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Fatty foci within the heart and the accompanying changes in the coronary arteries diagnosed in electrocardiogram-gated multislice computed tomography of the heart

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Tomaszewska M. , Czekajska-Chehab E. , Olchowik G. , Tomaszewski M. , Drop A.

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2014

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tom 73

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nr 4

EN

Background: The purpose of our study was to analyse the relationship between fatty foci within the heart and the accompanying changes in the coronary arteries supplying the relevant heart chambers in a large group of patients referred to multi-slice computed tomography with electrocardiogram-gating examinations (ECG-MSCT) for various clinical reasons. Materials and methods: The ECG-MSCT examinations of 1,830 consecutive patients were analysed. The examinations were performed using 8-row (1,015 patients) and 64-row (815 patients) MSCT, in pre- and postcontrast scanning. In the group of patients with fatty foci within the heart the concomitant changes in the coronary arteries were assessed. It was analysed: the type of changes in the arteries; the relationship between the locations of the fatty deposits and the occurrence and type of changes in the coronary arteries. Results: In 200 (10.9%) subjects fatty foci within the heart (112 men; 88 women; mean age 57.8) were detected. The distribution of the fat was as follows: right ventricle (RV) — 32.5%, left ventricle (LV) — 22.0%, biventricular — 45.5%. One hundred and seventy-two patients had concomitant changes in the coronary arteries. In patients with normal coronary arteries, significantly more often fatty deposits were localised within RV. Fat was primarily located subendocardially in the LV in patients with atherosclerosis in the left anterior descending artery (p < 0.001), in the right coronary artery (RCA) (p = 0.003), and in the left circumflex artery (LCX) (p < 0.001). Subpericardial locations of fatty deposits in RV significantly correlated with RCA bridging (p < 0.02); the subpericardial location of fat in LV significantly correlated with LCX bridging (p = 0.001). Conclusions: Fatty replacement of the myocardium is common, occurring in up to 10% of diagnosed patients and the majority of this group had concomitant changes in the coronary arteries. However, in the group of patients without changes in the coronary arteries, the fatty deposits locate themselves significantly more frequently within the RV. (Folia Morphol 2014; 73, 4: 445–461)

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Thoracic ectopic kidney in adults. A report of 2 cases

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Drop A. , Czekajska-Chehab E. , Maciejewski R. , Staskiewicz G. J. , Torres K.

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2003

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tom 62

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nr 3

313-316

EN

Thoracic kidney is the rarest, usually asymptomatic type of kidney ectopia. 2 cases of thoracic kidney discovered incidentally through chest radiography are reported. In both patients renal function tests were normal and no further treatment was necessary. Ultrasonography and computed tomography studies performed for confirmation of the diagnosis are presented. An embryonic background of this abnormality is discussed.

3

An unusual crossed course of separately originating left circumflex and left anterior descending arteries with concomitant anomalies found in multi-slice computed tomography

100%

Czekajska-Chehab E. , Staskiewicz G. J. , Mazur-Stazka E. , Drop A. , Maciejewski R.

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nr 4

334-337

EN

Coronary artery anomalies occur in approximately in 1–2% of the population. The split origin of branches of the left coronary artery is a relatively common anomaly, usually with no significant observable impairment of cardiac function. The application of multi-slice computed tomography (MSCT) for cardiac imaging is increasing and becoming, along with other techniques, a recognised method of examination of the coronary arteries. In the case presented we observed in an ECG-gated MSCT the anomalous origin and proximal course of the arteries of the left sinus of Valsalva. The ostiae of both coronary arteries were located unusually: the ostium of the LAD was found posterior to the ostium of the LCx. Because of this, the proximal part of the LAD crossed the proximal part of the LCx superiorly. Furthermore, muscular bridges were found in the middle part and in the first diameter branch of the LAD. To our knowledge, this is the first case of a crossed course of the LCx and the LAD to be presented in the literature. Applications of MSCT in coronary imaging are presented in comparison with other diagnostic imaging methods. The advantages and limitations of MSCT as a diagnostic tool for anomalies of the coronary arteries are discussed.

4

Quadricuspid pulmonary valve complicated with aneurysm of pulmonary trunk diagnosed with ECG-gated computed tomography

100%

Czekajska-Chehab E. , Uhlig S. , Staskiewicz G. , Widomska-Czekajska T. , Drop A.

Folia Morphologica

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2009

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tom 68

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nr 4

290-293

EN

Quadricuspid pulmonary valve (QPV) is an uncommon congenital defect reported in the general population with a frequency of up to 0.25%. The defect usually does not cause severe clinical complications and its presence frequently remains clinically silent. Moreover, there are several difficulties in visualization of pulmonary valve using basic diagnostic modalities such as echocardiography. Therefore, in the majority of cases, QPV is detected accidentally during cardiac procedures or post mortem. The authors present a case of QPV complicated with aneurysm of the pulmonary trunk, diagnosed with computed tomography in 70-year-old woman. Although the patient had undergone transthoracic echocardiography examinations several times in the past, only computed tomography allowed the detection of the anomalous valve. In addition, the examination confirmed aneurysm of the pulmonary trunk. To the best of our knowledge, this is the first case of QPV diagnosed in vivo with computed tomography. (Folia Morphol 2009; 68, 4: 290–293)

5

Immunotherapy of lung adenocarcinoma patient with peptide-pulsed dendritic cells: a case report

86%

Wojas-Krawczyk K. , Krawczyk P. , Buczkowski J. , Walkowska A. , Jankowska O. , Czekajska-Chehab E. , Milanowski J.

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nr 1

6

Arteria lusoria in patients with a normal and a right-sided aortic arch diagnosed with multi-slice computed tomography: a report of two cases

86%

Czekajska-Chehab E. , Uhlig S. , Staskiewicz G. , Mazur-Stazka E. , Torres A. , Gaweda K. , Drop A.

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tom 66

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nr 1

EN

A retro-oesophageal course of the right subclavian artery is referred to as “arteria lusoria”. It may be related to severe compression of the trachea and oesophagus, typically resulting in impaired swallowing. The paper presents two patients with arteria lusoria, which in one patient was an aberrant right subclavian artery and in the other an aberrant left subclavian artery, originating from the right-sided aortic arch. In both cases the diagnosis was made with multi-slice computed tomography. The embryology of the anomalies and clinical status of the patients is discussed. Arteria lusoria should be considered in differential diagnosis in patients with dyspnoea and dysphagia. Multi-slice computed tomography allows this anatomical variant to be reliably visualised.

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Coronary artery fistulas morphology in coronary computed tomography angiography

72%

Czekajska-Chehab E. , Skoczynski M. , Przybylski P. , Staskiewicz G. , Tomaszewski A. , Siek E. , Kurzepa J. , Skoczynski M. , Drop A.

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tom 79

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nr 4

8

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism

72%

Staskiewicz G. , Czekajska-Chehab E. , Uhlig S. , Tomaszewski A. , Torres K. , Torres A. , Walankiewicz M. , Surtel W. , Drop A.

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tom 72

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nr 2

EN

Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism (PE); however, it is affected by high interobserver variability. The aim of the study was to evaluate the application of volumetric reconstructions of the right ventricle for assessment of IVS position regarding its accuracy in identifying right ventricular dysfunction, as well as interobserver agreement in evaluating this sign. IVS bowing was evaluated with multiplanar reformations (MPR) and volumetric reconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowing sign was better for VR-based assessment; however, it was not significantly better than the MPR-based evaluation. Interobserver agreement was found to be fair (kappa = 0.381) for the MPR-based grading of IVS position as normal or abnormal, while it was significantly better for the VR method (kappa = 0.629, p < 0.001). The VR-based method may improve utilisation of IVS bowing sign in patients with PE. (Folia Morphol 2013; 72, 2: 107–112)

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Anatomical variations of the coeliac trunk in the homogeneous Polish population

72%

Torres K. , Staskiewicz G. , Denisow M. , Pietrzyk L. , Torres A. , Szukala M. , Czekajska-Chehab E. , Drop A.

Folia Morphologica

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2015

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tom 74

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nr 1

EN

Background: The abdominal vessels show a number of abnormalities and pathologies knowledge of which is important during open as well as laparoscopic surgeries. One of the most common vessels which pattern has many variations is the coeliac trunk. The present study was undertaken on homogeneous population to assess morphology of the coeliac trunk and to evaluate the possible variability of its branches. Materials and methods: Standard abdominal multidetector computed tomography examinations were performed on a total of 1569 patients diagnosed by 2 radiologists independently; in case of doubts common assessment was performed. Results: The coeliac trunk followed the classic pattern in 92.7% of the cases (1455/1569 of patients). The gastrosplenic trunk was detected in 4.1% of cases (64/1569); the hepatosplenic trunk in 2.2% of cases (34/1569); the coeliac-mesenteric trunk was observed in 0.5% of cases (8/1569); the hepatogastric trunk in 0.2% of cases (4/1569); the splenomesenteric trunk was detected in 0.1% of cases (2/1569). In the next 0.1% the coeliac trunk was absent. The hepatosplenomesenteric and the coeliac-colic trunk were not observed in the study population. Conclusions: Vascular anatomical abnormality is usually asymptomatic hovewer, its preoperative knowledge is helpful to reduce complications like vascular bleeding when dissecting the hapato-pancreatic region. The coeliac trunk and its branches can be fast and easy evaluated in computed tomography exams performed due to various symptoms from abdominal cavity. (Folia Morphol 2015; 74, 1: 93–99)

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Persistent trigeminal artery as a rare cause of ischaemic lesion and migraine-like headache

72%

Uhlig S. , Kurzepa J. , Czekajska-Chehab E. , Staskiewicz G. , Polar M. K. , Nastaj M. , Stochmal E. , Drop A.

Folia Morphologica

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2015

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tom 74

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nr 1

EN

The persistent trigeminal artery (PTA) is a rare remnant of the embryonic intracranial circulatory system that forms a carotid-vertebrobasilar anastomosis. In most cases PTA does not have clear clinical implications. However, some authors report the association of PTA occurrence with vertigo, dizziness and nerve palsy, resulting in diplopia, strabismus or trigeminal neuralgia in patients. In rare cases it may also be related to posterior cerebral circulation strokes. This work reports the case of a female patient who presented with migraine-like headache and an ischaemic lesion in the left temporal lobe in association with PTA. (Folia Morphol 2015; 74, 1: 133–136)