The aim of the study is to assess feasibility of using aortic valve calcification volume (AVCV) a... more The aim of the study is to assess feasibility of using aortic valve calcification volume (AVCV) as a surrogate marker for aortic stenosis (AS) by studying the correlation between AVCV on contrast enhanced CT (CECT) and severity of AS using echocardiographic indices. Materials and Methods: Ninety-four patients with AS, who underwent CECT and echocardiography as part of pre-transcatheter aortic valve implantation assessment were analysed. AVC was quantified on CECT using methodology validated by Bischoff et al. Severity of AS was categorized by echocardiography indices [transaortic jet velocity, mean pressure gradient, aortic valve area (AVA) by continuity and planimetry equations, indexed AVA to body surface area and dimensionless index (DI)]. Results: Moderate to strong correlation was found between AVCV with transaortic jet velocity (rs=0.397, p<0.001), peak pressure gradient (rs=0.410, p<0.001) and mean pressure gradient (rs=0.381, p<0.001). There was statistically significant correlation between AVCV with indexed AVA (rs=-0.225, p<0.001) and DI (rs=-0.644 p<0.001) but not with AVA by continuity equation (rs=-0.024, p<0.826) and by planimetry (rs=-0.185, p<0.158). Although not statistically significant, patients with higher degree of AS were noted to have higher AVCV burden on CECT. Conclusion: Quantification of AVCV using CECT is a potential complementary marker for grading of AS severity. AVCV has additive value when there is discrepancy between clinical and echocardiography examinations or discordant echocardiographic indices due to variation in techniques of imaging and small body size in Asian population.
Poster: "ECR 2018 / C-1441 / A Pictorial Review of the Common and Uncommon Imaging Findings ... more Poster: "ECR 2018 / C-1441 / A Pictorial Review of the Common and Uncommon Imaging Findings in Glenohumeral Instability" by: "P. I. Ngam, D. S. Y. Sia; Singapore/SG"
A 60-year-old man with a history of chronic kidney disease, type 2 diabetes mellitus and hearing ... more A 60-year-old man with a history of chronic kidney disease, type 2 diabetes mellitus and hearing impairment presented with short-term memory loss and slurring of speech. There was no neck stiffness, limb weakness, photophobia or sensory disturbances. He was afebrile and his vital signs were stable. No seizures were reported throughout the disease duration. On examination, he was found to have both expressive and receptive dysphasia, visual agnosia and apraxia. Non-contrast-enhanced computed tomography (CT) of the brain (Fig. 1) revealed an ill-defined area of hypodensity in the left occipital and temporal lobes that traversed the left middle cerebral artery (MCA) and posterior cerebral artery (PCA). Magnetic resonance imaging (MRI) of the brain (Fig. 2) was performed to further characterise the lesion. Time-of-flight (TOF) magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) were also performed. Cerebrospinal fluid (CSF) analysis revealed no evidence of pleoc...
Annals Academy of Medicine Dear Editor, Blunt cardiac injury refers to injury sustained due to bl... more Annals Academy of Medicine Dear Editor, Blunt cardiac injury refers to injury sustained due to blunt trauma to the heart. It encompasses a spectrum of pathologies ranging from myocardial contusion; myocardial, pericardial and valvular rupture/aneurysm to coronary artery injuries (dissection, thrombosis or rupture). The clinical manifestations range from clinically silent, transient arrhythmias, to acute myocardial infarction (AMI) and sudden cardiac death. The true incidence of blunt chest injury is unknown as reported rates vary greatly in the literature, ranging between 8% and 71%.1
The aim of the study is to assess feasibility of using aortic valve calcification volume (AVCV) a... more The aim of the study is to assess feasibility of using aortic valve calcification volume (AVCV) as a surrogate marker for aortic stenosis (AS) by studying the correlation between AVCV on contrast enhanced CT (CECT) and severity of AS using echocardiographic indices. Materials and Methods: Ninety-four patients with AS, who underwent CECT and echocardiography as part of pre-transcatheter aortic valve implantation assessment were analysed. AVC was quantified on CECT using methodology validated by Bischoff et al. Severity of AS was categorized by echocardiography indices [transaortic jet velocity, mean pressure gradient, aortic valve area (AVA) by continuity and planimetry equations, indexed AVA to body surface area and dimensionless index (DI)]. Results: Moderate to strong correlation was found between AVCV with transaortic jet velocity (rs=0.397, p<0.001), peak pressure gradient (rs=0.410, p<0.001) and mean pressure gradient (rs=0.381, p<0.001). There was statistically significant correlation between AVCV with indexed AVA (rs=-0.225, p<0.001) and DI (rs=-0.644 p<0.001) but not with AVA by continuity equation (rs=-0.024, p<0.826) and by planimetry (rs=-0.185, p<0.158). Although not statistically significant, patients with higher degree of AS were noted to have higher AVCV burden on CECT. Conclusion: Quantification of AVCV using CECT is a potential complementary marker for grading of AS severity. AVCV has additive value when there is discrepancy between clinical and echocardiography examinations or discordant echocardiographic indices due to variation in techniques of imaging and small body size in Asian population.
Poster: "ECR 2018 / C-1441 / A Pictorial Review of the Common and Uncommon Imaging Findings ... more Poster: "ECR 2018 / C-1441 / A Pictorial Review of the Common and Uncommon Imaging Findings in Glenohumeral Instability" by: "P. I. Ngam, D. S. Y. Sia; Singapore/SG"
A 60-year-old man with a history of chronic kidney disease, type 2 diabetes mellitus and hearing ... more A 60-year-old man with a history of chronic kidney disease, type 2 diabetes mellitus and hearing impairment presented with short-term memory loss and slurring of speech. There was no neck stiffness, limb weakness, photophobia or sensory disturbances. He was afebrile and his vital signs were stable. No seizures were reported throughout the disease duration. On examination, he was found to have both expressive and receptive dysphasia, visual agnosia and apraxia. Non-contrast-enhanced computed tomography (CT) of the brain (Fig. 1) revealed an ill-defined area of hypodensity in the left occipital and temporal lobes that traversed the left middle cerebral artery (MCA) and posterior cerebral artery (PCA). Magnetic resonance imaging (MRI) of the brain (Fig. 2) was performed to further characterise the lesion. Time-of-flight (TOF) magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) were also performed. Cerebrospinal fluid (CSF) analysis revealed no evidence of pleoc...
Annals Academy of Medicine Dear Editor, Blunt cardiac injury refers to injury sustained due to bl... more Annals Academy of Medicine Dear Editor, Blunt cardiac injury refers to injury sustained due to blunt trauma to the heart. It encompasses a spectrum of pathologies ranging from myocardial contusion; myocardial, pericardial and valvular rupture/aneurysm to coronary artery injuries (dissection, thrombosis or rupture). The clinical manifestations range from clinically silent, transient arrhythmias, to acute myocardial infarction (AMI) and sudden cardiac death. The true incidence of blunt chest injury is unknown as reported rates vary greatly in the literature, ranging between 8% and 71%.1
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