{"id":24355,"date":"2018-05-24T14:41:30","date_gmt":"2018-05-24T09:11:30","guid":{"rendered":"https:\/\/cardiophile.org\/?p=24355"},"modified":"2022-11-19T13:53:44","modified_gmt":"2022-11-19T08:23:44","slug":"multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\/","title":{"rendered":"Multi detector CT for differentiation of prosthetic valve thrombus from pannus"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/MpToBpQ8e1U\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Multi detector CT for differentiation of prosthetic valve thrombus from pannus<\/span><\/h2>\n<p><span style=\"color: #000000;\">Differentiation of prosthetic valve thrombus from pannus is often difficult by echocardiography. Both can cause abnormal masses and both can cause increase in the transvalvar gradients and leaflet thickness.<\/span><\/p>\n<p>Multi detector computed tomogram (MDCT) is useful for this differentiation. <span style=\"color: #0000ff;\"><em>Attenuation of signals as measured in Hounsfield units is lower for the thrombus compared to pannus.<\/em><\/span> Pannus has attenuation values similar to the adjacent interventricular septum.<\/p>\n<p>ECG (electrocardiogram) gated computed tomography (CT) also helps in the assessment of the dynamic function of the prosthetic valve in systole and diastole.&nbsp;<span style=\"color: #0000ff;\">Early hypoattenuated leaflet thickening indicative of subclinical prosthetic valve thrombosis<\/span> was detected in 10% of cases in one study [1]. It was fully reversible on anticoagulation. The study used <span style=\"color: #0000ff;\">ECG triggered dual source CT angiography<\/span>.<\/p>\n<p><span style=\"color: #0000ff;\">Computed tomography radiomic analysis<\/span> can also be used to differentiate between thrombus and pannus. A retrospective study evaluated 39 periprosthetic masses in 34 patients with clinically suspected prosthetic valve obstruction who underwent redo surgery during which the cause of obstruction was confirmed and classified as thrombus, pannus or vegetation. Visual analysis from axial and valve dedicated CT views were done. Computed radiomic analysis of the periprosthetic masses were also done and advantage of radiomic score assessed. Radiomic score was significantly higher in those with pannus compared to thrombus and vegetation [2].<\/p>\n<p>Radiomics aims at enhancing the existing data available to clinicians by advanced mathematical analysis. Mathematical extraction of spatial distribution of signal intensities and pixel interrelationships is used to quantify textural information using artificial intelligence [3].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Pache G, Schoechlin S, Blanke P, Dorfs S, Jander N, Arepalli CD, Gick M, Buettner HJ, Leipsic J, Langer M, Neumann FJ, Ruile P. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26446193\">Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves<\/a>. Eur Heart J. 2016 Jul 21;37(28):2263-71.<\/li>\n<li>Nam K, Suh YJ, Han K, Park SJ, Kim YJ, Choi BW. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31739677\">Value of Computed Tomography Radiomic Features for Differentiation of Periprosthetic Mass in Patients With Suspected Prosthetic Valve Obstruction<\/a>. Circ Cardiovasc Imaging. 2019 Nov;12(11):e009496.<\/li>\n<li>van Timmeren JE, Cester D, Tanadini-Lang S, Alkadhi H, Baessler B. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32785796\/\">Radiomics in medical imaging-&#8220;how-to&#8221; guide and critical reflection<\/a>. Insights Imaging. 2020 Aug 12;11(1):91. doi: 10.1186\/s13244-020-00887-2. PMID: 32785796; PMCID: PMC7423816.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Multi detector CT for differentiation of prosthetic valve thrombus from pannus Differentiation of prosthetic valve thrombus from pannus is often difficult by echocardiography. Both can cause abnormal masses and both can cause increase in the transvalvar gradients and leaflet thickness. Multi detector computed tomogram (MDCT) is useful for this differentiation. Attenuation of signals as measured [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":32036,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[848,3214,3215],"class_list":["post-24355","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-computed-tomography-radiomic-analysis","tag-radiomic-analysis","tag-radiomic-score"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>MDCT for\u00a0differentiation of prosthetic valve thrombus from pannus<\/title>\n<meta name=\"description\" content=\"MDCT is useful for\u00a0differentiation of prosthetic valve thrombus from pannus. Attenuation is lower for the thrombus compared to pannus.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MDCT for\u00a0differentiation of prosthetic valve thrombus from pannus\" \/>\n<meta property=\"og:description\" content=\"MDCT is useful for\u00a0differentiation of prosthetic valve thrombus from pannus. Attenuation is lower for the thrombus compared to pannus.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2018-05-24T09:11:30+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-11-19T08:23:44+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Multi detector CT for differentiation of prosthetic valve thrombus from pannus\",\"datePublished\":\"2018-05-24T09:11:30+00:00\",\"dateModified\":\"2022-11-19T08:23:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/\"},\"wordCount\":372,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"Computed tomography radiomic analysis\",\"radiomic analysis\",\"radiomic score\"],\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/\",\"name\":\"MDCT for\u00a0differentiation of prosthetic valve thrombus from pannus\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/multi-detector-ct-for-differentiation-of-prosthetic-valve-thrombus-from-pannus\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2018-05-24T09:11:30+00:00\",\"dateModified\":\"2022-11-19T08:23:44+00:00\",\"description\":\"MDCT is useful for\u00a0differentiation of prosthetic valve thrombus from pannus. 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