67-year-old
man presented with chest discomfort. At the age of 65 years, he
had been hospitalized because of acute anteroseptal myocardial
infarction. Coronary angiography and LVG were performed to
evaluate his present status. The LVG revealed LV aneurysm.
An LV thrombus at the apex was suspected (Figure
CT-VG is a new application of helical CT, which can assess heart
function such as wall motion and systolic thickening in any
direction (2D and 3D + cine movie) as well as clear
morphological information. The 50-rotation raw data were acquired with
a single-breath-hold helical CT. Approximately 500 transaxial slices
were obtained from the raw data with 0.1 pitch overlapping
reconstruction (3 mm thick, 0.08 second, and 0.2-mm slice
per frame interval). All 500 transaxial slices, which
included different cardiac phases, were reordered to
separate different cardiac cycles (end-diastolic,
end-systolic, and others) and stored in new files. The
separated new files were reformatted to 2D and 3D
images.
Selected Abbreviations and Acronyms
Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
© 1998 American Heart Association, Inc.
Images in Cardiovascular Medicine
Left Ventricular Thrombus Detected by Two- and Three-Dimensional Computed Tomographic Ventriculography
A New Application of Helical CT
, A). By
use of a new application of helical CT with contrast enhancement, ie,
CT-VG, an LV aneurysm and the apical thrombus were demonstrated
by both 2D and 3D CT-VG (Figure, B and C). In addition, the 2D CT-VG
depicted markedly thinned anteroseptal wall.
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Figure 1. A, LVG depicts LV aneurysm. Thrombus at apex is
suspected. CT-VG from same view of LVG clearly demonstrates both LV
aneurysm and apical thrombus (yellow mass, arrow). Top,
End-diastolic (ED) and bottom, end-systolic (ES)
phases. LV volumes were assessed. EDV indicates
end-diastolic volume; ESV, end-systolic volume; SV,
stroke volume; LVEF, LV ejection fraction; HR, heart rate; and C.O.,
cardiac output. B, 2D CT-VG in transaxial (left), vertical long-axial
(middle), and horizontal long-axial (right) planes. Both ED (top) and
ES (bottom) images depict LV thrombus. In vertical long axis, markedly
thinned anterior (arrowhead) wall and LV aneurysm are evident.
Neither wall motion nor systolic thickening was observed in
infarct lesion. C, 2D CT-VG in short-axial plane (left, basal; middle,
midventricle; and right, apex). In midventricular and
apical short-axial images, markedly thinned anteroseptal wall
(arrowhead) is evident. LV thrombus (arrow) at apex is also
depicted.
CT
=
computed tomographic
CT-VG
=
CT ventriculography
2D
=
two-dimensional
3D
=
three-dimensional
LV
=
left ventricular
LVG
=
left ventriculography
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