- 著者
- Nobuhiro Hara Yumi Tanaka Soichiro Ogura Akihiko Ueno Daisuke Iida Masahiro Yamauchi Sou Takenaka Tomonobu Okuno Masayoshi Sakakibara
- 出版者
- The Japanese Coronary Association
- 雑誌
- Journal of Coronary Artery Disease (ISSN:24342173)
- 巻号頁・発行日
- pp.21-00019, (Released:2022-01-26)
- 参考文献数
- 13
It is rare to detect single coronary arteries during angiography and rarer still to detect abnormal origins of the right coronary artery (RCA) from the left anterior descending artery (LAD). A 49-year-old man with hypertension and hyperlipidemia presented to our hospital with a chief complaint of exertion-induced chest pain in the month leading up to presentation. Inverted T-waves were seen in leads V1–V5 on the electrocardiogram, and coronary computed tomography (CT) demonstrated that all three major coronary arteries originated from the same ostium in the left sinus of Valsalva. An anomalous RCA arose from the LAD as a separate branch and then coursed anteriorly down the right atrioventricular groove. Coronary angiography showed a high-grade stenosis (>90%) in the proximal LAD and mid-distal RCA. The cardiology team discussed the treatment plan and consequently performed complete revascularization with percutaneous coronary intervention (PCI). The approach was successful, and at the 10-month follow-up, the patient was symptom-free and coronary CT showed no restenosis.
- 著者
- Yumi Tanaka Yoshiharu Ohno Satomu Hanamatsu Yuki Obama Takahiro Ueda Hirotaka Ikeda Akiyoshi Iwase Takashi Fukuba Hidekazu Hattori Kazuhiro Murayama Takeshi Yoshikawa Daisuke Takenaka Hisanobu Koyama Hiroshi Toyama
- 出版者
- Japanese Society for Magnetic Resonance in Medicine
- 雑誌
- Magnetic Resonance in Medical Sciences (ISSN:13473182)
- 巻号頁・発行日
- pp.rev.2020-0184, (Released:2021-04-29)
- 参考文献数
- 228
- 被引用文献数
- 6
Since thoracic MR imaging was first used in a clinical setting, it has been suggested that MR imaging has limited clinical utility for thoracic diseases, especially lung diseases, in comparison with x-ray CT and positron emission tomography (PET)/CT. However, in many countries and states and for specific indications, MR imaging has recently become practicable. In addition, recently developed pulmonary MR imaging with ultra-short TE (UTE) and zero TE (ZTE) has enhanced the utility of MR imaging for thoracic diseases in routine clinical practice. Furthermore, MR imaging has been introduced as being capable of assessing pulmonary function. It should be borne in mind, however, that these applications have so far been academically and clinically used only for healthy volunteers, but not for patients with various pulmonary diseases in Japan or other countries. In 2020, the Fleischner Society published a new report, which provides consensus expert opinions regarding appropriate clinical indications of pulmonary MR imaging for not only oncologic but also pulmonary diseases. This review article presents a brief history of MR imaging for thoracic diseases regarding its technical aspects and major clinical indications in Japan 1) in terms of what is currently available, 2) promising but requiring further validation or evaluation, and 3) developments warranting research investigations in preclinical or patient studies. State-of-the-art MR imaging can non-invasively visualize lung structural and functional abnormalities without ionizing radiation and thus provide an alternative to CT. MR imaging is considered as a tool for providing unique information. Moreover, prospective, randomized, and multi-center trials should be conducted to directly compare MR imaging with conventional methods to determine whether the former has equal or superior clinical relevance. The results of these trials together with continued improvements are expected to update or modify recommendations for the use of MRI in near future.