To assess the correlation between breast arterial calcifications (BAC) on digital mammography and the extent of coronary artery disease (CAD) diagnosed with dual source coronary computed tomography angiography (CTA) in a population of women both symptomatic and asymptomatic for coronary artery disease. 100 consecutive women (aged 34 - 86 years) who underwent both coronary CTA and digital mammography were included in the study. Health records were reviewed to determine the presence of cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus, and smoking. Digital mammograms were reviewed for the presence and degree of BAC, graded in terms of severity and extent. Coronary CTAs were reviewed for CAD, graded based on the extent of calcified and non-calcified plaque, and the degree of major vessel stenosis. A four point grading scale was used for both coronary CTA and mammography. The overall prevalence of positive BAC and CAD in the studied population were 12% and 29%, respectively. Ten of the 12 patients with moderate or advanced BAC on mammography demonstrated moderate to severe CAD as determined by coronary CTA. For all women, the positive predictive value of BAC for CAD was 0.83 and the negative predictive value was 0.78. The presence of BAC on mammography appears to correlate with CAD as determined by coronary CTA (Spearman's rank correlation coefficient = 0.48, p<.000001). Using logistic regression, the inclusion of BAC as a feature in CAD predication significantly increased classification results (p=0.04).

To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room.

AIM: To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of congenital heart disease patients about to undergo redo sternotomy.MATERIALS AND METHODS: Forty-three patients (26 male, 17 female, median age 65 months) underwent contrast-enhanced CT and 24 patients (16 male, eight female, median age 89 months) underwent MRI prior to redo sternotomy for congenital heart disease. The informed consent requirement was waived by the institutional review board for this Health Insurance Portability and Accountability Act (HIPAA) compliant study. A standardized CT protocol utilizing a 64 section multidetector machine and an unenhanced and contrastenhanced MRI multisequence protocol was used. Images were qualitatively graded and retrosternal distances were measured as part of a risk assessment score.RESULTS: There were no statistically significant differences between the observers' grades regarding most retrosternal structures at both CT and MRI, separately (p > 0.05); furthermore, both readers found CT to be superior to MRI in qualitative grading except one reader's grades for shunts/conduits (p = 0.107). K-values were good to excellent (K >= 0.61) for most structures in qualitative grading of cases and risk assessment scores. There were no significant differences between grades of important structures using the same technique based on Friedman's test (p > 0.05). Analysis showed no difference between risk scores given to CT and MRI patients (p > 0.05).CONCLUSION: The present findings demonstrate the value of imaging to evaluate retrosternal anatomy. CT could be more valuable than MRI and could play a pivotal role in the surgical planning of CHD patients prior to redo operations. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.