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Cardiac
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| 4D
heart: 3D and 4D rendering of the heart with emphasis
on the aortic valve. Example of the valve opening and closing,
shown dynamically by 4D CT. |
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Bicuspid Aortic Valve : 4D of a patient with a bicuspid
aortic valve. Please note that the best way to visualize the
bicuspid valve in this case is the Fishmouth configuration,
when the valve is open. |
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| Bicuspid
valve: 4 dimensional and 3 dimensional visualization of
the aortic valve prior to operative repair. This is a bicuspid
valve. |
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| Calcified
aortic valve: 3D and 4D mapping demonstrates a tricuspid
aortic valve with calcifications on the valve. |
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| Coarctation:
A series of 3 dimensional and 4 dimensional views are provided
defining a patient with prior repair of a coartation. The
4 dimensional imaging of the heart, with a special focus of
the aortic valve shows that it functions normally. |
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| Mechanical
aortic valve: Coronary artery disease with prosthetic
valve which functions normally. |
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| Aortic
valve: The study is an excellent example of dense calcification
of the aortic valve leaflets leading to aortic stenosis and
poststenotic dilatation. Calcifications with this appearance
are typically seen in patients with bicuspid aortic valves. |
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| Chest:
This study is a gated acquisition of a patient with a
type A dissection. Note that on the 4D images the importance
of the cardiac motion, as well as visualization of the flap
is clearly defined. Gating may become the standard for evaluation
of the ascending aorta because it allows us to not only see
the ascending aorta, which one can visualize fairly well on
axial imaging, but also define extent dissection as it relates
to coronary arteries and aortic valve. |
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| 4D
heart: Sequence of images showing 3D and 4D evaluation of
the Aorta and aortic root including aortic valve motion with
clear definition of aortic valve opening and closing. Note
the value of reversing the look up tables which give a better
definition of the cardiac valves. |
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| Dilated
aortic root: A sequence of images defines the dilated
aortic root with good definition of both the root and valve.
The use of 3D and 4 D imaging is nicely shown in this case.
Note calcification in the patient's left anterior descending
coronary artery. |
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| Arch
Pseudoaneurysm : A sequence of images is provided using
both 3D and 4 D reconstruction in a complicated case of a
patient with a pseudo-aneurysm off the aortic arch. 3D mapping
defines the extent of aneurysm using a series of axial, coronal,
and sagittal planes with volume rendering and 3D mapping.
The 4 dimensional reconstructions also nicely show the ulceration
with aneurysm off the arch. This can be best described as
a pseudo-aneurysm. The multiple volume rendered views nicely
show the pseudo-aneurysm. |
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| Prior
cardiac surgery: The patent has a history of prior cardiac
surgery. Notice the bulge off the right side of the ascending
aorta consistent with a pseudo-aneurysm, possibly iatrogenic
in nature. This is clearly seen on all 3D reconstructions
as a discreet out-patching. This would be eventually repaired
by banding. |
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| Repaired
coarctation of the aorta: This is a nice example of a
patient who had a coarctation of the aorta, which was subsequently
repaired. It was literally impossible to try to figure out
the anastomoses when one looked only at the axial images,
but in 3D, this is very clear exactly where the anastomoses
are. This is just a great example of where multiplanar and
3D imaging becomes so critical. |
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| Pseudoaneurysm:
3D and 4D imaging of a patient with a pseudo aneurysm of the
ascending aorta, just above the coronary arteries. |
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| Focal
pseudo aneurysm of the ascending aorta: Multiple sequences
using 3D imaging defining the focal pseudo aneurysm of the
ascending aorta. This is also nicely seen on some of the 4D
images. |
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| Right
Arch with Mirror Branching : This is an example of an
unusual variation of a right-sided arch with a near double
aortic arch but lack of connection of the left portion and
right portion of the arch. There is mirror branching present
as well. This configuration can lead to airway compression
but not with the frequency that one would see with a true
double aortic arch. The patient does have a diverticulum off
the left component of the arch. |
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| Ascending
aorta : This is a study done with 3D and 4D mapping demonstrating
a dilated ascending aorta down to the level of the aortic
root. This study also shows you the amount of motion present
on the CT scan and the advantages of gating. Note the pulmonary
vasculature motion as well as the significant motion of the
ascending aorta. This patient had aortic stenosis as the cause
of the dilated aorta. |
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| Mitral
valve: Whereas prior studies in this section have defined
the aortic valve with the opening and closing of the valve,
this study demonstrates the delicate mitral valve opening
and closing through a range of perspectives. |
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| Aortic
valve replacement: This case demonstrates, nicely, the
presence of an aortic valve replacement. The 3D mapping clearly
shows the normal valve function. The study also demonstrated
nicely motion associated with the heart relative to the lung.
Even with the 64 slice CT, there is still a potential for
motion related artifact, simply due to cardiac pulsation. |
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