We compared coronary dual-source computed tomography angiography (corDSCTA) with technetium-99m single-photon emission computed tomography (SPECT) for the detection of myocardial perfusion abnormalities. Fifty-five consecutive patients underwent both gated myocardial perfusion SPECT and corDSCTA, the latter during a single arterial-phase injection of contrast agent. The perfusion defects visualised by corDSCTA correlated with the findings of rest/stress SPECT. Abnormal findings on stress SPECT, which were due to either ischaemia or infarct, were found in 24 patients. In comparison to SPECT at rest, corDSCTA detected perfusion defects with a sensitivity and specificity of 100% and 78%, respectively. Compared to SPECT at stress, the sensitivity and specificity values of corDSCTA were 83.3% and 90.3%, respectively. On corDSCTA , the average attenuation values of perfusion defects that corresponded to chronic infarcts (-8.5+/-22.2 HU) were significantly lower (p = 0.002) than those of non-infarct-related perfusion defects (43.1+/-17.5 HU). Using rest/stress SPECT is the gold standard for the diagnosis of myocardial ischaemia, corDSCTA was able to diagnose ischaemic disease (defined as the presence of high-grade stenotic CAD (>or=50% luminal narrowing)) with a sensitivity and specificity of 59% and 89%, respectively, in patients with no known history of myocardial infarction (n = 4). Thus, corDSCTA may serve as a diagnostic tool for the detection of perfusion abnormalities (first) visualised by SPECT. There appears to be a limited correlation between coronary stenotic disease and SPECT findings.

CT-guided percutaneous adrenal biopsy is commonly performed using a posterior or trans-abdominal approach. However, trans-abdominal access to the gland may not be technically feasible in some patients. In our case, CT-guided transthoracic percutaneous biopsy of the adrenal gland was performed with technical success, identifying the tumour. To the best of our knowledge, there has been no previous case describing this transpulmonary approach in the literature.

Figure 2. (A) Non contrast IR-SSFP MRA in a patient with transplanted right kidney demonstrates a mild less than 50% luminal narrowing at the anastamosis (long white arrow) with ipsilateral native right distal common iliac artery (short arrow). First order branches (arrowheads) are unremarkable. (B) Non contrast IR-SSFP MRA in a patient with transplanted right kidney demonstrates normal transplant renal artery arising from the distal right common iliac artery (short arrow) without a focal significant stenosis. Note normal first order (arrowhead) and intrarenal (long arrows) branches which are well depicted. CE-MRA was not performed for either patient as per physician request. Non Contrast-Enhanced 3D MR Angiography of Renal Arteries using a Novel Inversion Recovery Steady State Free Precession Technique: Our Initial Experience