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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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