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JACQUIER Alexis

MD PhD

alexis.jacquier@ap-hm.fr
tel : +33 4 91 38 84 57
Key Words
- Dilated cardiomyopathy
- Fibrosis quantification
- Treadmill exercise during cardiac MRI

Current Research Interest and projects

Publications

2017

Journal Article

  • GABORIT B., SENGENES C., ANCEL P., JACQUIER A., DUTOUR A. “Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?”. Comprehensive Physiology [En ligne]. 2017. Vol. 7, n°3, p. 1051-1082. Disponible sur : < http://dx.doi.org/10.1002/cphy.c160034 > (consulté le no date)
    Résumé : Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.

  • HABIB G., BUCCIARELLI-DUCCI C., CAFORIO A. L. P., CARDIM N., CHARRON P., COSYNS B., DEHAENE A., DERUMEAUX G., DONAL E., DWECK M. R., EDVARDSEN T., ERBA P. A., ERNANDE L., GAEMPERLI O., GALDERISI M., GRAPSA J., JACQUIER A., KLINGEL K., LANCELLOTTI P., NEGLIA D., PEPE A., PERRONE-FILARDI P., PETERSEN S. E., PLEIN S., POPESCU B. A., REANT P., SADE L. E., SALAUN E., SLART R. H. J. A., TRIBOUILLOY C., ZAMORANO J., REVIEWERS: VICTORIA DELGADO, KRISTINA HAUGAA (EACVI SCIENTIFIC DOCUMENTS COMMITTEE) AND G VIJAYARAGHAVAN (INDIAN ACADEMY OF ECHOCARDIOGRAPHY). “Multimodality imaging in restrictive cardiomyopathies: an EACVI expert consensus document: In collaboration with the 'Working Group on myocardial and pericardial diseases' of the European Society of Cardiology Endorsed by the Indian Academy of Echocardiography.”. European Heart Journal Cardiovascular Imaging [En ligne]. 2017. Disponible sur : < http://dx.doi.org/10.1093/ehjci/jex034 > (consulté le no date)
    Résumé : Restrictive cardiomyopathies (RCMs) are a diverse group of myocardial diseases with a wide range of aetiologies, including familial, genetic and acquired diseases and ranging from very rare to relatively frequent cardiac disorders. In all these diseases, imaging techniques play a central role. Advanced imaging techniques provide important novel data on the diagnostic and prognostic assessment of RCMs. This EACVI consensus document provides comprehensive information for the appropriateness of all non-invasive imaging techniques for the diagnosis, prognostic evaluation, and management of patients with RCM.
    Mots-clés : cardiac magnetic resonance, Cardiomyopathies, Computed tomography, Echocardiography, nuclear imaging, restrictive cardiomyopathies.

  • ROUX V., SALAUN E., TRIBOUILLOY C., HUBERT S., BOHBOT Y., CASALTA J. - P., BARRAL P. - A., RUSINARU D., GOURIET F., LAVOUTE C., HAENTJENS J., DI BISCEGLI M., DEHAENE A., RENARD S., CASALTA A. - C., PRADIER J., AVIERINOS J. - F., RIBERI A., LAMBERT M., COLLART F., JACQUIER A., THUNY F., CAMOIN-JAU L., LEPIDI H., RAOULT D., HABIB G. “Coronary events complicating infective endocarditis.”. Heart (British Cardiac Society) [En ligne]. 2017. Disponible sur : < http://dx.doi.org/10.1136/heartjnl-2017-311624 > (consulté le no date)
    Résumé : OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management. METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included. The incidence, mechanism and prognosis of patients with ACS were studied. RESULTS: Among 1210 consecutive patients with definite IE, 26 patients (2.2%) developed an ACS. Twenty-three patients (88%) had a coronary embolism. Two patients had coronary compression by an abscess or a pseudoaneurysm and one patient had an obstruction of his bioprosthesis and left coronary ostium by a large vegetation. Nineteen (73%) patients with ACS developed heart failure and this complication was 2.5 times more frequent than in patients without ACS (p<0.0001). In the ACS population, mortality rate was twice than the population without ACS. CONCLUSIONS: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate.
    Mots-clés : acute coronary syndromes, endocarditis.

2016

Journal Article

  • ABDESSELAM I., DUTOUR A., KOBER F., ANCEL P., BEGE T., DARMON P., LESAVRE N., BERNARD M., GABORIT B. “Time Course of Change in Ectopic Fat Stores After Bariatric Surgery.”. Journal of the American College of Cardiology [En ligne]. 2016. Vol. 67, n°1, p. 117-119. Disponible sur : < http://dx.doi.org/10.1016/j.jacc.2015.10.052 > (consulté le no date)

  • BRICQ S., FRANDON J., BERNARD M., GUYE M., FINAS M., MARCADET L., MIQUEROL L., KOBER F., HABIB G., FAGRET D., JACQUIER A., LALANDE A. “Semiautomatic detection of myocardial contours in order to investigate normal values of the left ventricular trabeculated mass using MRI.”. Journal of magnetic resonance imaging: JMRI [En ligne]. 2016. Vol. 43, n°6, p. 1398-1406. Disponible sur : < http://dx.doi.org/10.1002/jmri.25113 > (consulté le no date)
    Résumé : PURPOSE: To propose, assess, and validate a semiautomatic method allowing rapid and reproducible measurement of trabeculated and compacted left ventricular (LV) masses from cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS: We developed a method to automatically detect noncompacted, endocardial, and epicardial contours. Papillary muscles were segmented using semiautomatic thresholding and were included in the compacted mass. Blood was removed from trabeculae using the same threshold tool. Trabeculated, compacted masses and ratio of noncompacted to compacted (NC:C) masses were computed. Preclinical validation was performed on four transgenic mice with hypertrabeculation of the LV (high-resolution cine imaging, 11.75T). Then analysis was performed on normal cine-MRI examinations (steady-state free precession [SSFP] sequences, 1.5T or 3T) obtained from 60 healthy participants (mean age 49 ± 16 years) with 10 men and 10 women for each of the following age groups: [20,39], [40,59], and [60,79]. Interobserver and interexamination segmentation reproducibility was assessed by using Bland-Altman analysis and by computing the correlation coefficient. RESULTS: In normal participants, noncompacted and compacted masses were 6.29 ± 2.03 g/m(2) and 62.17 ± 11.32 g/m(2) , respectively. The NC:C mass ratio was 10.26 ± 3.27%. Correlation between the two observers was from 0.85 for NC:C ratio to 0.99 for end-diastolic volume (P < 10(-5) ). The bias between the two observers was -1.06 ± 1.02 g/m(2) for trabeculated mass, -1.41 ± 2.78 g/m(2) for compacted mass, and -1.51 ± 1.77% for NC:C ratio. CONCLUSION: We propose a semiautomatic method based on region growing, active contours, and thresholding to calculate the NC:C mass ratio. This method is highly reproducible and might help in the diagnosis of LV noncompaction cardiomyopathy. J. Magn. Reson. Imaging 2016;43:1398-1406.
    Mots-clés : cardiovascular magnetic resonance imaging, crmbm, left ventricle, noncompaction, papillary muscles, trabeculae.

  • DUTOUR A., ABDESSELAM I., ANCEL P., KOBER F., MRAD G., DARMON P., RONSIN O., PRADEL V., LESAVRE N., MARTIN J. C., JACQUIER A., LEFUR Y., BERNARD M., GABORIT B. “Exenatide decreases liver fat content and epicardial adipose tissue in patients with obesity and type 2 diabetes: a prospective randomized clinical trial using magnetic resonance imaging and spectroscopy.”. Diabetes, Obesity & Metabolism [En ligne]. 2016. Vol. 18, n°9, p. 882-891. Disponible sur : < http://dx.doi.org/10.1111/dom.12680 > (consulté le no date)
    Résumé : AIM: To conduct a prospective randomized trial to investigate the effect of glucagon-like peptide-1 (GLP-1) analogues on ectopic fat stores. METHODS: A total of 44 obese subjects with type 2 diabetes uncontrolled on oral antidiabetic drugs were randomly assigned to receive exenatide or reference treatment according to French guidelines. Epicardial adipose tissue (EAT), myocardial triglyceride content (MTGC), hepatic triglyceride content (HTGC) and pancreatic triglyceride content (PTGC) were assessed 45 min after a standardized meal with 3T magnetic resonance imaging and proton magnetic resonance spectroscopy before and after 26 weeks of treatment. RESULTS: The study population had a mean glycated haemoglobin (HbA1c) level of 7.5 ± 0.2% and a mean body mass index of 36.1 ± 1.1 kg/m(2) . Ninety five percent had hepatic steatosis at baseline (HTGC ≥ 5.6%). Exenatide and reference treatment led to a similar improvement in HbA1c (-0.7 ± 0.3% vs. -0.7 ± 0.4%; p = 0.29), whereas significant weight loss was observed only in the exenatide group (-5.5 ± 1.2 kg vs. -0.2 ± 0.8 kg; p = 0.001 for the difference between groups). Exenatide induced a significant reduction in EAT (-8.8 ± 2.1%) and HTGC (-23.8 ± 9.5%), compared with the reference treatment (EAT: -1.2 ± 1.6%, p = 0.003; HTGC: +12.5 ± 9.6%, p = 0.007). No significant difference was observed in other ectopic fat stores, PTGC or MTGC. In the group treated with exenatide, reductions in liver fat and EAT were not associated with homeostatic model assessment of insulin resistance index, adiponectin, HbA1c or fructosamin change, but were significantly related to weight loss (r = 0.47, p = 0.03, and r = 0.50, p = 0.018, respectively). CONCLUSION: Our data indicate that exenatide is an effective treatment to reduce liver fat content and epicardial fat in obese patients with type 2 diabetes, and these effects are mainly weight loss dependent.
    Mots-clés : crmbm, epicardial adipose tissue, glucagon-like peptide 1 receptor agonist, hepatic triglyceride content, Magnetic Resonance Imaging, magnetic-resonance imaging, myocardial triglyceride content, Obesity, pancreatic triglyceride content, Proton Magnetic Resonance Spectroscopy, proton magnetic-resonance spectroscopy, type 2 diabetes.

  • ENGBLOM H., TUFVESSON J., JABLONOWSKI R., CARLSSON M., ALETRAS A. H., HOFFMANN P., JACQUIER A., KOBER F., METZLER B., ERLINGE D., ATAR D., ARHEDEN H., HEIBERG E. “A new automatic algorithm for quantification of myocardial infarction imaged by late gadolinium enhancement cardiovascular magnetic resonance: experimental validation and comparison to expert delineations in multi-center, multi-vendor patient data.”. Journal of Cardiovascular Magnetic Resonance: Official Journal of the Society for Cardiovascular Magnetic Resonance [En ligne]. 2016. Vol. 18, n°1, p. 27. Disponible sur : < http://dx.doi.org/10.1186/s12968-016-0242-5 > (consulté le no date)
    Résumé : BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) using magnitude inversion recovery (IR) or phase sensitive inversion recovery (PSIR) has become clinical standard for assessment of myocardial infarction (MI). However, there is no clinical standard for quantification of MI even though multiple methods have been proposed. Simple thresholds have yielded varying results and advanced algorithms have only been validated in single center studies. Therefore, the aim of this study was to develop an automatic algorithm for MI quantification in IR and PSIR LGE images and to validate the new algorithm experimentally and compare it to expert delineations in multi-center, multi-vendor patient data. METHODS: The new automatic algorithm, EWA (Expectation Maximization, weighted intensity, a priori information), was implemented using an intensity threshold by Expectation Maximization (EM) and a weighted summation to account for partial volume effects. The EWA algorithm was validated in-vivo against triphenyltetrazolium-chloride (TTC) staining (n = 7 pigs with paired IR and PSIR images) and against ex-vivo high resolution T1-weighted images (n = 23 IR and n = 13 PSIR images). The EWA algorithm was also compared to expert delineation in 124 patients from multi-center, multi-vendor clinical trials 2-6 days following first time ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) (n = 124 IR and n = 49 PSIR images). RESULTS: Infarct size by the EWA algorithm in vivo in pigs showed a bias to ex-vivo TTC of -1 ± 4%LVM (R = 0.84) in IR and -2 ± 3%LVM (R = 0.92) in PSIR images and a bias to ex-vivo T1-weighted images of 0 ± 4%LVM (R = 0.94) in IR and 0 ± 5%LVM (R = 0.79) in PSIR images. In multi-center patient studies, infarct size by the EWA algorithm showed a bias to expert delineation of -2 ± 6 %LVM (R = 0.81) in IR images (n = 124) and 0 ± 5%LVM (R = 0.89) in PSIR images (n = 49). CONCLUSIONS: The EWA algorithm was validated experimentally and in patient data with a low bias in both IR and PSIR LGE images. Thus, the use of EM and a weighted intensity as in the EWA algorithm, may serve as a clinical standard for the quantification of myocardial infarction in LGE CMR images. CLINICAL TRIAL REGISTRATION: CHILL-MI: NCT01379261 . MITOCARE: NCT01374321 .
    Mots-clés : Automatic quantification algorithm, Expectation maximization, Experimental validation, LGE CMR, Multi-center patient data.

2015

Journal Article


  • CAPRON T., TROALEN T., ROBERT B., JACQUIER A., BERNARD M., KOBER F. “Myocardial perfusion assessment in humans using steady-pulsed arterial spin labeling.”. Magnetic Resonance in Medicine [En ligne]. 2015. Vol. 74, n°4, p. 990-998. Disponible sur : < http://dx.doi.org/10.1002/mrm.25479 >
    Résumé : Purpose Although arterial spin labeling (ASL) has become a routinely performed method in the rodent heart, its application to the human heart remains challenged by low tissue blood flow and cardiac and respiratory motion. We hypothesized that an alternative steady-pulsed ASL (spASL) method would provide more efficient perfusion signal averaging by driving the tissue magnetization into a perfusion-dependent steady state. Methods We evaluated the feasibility of spASL in the human heart by combining pulsed labeling in the aortic root with a balanced steady state free precession sequence. The spASL scheme was applied to 13 subjects under free breathing. Breathing motion was addressed using retrospective image exclusion based on a contour-based cross-correlation algorithm. Results The measured signal with spASL was due to labeled blood. We found that the perfusion signal was larger than that obtained with the earlier flow-sensitive alternating inversion recovery (FAIR) method. Averaged myocardial blood flow (MBF) over four myocardial regions was 1.28 ± 0.36 mL·g−1·min−1. Conclusion spASL was able to quantify MBF in healthy subjects under free breathing. Because quantification with ASL is more direct than with first-pass perfusion MRI, it appears particularly suited for pathologies with diffuse microvascular alterations, MBF reserve, and follow-up studies. Magn Reson Med 74:990–998, 2015. © 2014 Wiley Periodicals, Inc.
    Mots-clés : arterial spin labeling, Blood flow, cine-ASL, crmbm, myocardial perfusion, steady state, steady-pulsed.

  • GABORIT B., ABDESSELAM I., KOBER F., JACQUIER A., RONSIN O., EMUNGANIA O., LESAVRE N., ALESSI M. - C., MARTIN J. C., BERNARD M., DUTOUR A. “Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss.”. International Journal of Obesity (2005) [En ligne]. 2015. Vol. 39, n°3, p. 480-487. Disponible sur : < http://dx.doi.org/10.1038/ijo.2014.126 > (consulté le no date)
    Résumé : OBJECTIVES: Recent literature suggests that ectopic fat deposition in the pancreas may contribute to endocrine and exocrine organ dysfunction, such as type 2 diabetes (T2D), pancreatitis or pancreatic cancer. The aim of this study was to determine factors associated with pancreatic triglyceride content (PTGC), and to investigate the impact of bariatric surgery on ectopic fat pads, pancreatic fat (PTGC) and hepatic fat (HTGC). SUBJECTS: In all, 45 subjects (13 lean, 13 obese nondiabetics and 19 T2D, matched for age and gender) underwent 1H-magnetic resonance spectroscopy, computed tomography of the visceral abdominal fat, metabolic and lipidomic analysis, including insulin-resistance homeostasis model assessment (HOMA-IR), insulin-secretion homeostasis model assessment (HOMA-B) and plasma fatty-acid composition. Twenty obese subjects were reassessed 6 months after the bariatric surgery. RESULTS: PTGC was significantly higher in type 2 diabetic subjects (23.8±3.2%) compared with obese (14.0±3.3; P=0.03) and lean subjects (7.5±0.9%; P=0.0002). PTGC remained significantly associated with T2D after adjusting for age and sex (β=0.47; P=0.004) or even after adjusting for waist circumference, triglycerides and HOMA-IR (β=0.32; P=0.04). T2D, C18:1n-9 (oleic acid), uric acid, triglycerides and plasminogen activator inhibitor-1 were the five more important parameters involved in PTGC prediction (explained 80% of PTGC variance). Bariatric surgery induced a huge reduction of both HTGC (-51.2±7.9%) and PTGC (-43.8±7.0%) reaching lean levels, whereas body mass index remained greatly elevated. An improvement of insulin resistance HOMA-IR and no change in HOMA-B were observed after bariatric surgery. The PTGC or HTGC losses were not correlated, suggesting tissue-specific mobilization of these ectopic fat stores. CONCLUSION: Pancreatic fat increased with T2D and drastically decreased after the bariatric surgery. This suggests that decreased PTGC may contribute to improved beta cell function seen after the bariatric surgery. Further, long-term interventional studies are warranted to examine this hypothesis and to determine the degree to which ectopic fat mobilization may mediate the improvement in endocrine and exocrine pancreatic functions.
    Mots-clés : crmbm.

  • SAEED KILANI M., IZAARYENE J., COHEN F., VAROQUAUX A., GAUBERT J. Y., LOUIS G., JACQUIER A., BARTOLI J. M., MOULIN G., VIDAL V. “Ethylene vinyl alcohol copolymer (Onyx®) in peripheral interventional radiology: indications, advantages and limitations.”. Diagnostic and Interventional Imaging [En ligne]. 2015. Vol. 96, n°4, p. 319-326. Disponible sur : < http://dx.doi.org/10.1016/j.diii.2014.11.030 > (consulté le no date)
    Résumé : Onyx(®) is a remarkable liquid embolizing agent that may allow a well-trained operator to undertake challenging embolization procedures. In multiple interventional radiology indications, the physico-chemical properties of Onyx(®) allow safe embolization. The purpose of this article is to review the advantages and disadvantages of Onyx(®) and identify its main indications.
    Mots-clés : AVM, Embolization, Embolization, Therapeutic, Ethylene vinyl alcohol copolymer, Humans, Onyx(®), Polyvinyls, Radiology, Interventional, Type II endoleak.

  • SIMONNET B., JACQUIER A., SALAUN E., HUBERT S., HABIB G. “Cardiac involvement in hypereosinophilic syndrome: role of multimodality imaging.”. European Heart Journal Cardiovascular Imaging [En ligne]. 2015. Vol. 16, n°2, p. 228. Disponible sur : < http://dx.doi.org/10.1093/ehjci/jeu196 > (consulté le no date)

2014

Journal Article

  • BERNARD M., JACQUIER A., KOBER F. “Cardiovascular magnetic resonance in ischemic heart disease.”. Future Cardiology [En ligne]. 2014. Vol. 10, n°4, p. 487-496. Disponible sur : < http://dx.doi.org/10.2217/fca.14.39 > (consulté le no date)
    Résumé : Ischemic heart disease is the major cause of death in developed countries. Recently, cardiovascular magnetic resonance (CMR) has appeared as a powerful technique for diagnosis and prognosis of ischemia, as well as for postischemic therapy follow-up. The objective of this chapter is to provide an overview of the role of CMR in assessing ischemic myocardium. It reviews the most recent studies in this field and includes CMR parameters that are already well established in the clinical setting as well as promising or emerging parameters in clinical use.
    Mots-clés : crmbm.

  • CAPOROSSI J. - M., VIDAL V., JACQUIER A., REYRE A., FLAVIAN A., MULLER C., GAUBERT J. - Y., BARTOLI J. - M., MOULIN G., VAROQUAUX A. “Balloon occlusion versus wedged hepatic venography using iodinated contrast for targeting the portal vein during TIPS.”. Diagnostic and Interventional Imaging [En ligne]. 2014. Disponible sur : < http://dx.doi.org/10.1016/j.diii.2014.11.011 > (consulté le no date)
    Résumé : PURPOSE: To assess the efficacy, safety and gain in procedure time of the technique of balloon occlusion hepatic venography with iodinated contrast used to target the portal vein during TIPS. The technique is assessed versus wedged hepatic venography. MATERIALS AND METHODS: Fifty-eight TIPS were prospectively included. The portal vein was located in 30 cases by the wedged hepatic venography (group 1) and in 28 cases by balloon occlusion hepatic venography (group 2). To compare both techniques a "portogram quality" score was defined using a 5 points scale. The time required to achieve portal puncture was also recorded. The complications of both procedures were assessed and classified in groups as intrahepatic hematoma or intraperitoneal hemorrhage. RESULTS: The right portal vein was visualized in a significantly higher number of patients using balloon than with wedged retrograde venography 71.3% (20/28) versus 13.3% (4/30) respectively (P=0.002). The quality score for the portogram was significantly higher for balloon hepatic venography 2.21 than for wedged hepatic venography 1.07 (P=0.002). The mean time required to puncture the portal vein was significantly shorter when the right branch of the portal vein was visualized 21min versus 33.5min (P=0.046). We recorded one intrahepatic hematoma (3.3%) and 4 intraperitoneal hemorrhage (13.3%) secondary to wedged hepatic venography. There were no complications with balloon occlusion hepatic venography (P=0.053). CONCLUSION: The use of balloon occlusion hepatic venography improves the quality of the retrograde portal venography to target the portal vein and decreases procedure time. The balloon technique is also burdened with fewer complications than the standard wedged hepatic venography.

  • GROB A., THUNY F., VILLACAMPA C., FLAVIAN A., GAUBERT J. Y., RAOULT D., CASALTA J. P., HABIB G., MOULIN G., JACQUIER A. “Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay.”. Insights into Imaging [En ligne]. 2014. Vol. 5, n°5, p. 559-570. Disponible sur : < http://dx.doi.org/10.1007/s13244-014-0353-1 > (consulté le no date)
    Résumé : OBJECTIVES: The goals of this pictorial essay are: (1) to set out a multislice computed tomography (MSCT) imaging protocol to assess infective endocarditis (IE); (2) to give an MSCT overview of valvular and peri-valvular involvement during IE; (3) to give a CT overview of septic embolism and infectious pseudoaneurysms during IE. METHODS: MSCT acquisition protocols to assess IE are performed in two different phases: the first acquisition, under electrocardiography (ECG) gating, covers the cardiac structures during first-pass iodine injection; the second acquisition covers the thorax, abdomen, pelvic and cerebral regions. RESULTS: Valvular and peri-valvular lesions during IE are: vegetation-a hypodense, homogeneous, irregular mass on a valve or endocardial structure; perforation-a defect in the leaflet; valvular aneurysm-loss of the homogenous curvature of the leaflet; valvular thickening; peri-valvular abscess; pseudoaneurysm; fistula and disinsertion of a prosthetic valve. Extra-cardiac location could involve all organs. CONCLUSIONS: MSCT can be considered as a useful complement in visualising the cardiac lesions of IE if echocardiography is inconclusive. MSCT is the only imaging modality that provides assessment of valvular and peri-valvular involvement, extra-cardiac lesions, and non-invasive evaluation of the coronary artery anatomy, simultaneously. MAIN MESSAGES: • MSCT provides assessment of coronary anatomy, cardiac and extra-cardiac lesions. • MSCT represents an alternative to echocardiography during IE. • Surgical valve replacement is usually required if vegetation is >10 mm. • Peri-valvular extension (abscesses, pseudoaneurysm and fistulae) required surgical treatment.

  • JACQUIER A., KALLIFATIDIS A., GUIBERT N., GIORGI R., FALQUE C., THUNY F., CROISILLE P., CLARYSSE P., MAUREL B., FLAVIAN A., GAUBERT J. - Y., MOULIN G., HABIB G. “Assessment of myocardial partition coefficient of gadolinium (λ) in dilated cardiomyopathy and its impact on segmental and global systolic function.”. Journal of magnetic resonance imaging: JMRI [En ligne]. 2014. Vol. 40, n°6, p. 1336-1341. Disponible sur : < http://dx.doi.org/10.1002/jmri.24515 > (consulté le no date)
    Résumé : PURPOSE: 1) To assess the myocardial partition coefficient (λ) of gadolinium quantified using T1 mapping in dilated cardiomyopathy (DCM); and 2) to assess the impact of increased λ on left ventricular (LV) circumferential strain and ejection fraction in DCM. MATERIALS AND METHODS: Seventeen patients with DCM and 11 controls were prospectively included. All patients and controls underwent a 1.5T MRI using: 1) cine to quantify LV volumes and function; 2) tagging to quantify circumferential strain in mid-LV; 3) T1 mapping before and 9 minutes after contrast injection to quantify R1 , ΔR1 , and λ; and 4) inversion recovery 3D Flash was used to assess late gadolinium enhancement (LGE) 10 minutes after Gd DOTA injection (0.2 mmol/kg). We used Student's t-test to compare means, Pearson's test for correlation assessment, and a mixed linear model to integrate the dependency between myocardial segments. RESULTS: No difference in median λ was measured between patients with (0.52 [interquartile range = 0.48-0.56]) and without enhancement on LGE (0.51 [0.47-0.54]; P = 0.07). Circumferential strain value measured in each segment was correlated with the λ measured in the corresponding segment (r = 0.55; P < 0.0001). Multivariate analysis revealed a significant link between the λ in each segment and circumferential strain (0.002 ± 0.001; P = 0.009) and also with ejection fraction (-0.001 ± 0.0008; P = 0.04). CONCLUSION: In DCM, λ correlates independently with circumferential strain and ejection fraction, suggesting that there is a link between λ and systolic function.J. Magn. Reson. Imaging 2014;40:1336-1341. © 2013 Wiley Periodicals, Inc.

  • QUATRE A., JACQUIER A., PETIT P., GIORGI R., THURET I. “MRI monitoring of myocardial iron overload: use of cardiac MRI combined with hepatic MRI in a cohort of multi-transfused patients with thalassaemia.”. Diagnostic and Interventional Imaging [En ligne]. 2014. Vol. 95, n°11, p. 1065-1069. Disponible sur : < http://dx.doi.org/10.1016/j.diii.2014.01.007 > (consulté le no date)
    Résumé : PURPOSE: We report the results of combining cardiac and hepatic MRI in the same examination to monitor 48 multi-transfused patients presenting iron overload secondary to their transfusions. This cardiac MRI technique uses acquisition sequences and calculation software that are readily available for 1.5 T systems, and it has been validated to screen for patients at risk of cardiac complications who present myocardial iron overload (T2*<20milliseconds). PATIENTS AND METHODS: A total of 176 combined MRI examinations were performed between May 2006 and January 2012 in 48 patients who had received transfusions due to thalassaemia. This monocentric retrospective study brings together all of the imaging examinations carried out. RESULTS: There was a positive correlation between the cardiac T2* values and left ventricular ejection fraction, which were measured in the same examination. At the first assessment 23/48 patients had a T2*<20ms. These patients showed a significant improvement in cardiac T2* over time while their iron chelation therapy was being intensified. CONCLUSION: This study validates the application of the cardiac MRI technique used to monitor cardiac iron overload in patients who have undergone multiple transfusions.

  • THERON A., JACQUIER A., RAVIS E., RONCHARD T., GAUBERT J. - Y., GRISOLI D., GARIBOLDI V., COLLART F. “Role of three-dimensional transesophageal echocardiography in diagnosis of coronary anomalies.”. Echocardiography (Mount Kisco, N.Y.) [En ligne]. 2014. Vol. 31, n°10, p. E317-318. Disponible sur : < http://dx.doi.org/10.1111/echo.12751 > (consulté le no date)

2013

Journal Article


  • THUNY F., GAUBERT J. - Y., JACQUIER A., TESSONNIER L., CAMMILLERI S., RAOULT D., HABIB G. “Imaging investigations in infective endocarditis: Current approach and perspectives.”. Archives of Cardiovascular Diseases [En ligne]. 2013. Vol. 106, n°1, p. 52-62. Disponible sur : < http://dx.doi.org/10.1016/j.acvd.2012.09.004 >
    Résumé : Summary Infective endocarditis is a serious disease that needs rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Echocardiography plays a key role in the management of the disease but may be limited in some clinical situations. Moreover, this method is insensitive for very early detection of the infection and assessment of therapeutic response because it does not provide imaging at the molecular and cellular levels. Recently, several novel morphological, molecular and hybrid imaging modalities have been investigated in infective endocarditis and offer new perspectives for better management of the disease.
    Mots-clés : Computed tomography, Échocardiographie, Echocardiography, Endocardite, endocarditis, Imagerie, Imagerie par résonance magnétique nucléaire, Imaging, Magnetic Resonance Imaging, Positron emission tomography, Tomodensitométrie, Tomographie par émission de positons.

2012

Journal Article

  • AMABILE N., JACQUIER A., SHUHAB A., GAUDART J., BARTOLI J. - M., PAGANELLI F., MOULIN G. “Incidence, predictors, and prognostic value of intramyocardial hemorrhage lesions in ST elevation myocardial infarction.”. Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions [En ligne]. 2012. Vol. 79, n°7, p. 1101-1108. Disponible sur : < http://dx.doi.org/10.1002/ccd.23278 > (consulté le no date)
    Résumé : BACKGROUND: Intra myocardial hemorrhage lesions (IMH) are underdiagnosed complication of ST elevation myocardial infarction (STEMI). We sought to determine the incidence, predictors and the prognostic value of IMH in STEMI using cardiac MR imaging (CMR) techniques. METHODS: We screened for inclusion consecutive patients with STEMI treated by percutaneous coronary intervention (PCI) within the first 12 hr of evolution. IMH lesions were identified on T2-weighted sequences on CMR between days 4 and 8 after PCI. Adverse cardiac events were defined as a composite of death + severe ventricular arrhythmias + acute coronary syndrome + acute heart failure. RESULTS: N = 114 patients were included and n = 11 patients (10%) presented IMH lesions. Patients with IMH lesions had a larger myocardial infarction extent (25.6 ± 1.8 vs. 13.5 ± 1.0 % LV mass, P < 0.01), microvascular obstructive lesions extent (4.6 ± 1.0 vs. 1.3 ± 0.3% LV mass, P < 0.01) and lower LV ejection fraction (40.7 ± 2.3% vs. 50.7 ± 1.3%, P < 0.01). The value of glycemia at admission was an independent predictor of IMH development (Odd ratio 1.8 [1.1-2.8] per mmol l(-1), P = 0.01). The incidence of adverse cardiac events was higher in the IMH group than in the non-IMH group during the first year following STEMI (P = 0.01, log-rank analysis). Cox regression analysis identified the presence of IMH lesions as an independent predictor of adverse clinical outcome (Hazard Ratio = 2.8 [1.2-6.8], P = 0.02). CONCLUSION: Our study indicates that IMH is a rare but severe finding in STEMI, associated with a larger myocardial infarction and a worse clinical outcome. Per-PCI glycemia might influence IMH development.
    Mots-clés : Angioplasty, Balloon, Coronary, Cardiovascular Diseases, Chi-Square Distribution, France, Hemorrhage, Hyperglycemia, Incidence, Kaplan-Meier Estimate, Logistic Models, Magnetic Resonance Imaging, Cine, Multivariate Analysis, Myocardial Infarction, Myocardium, Odds Ratio, Predictive Value of Tests, Proportional Hazards Models, Risk Assessment, Risk Factors.

  • BUN S. - S., KOBER F., JACQUIER A., ESPINOSA L., KALIFA J., BONZI M. - F., KOPP F., LALEVEE N., ZAFFRAN S., DEHARO J. - C., COZZONE P. J., BERNARD M. “Value of in vivo T2 measurement for myocardial fibrosis assessment in diabetic mice at 11.75 T.”. Investigative radiology [En ligne]. 2012. Vol. 47, n°5, p. 319-323. Disponible sur : < http://dx.doi.org/10.1097/RLI.0b013e318243e062 > (consulté le no date)
    Résumé : OBJECTIVE: The aim of the study was to assess the value of in vivo T2 measurements to noninvasively quantify myocardial fibrosis in diabetic mice at 11.75 T. Diabetic cardiomyopathy is characterized by extracellular matrix alteration and microcirculation impairment. These conditions might provide electrical heterogeneity, which is a substrate for arrhythmogenesis. T1 mapping has been proposed to quantify diffuse myocardial fibrosis in cardiac diseases but has several limitations. T2 measurement may represent an alternative for fibrosis quantification at high magnetic field. MATERIALS AND METHODS: A magnetic resonance imaging protocol including in vivo T2 measurements at 11.75 T was performed in 9 male C57BL/6J mice after 8 weeks of streptozotocin-induced diabetes and in 9 control mice. Programmed ventricular stimulation was performed in both groups. T2 measurements were compared with histologic quantification of fibrosis using picrosirius red staining. RESULTS: Myocardial T2 was significantly lower in diabetic mice (13.8 ± 2.8 ms) than in controls (18.9 ± 2.3 ms, P < 0.001). There was a good correlation between T2 and fibrosis area obtained by histopathology (R = 0.947, P < 0.001). During programmed ventricular stimulation, 3 nonsustained ventricular tachycardias were induced in diabetic mice versus none in the control group. CONCLUSIONS: The in vivo T2 relaxation time strongly correlated with myocardial fibrosis area assessed with histologic staining in diabetic mice.
    Mots-clés : Animals, crmbm, Diabetes Mellitus, Experimental, Endomyocardial Fibrosis, Magnetic Resonance Imaging, Male, Mice, Mice, Inbred C57BL, Reproducibility of Results, Sensitivity and Specificity, Streptozocin.

  • CASSAGNEAU P., JACQUIER A., GIORGI R., AMABILE N., GAUBERT J. - Y., COHEN F., MULLER C., JOLIBERT M., LOUIS G., VAROQUAUX A., VIDAL V., BARTOLI J. - M., MOULIN G. “Prognostic value of preoperative coronary computed tomography angiography in patients treated by orthotopic liver transplantation.”. European journal of gastroenterology & hepatology [En ligne]. 2012. Vol. 24, n°5, p. 558-562. Disponible sur : < http://dx.doi.org/10.1097/MEG.0b013e3283522df3 > (consulté le no date)
    Résumé : OBJECTIVES: The aim of this study was to assess the feasibility of 64-slice coronary computed tomography (CT) angiography in patients treated by orthotopic liver transplantation, and to compare prognostic values of CT angiography and dobutamine stress echocardiography in the same population. METHODS: Eighty-two consecutive patients, without known coronary artery disease, who underwent orthotopic liver transplantation, were included in this study. A CT angiography was performed along with usual explorations including dobutamine stress echography. A one-year minimal follow-up was performed to seek cardiac events. RESULTS: Fifty-two (65.8%) patients underwent a CT angiography. Thirty-seven (71%) were totally normal or showed nonobstructive coronary plaque, six (12%) showed at least one obstructive coronary plaque greater than 50%. Nine (17%) of the examined patients had at least one nonassessable segment. A total of six (7.6%) major cardiac events occurred in a mean-time follow-up of 17.8 ± 12.7 months. CONCLUSION: CT angiography that is normal or with a nonobstructive coronary plaque has a negative predicting value of 95% [0.82-0.99] for major cardiac adverse events, and of 100% [0.91-1] for clinical coronary events in patients undergoing orthotopic liver transplantation. The prognostic value of CT angiography was comparable with that of dobutamine stress echography.
    Mots-clés : Coronary Angiography, Coronary Artery Disease, Echocardiography, Stress, Feasibility Studies, Liver Diseases, Liver Transplantation, Predictive Value of Tests, Tomography, X-Ray Computed.

  • DAUMAS A., ROSSI P., JACQUIER A., GRANEL B. “Myopericarditis revealing giant cell arteritis in the elderly.”. The Journal of rheumatology [En ligne]. 2012. Vol. 39, n°3, p. 665-666. Disponible sur : < http://dx.doi.org/10.3899/jrheum.110934 > (consulté le no date)
    Mots-clés : Acute Disease, Aged, Biopsy, Comorbidity, Echocardiography, Electrocardiography, Giant Cell Arteritis, Humans, Magnetic Resonance Imaging, Male, Myocarditis, Temporal Arteries.

  • FLAVIAN A., CARTA F., THUNY F., BERNARD M., KOBER F., MOULIN G., VAROQUAUX A., JACQUIER A. “Cardiac MRI in the diagnosis of complications of myocardial infarction.”. Diagnostic and interventional imaging [En ligne]. 2012. Vol. 93, n°7-8, p. 578-585. Disponible sur : < http://dx.doi.org/10.1016/j.diii.2012.05.012 > (consulté le no date)
    Résumé : The improvement in revascularization techniques and medicine treatment during infarction has substantially reduced mortality during the acute phase of this condition. Since the advent of kinetic sequences and the concomitant development of gadolinium chelates and delayed enhancement sequences, cardiac MRI has become the second-line reference examination for ischemic heart disease. The technique of delayed enhancement with the inversion recovery sequence performed after injection has been validated for numerous indications in ischemic disease. Delayed enhancement sequences make it possible in particular to look for "no-reflow" areas (microvascular obstructions), to quantify the infarction area, and to assess prognosis. MRI also allows us to define the area at risk, that is, the area with edema, and to look for and assess the mechanical complications of the infarction. The aim of this review is to summarize current knowledge about: the pharmacokinetic principles that regulate myocardial enhancement; the different sequences available to acquire delayed enhancement images, and; the value of cardiac MRI in the diagnosis of complications of myocardial infarction.
    Mots-clés : Cardiac Imaging Techniques, crmbm, Heart Diseases, Humans, Magnetic Resonance Imaging, Myocardial Infarction.

  • GABORIT B., KOBER F., JACQUIER A., MORO P. J., CUISSET T., BOULLU S., DADOUN F., ALESSI M. - C., MORANGE P., CLÉMENT K., BERNARD M., DUTOUR A. “Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat.”. International journal of obesity (2005) [En ligne]. 2012. Vol. 36, n°3, p. 422-430. Disponible sur : < http://dx.doi.org/10.1038/ijo.2011.117 > (consulté le no date)
    Résumé : OBJECTIVE: To assess epicardial fat volume (EFV), myocardial TG content (MTGC) and metabolic profile in severely obese patients, and to determine whether ectopic fat depots are linked to metabolic disorders or myocardial function. RESEARCH DESIGN AND METHODS: Sixty-three subjects with normal LV function and no coronary artery disease, including 33 lean (BMI: 21.4 ± 2.0 kg m(-2)) and 30 obese (BMI: 41.8 ± 6 kg m(-2)) patients, underwent 3-T cardiovascular MRI, and anthropometric, biological and visceral abdominal fat (VAT) assessments. EFV was measured by short-axis slice imaging and myocardial (intra-myocellular) TG content was measured by proton magnetic resonance spectroscopy. RESULTS: EFV and MTGC were positively correlated (r=0.52, P<0.0001), and were both strongly correlated with age, BMI, waist circumference and VAT, but not with severity of obesity. EFV and MTGC were significantly higher in obese patients than in lean controls (141 ± 18 versus 79 ± 7 ml, P=0.0001; 1.0 ± 0.1 versus 0.6 ± 0.1%, P=0.01, respectively), but some differences were found between the two cardiac depots: EFV was higher in diabetic obese subjects as compared with that in non-diabetic obese subjects (213 ± 34 versus 141 ± 18 ml, P=0.03), and was correlated with parameters of glucose tolerance (fasting plasma glucose, insulin and HOMA-IR), whereas MTGC was not. EFV and MTGC were both associated with parameters of lipid profile or inflammation (TGs, CRP). Remarkably, this was VAT-dependent, as only VAT remained independently associated with metabolic parameters (P<0.01). Concerning myocardial function, MTGC was the only parameter independently associated with stroke volume (β=-0.38, P=0.01), suggesting an impact of cardiac steatosis in cardiac function. CONCLUSIONS: These data show that VAT dominates the relationship between EFV, MTGC and metabolic measures, and uncover specific partitioning of cardiac ectopic lipid deposition.
    Mots-clés : Adult, crmbm, Diabetes Mellitus, Type 2, Female, Humans, Intra-Abdominal Fat, Lipid Metabolism, Magnetic Resonance Spectroscopy, Male, Metabolome, Obesity, Morbid, Pericardium, Triglycerides, Ventricular Dysfunction, Left.

  • GABORIT B., JACQUIER A., KOBER F., ABDESSELAM I., CUISSET T., BOULLU-CIOCCA S., EMUNGANIA O., ALESSI M. - C., CLÉMENT K., BERNARD M., DUTOUR A. “Effects of bariatric surgery on cardiac ectopic fat: lesser decrease in epicardial fat compared to visceral fat loss and no change in myocardial triglyceride content.”. Journal of the American College of Cardiology [En ligne]. 2012. Vol. 60, n°15, p. 1381-1389. Disponible sur : < http://dx.doi.org/10.1016/j.jacc.2012.06.016 > (consulté le no date)
    Résumé : OBJECTIVES: This study investigated the effect of bariatric surgery (BS)-induced weight loss on cardiac ectopic fat using 3T magnetic resonance imaging in morbid obesity. BACKGROUND: Heart disease is one of the leading causes of mortality and morbidity in obese patients. Deposition of cardiac ectopic fat has been related to increased heart risk. Whether sustained weight loss can modulate epicardial fat or myocardial fat is unknown. METHODS: Twenty-three morbidly obese patients underwent 1H-magnetic resonance spectroscopy to determine myocardial triglyceride content (MTGC), magnetic resonance imaging to assess epicardial fat volume (EFV), cardiac function, and computed tomography visceral abdominal fat (VAF) measurements at baseline and 6 months after BS. RESULTS: The BS reduced body mass index significantly, from 43.1±4.5 kg/m2 to 32.3±4.0 kg/m2, subcutaneous fat from 649±162 cm2 to 442±127 cm2, VAF from 190±83 cm2 to 107±44 cm2, and EFV from 137±37 ml to 98±25 ml (all p<0.0001). There was no significant change in MTGC: 1.03±0.2% versus 1.1±0.2% (p=0.85). A significant reduction in left ventricular mass (118±24 g vs. 101±18 g) and cardiac output (7.1±1.6 l/min vs. 5.4±1.0 l/min) was observed and was statistically associated with weight loss (p<0.05). The loss in EFV was limited (-27±11%) compared to VAF diminution (-40±19%). The EFV variation was not correlated with percentage of body mass index or VAF loss (p=0.007). The ratio of %EFV to %VAF loss decreased with sleep apnea syndrome (1.34±0.3 vs. 0.52±0.08, p<0.05). CONCLUSIONS: Six-month BS modulates differently cardiac ectopic fat deposition, with a significant decrease in epicardial fat and no change in myocardial fat. Epicardial fat volume loss was limited in patients with sleep apnea. (Impact of Bariatric Surgery on Epicardial Adipose Tissue and on Myocardial Function; NCT01284816).
    Mots-clés : Adult, Bariatric Surgery, Body Mass Index, crmbm, Female, Follow-Up Studies, Heart Diseases, Humans, Intra-Abdominal Fat, Lipid Metabolism, Magnetic Resonance Imaging, Cine, Magnetic Resonance Spectroscopy, Male, Myocardium, Obesity, Morbid, Pericardium, Retrospective Studies, Risk Factors, Tomography, X-Ray Computed, Triglycerides.

  • GABORIT B., KOBER F., JACQUIER A., MORO P. J., FLAVIAN A., QUILICI J., CUISSET T., SIMEONI U., COZZONE P., ALESSI M. - C., CLÉMENT K., BERNARD M., DUTOUR A. “Epicardial fat volume is associated with coronary microvascular response in healthy subjects: a pilot study.”. Obesity (Silver Spring, Md.) [En ligne]. 2012. Vol. 20, n°6, p. 1200-1205. Disponible sur : < http://dx.doi.org/10.1038/oby.2011.283 > (consulté le no date)
    Résumé : Epicardial fat (EF) is an active ectopic fat depot, which has been associated with coronary atherosclerosis, and which could early influence endothelial function. We thus investigated the relationship between EF and endothelium-dependent vasoreactivity of the coronary microcirculation, in highly selected healthy volunteers. Myocardial blood flow (MBF) was determined by measuring coronary sinus flow with velocity-encoded cine magnetic resonance imaging (MRI) at 3T. We measured MBF at baseline and in response to sympathetic stimulation by cold pressor testing (CPT) in 30 healthy volunteers with normal left ventricular (LV) function (age 22 ± 4 years, BMI = 21.3 ± 2.8 kg/m(2)). EF volume was volumetrically assessed by manual delineation on short-axis views. CPT was applied by immersing one foot in ice water for 4 min. Mean EF volume was 56 ± 26 ml and mean LV mass 100 ± 28 g. CPT significantly increased heart rate (HR) by 32 ± 19%, systolic blood pressure by 14 ± 10%, and rate-pressure product by 45 ± 25%, P < 0.0001. The increase in HR, reflecting sympathetic stimulation, was not influenced by sex, age or EF volume. CPT induced a decrease in coronary vascular resistance (135 ± 72 vs. 100 ± 42 mm Hg.ml(-1).min.g, P = 0.0006), and a significant increase in MBF (0.81 ± 0.37 vs. 1.24 ± 0.56 ml.min(-1).g(-1), P < 0.0001). Interestingly, we found a significant negative correlation between EF volume and ΔMBF (r= - 0.40, P = 0.03), which remained significant after adjusting for ΔHR. ΔMBF was also associated with adiponectin (r = 0.41, P = 0.046), but not with waist circumference, BMI, C-reactive protein, lipid or glycemic parameters. In multivariate analysis, adiponectin and EF volume remained both independently associated with ΔMBF. A high EF amount is associated with a lower coronary microvascular response, suggesting that EF could early influence endothelial function.
    Mots-clés : Adolescent, Adult, Blood Pressure, Cold Temperature, Coronary Artery Disease, Coronary Circulation, Coronary Vessels, crmbm, Endothelium, Vascular, Female, Humans, Male, Microcirculation, Pilot Projects, Reproducibility of Results, Ventricular Function, Left, Young Adult.

  • PEYROL M., SBRAGIA P., ORABONA M., CASALTA A. - C., LAINE M., DECOURT A., QUATRE A., JACQUIER A., SIDDO N. D., PAGANELLI F. “Ventricular allorhythmia during infarct-related ventricular tachycardia.”. Journal of electrocardiology [En ligne]. 2012. Vol. 45, n°4, p. 394-397. Disponible sur : < http://dx.doi.org/10.1016/j.jelectrocard.2012.02.006 > (consulté le no date)
    Résumé : Ventricular allorhythmia is an electrocardiogram feature leading to a pattern of "regularly irregular" arrhythmia mainly reported during non-life-threatening organized atrial tachycardia. We report the infrequent case of a patient presenting with ventricular allorhythmia during infarct-related ventricular tachycardia. The potential mechanisms of this tachycardia are discussed.
    Mots-clés : Aged, Electrocardiography, Electrophysiologic Techniques, Cardiac, Humans, Male, Myocardial Infarction, Tachycardia, Ventricular, Ventricular Function.

2011

Journal Article

  • JACQUIER A., KOBER F., BUN S., GIORGI R., COZZONE P. J., BERNARD M. “Quantification of myocardial blood flow and flow reserve in rats using arterial spin labeling MRI: comparison with a fluorescent microsphere technique.”. NMR in biomedicine [En ligne]. 2011. Vol. 24, n°9, p. 1047-1053. Disponible sur : < http://dx.doi.org/10.1002/nbm.1645 > (consulté le no date)
    Résumé : To quantify noninvasively myocardial blood flow (MBF) and MBF reserve in isoflurane-anesthetized rats using the Look-Locker flow-alternating inversion recovery gradient-echo arterial spin labeling technique (LLFAIRGE-ASL), and to compare the results with the fluorescent microsphere (FM) technique. Male Wistar rats (weight = 200-240 g, n = 21) were anesthetized with 2.0% isoflurane. Hemodynamic parameters were recorded. In seven rats, MBF was assessed on a Bruker Biospec 4.7T MR system using an ECG- and respiration-gated LLFAIRGE-ASL (pixel size = 234 × 468µm(2) , TE = 1.52ms) at rest and during adenosine infusion (140 µg/kg/min). A mixture of 200 000 FM was injected into a second group of rats at rest and during adenosine infusion (n = 7 each), under similar physiologic conditions. Hearts and skeletal muscle samples were processed for fluorescence spectroscopy. Two-tailed unpaired, paired Student's t-test and ANOVA were used to compare groups. MBF measured with LLFAIRGE-ASL was 5.2 ± 1.0 mL/g/min at rest and 13.3 ± 3.0 mL/g/min during adenosine infusion. Results obtained with fluorescent microspheres yielded 5.9 ± 2.3 mL/g/min (nonsignificant vs. LLFAIRGE-ASL, p = 0.9) at rest and 13.1 ± 2.1 mL/g/min (nonsignificant vs. LLFAIRGE-ASL, p = 0.4) during adenosine infusion. Myocardial blood flow reserve measured using LLFAIRGE-ASL and FM were not significantly different (2.5 ± 0.6 vs. 2.4 ± 0.9, respectively; p = 0.8). Hemodynamic parameters during the experiments were not different between the groups. The myocardial blood flow reserve determined under isoflurane anesthesia was 2.5 ± 0.6, which was not different from the value obtained with FM. LLFAIRGE-ASL provided MBF maps with high spatial resolution in rats under isoflurane anesthesia. LLFAIRGE-ASL is a noninvasive measure to assess myocardial blood flow reserve and provides an interesting tool for cardiovascular research.
    Mots-clés : Adenosine, Animals, Arteries, Coronary Circulation, crmbm, Fluorescence, Heart, Heart Ventricles, Hemodynamics, Magnetic Resonance Imaging, Magnetic Resonance Imaging, Cine, Male, Microspheres, Myocardium, Rats, Rats, Sprague-Dawley, Spin Labels, Ventricular Function.

  • JACQUIER A., PROST C., AMABILE N., GIORGI R., FLAVIAN A., GAUBERT J. - Y., VAROQUAUX A., PAGANELLI F., BARTOLI J. - M., MOULIN G. “Gadolinium chelate kinetics in cardiac MR imaging of myocarditis: comparison to acute myocardial infarction and impact on late gadolinium enhancement.”. Investigative radiology [En ligne]. 2011. Vol. 46, n°11, p. 705-710. Disponible sur : < http://dx.doi.org/10.1097/RLI.0b013e31822b049d > (consulté le no date)
    Résumé : OBJECTIVES: To compare the kinetics of gadolinium in myocarditis and myocardial infarction and to establish the best interval between contrast injection and late gadolinium-enhanced (LGE) image acquisition for the diagnosis of acute myocarditis. METHODS: Seventeen patients with acute myocarditis and 12 with acute myocardial infarction underwent Look-Locker sequences before and after administration of 0.2 mmol/kg gadolinium chelate for a period of 14 minutes. The apparent longitudinal relaxation rates (R'1) were calculated from left ventricular blood, enhanced and normal myocardium. LGE cardiac magnetic resonance images were acquired at 5, 10, and 15 minutes after contrast injection. The contrast between enhanced and normal myocardium (Contrastenhaced-normal) was measured, and the quality of the images was analyzed. RESULTS: A faster decline in the R'1 values measured in the areas of myocardial enhancement was recorded in myocarditis than that in myocardial infarction. In myocarditis, the Contrastenhaced-normal values decreased over time (from 60.7 ± 35.1 at 5 minutes vs. 42.1 ± 26.7 at 15 minutes; P = 0.001). However, in myocardial infarction, the Contrastenhaced-normal value remained stable in time (60.7 ± 22.9 at 5 minutes vs. 68.8 ± 16.6 at 15 minutes; P = ns). CONCLUSION: The gadolinium kinetics of acute myocarditis are different from those of acute myocardial infarction. In myocarditis, LGE images acquired 5 minutes after contrast injection provide higher Contrastenhaced-normal and better image quality compared with images taken at later points.
    Mots-clés : Acute Disease, Chi-Square Distribution, Contrast Media, Meglumine, Myocardial Infarction, Myocarditis, Organometallic Compounds.

  • JOLIBERT M., VIDAL V., COHEN F., BARTOLI J. - M., MOULIN G., JACQUIER A., GAUBERT J. - Y. “[Improvement of pulmonary angiography in the framework of a maintenance of certification].”. Journal de radiologie [En ligne]. 2011. Vol. 92, n°1, p. 20-24. Disponible sur : < http://dx.doi.org/10.1016/j.jradio.2010.08.001 > (consulté le no date)
    Résumé : PURPOSE: This evaluation of clinical practices (pulmonary embolus) was performed to evaluate the quality of CT pulmonary angiograms for suspected acute pulmonary embolus. MATERIALS AND METHODS: Five validated criteria evaluating both the acquisition technique and the quality of image interpretation were selected: slice thickness, pulmonary arterial enhancement over 250 HU, caudocranial acquisition, visualization of fifth order pulmonary arterial branches, and right-left ventricular ratio in the presence of pulmonary embolus. Forty CT pulmonary angiograms were reviewed before and after implementation of a practice quality improvement program: modification of acquisition protocol, training of medical and paramedical staff, and implementation of a standardized radiology report. RESULTS: Thin collimation was already implemented. The implementation of two other technical parameters significantly improved the technical quality of the examinations. The detection of findings with adverse clinical outcome was also significantly improved. Only the accuracy of detection of embolus involving fifth order pulmonary arterial branches could not be improved, a criteria allowing formal exclusion of pulmonary embolus. CONCLUSION: This study resulted in an improvement in the quality of CT pulmonary angiograms and increased awareness of radiologists for the prognostic value of right ventricular dilatation. It has also underscored the need for quality control of a CT pulmonary angiogram prior to interpretation.
    Mots-clés : Angiography, Clinical Competence, Pulmonary Embolism, Tomography, X-Ray Computed.

  • MORO P. - J., FLAVIAN A., JACQUIER A., KOBER F., QUILICI J., GABORIT B., BONNET J. - L., MOULIN G., COZZONE P. J., BERNARD M. “Gender differences in response to cold pressor test assessed with velocity-encoded cardiovascular magnetic resonance of the coronary sinus.”. Journal of cardiovascular magnetic resonance: official journal of the Society for Cardiovascular Magnetic Resonance [En ligne]. 2011. Vol. 13, p. 54. Disponible sur : < http://dx.doi.org/10.1186/1532-429X-13-54 > (consulté le no date)
    Résumé : BACKGROUND: Gender-specific differences in cardiovascular risk are well known, and current evidence supports an existing role of endothelium in these differences. The purpose of this study was to assess non invasively coronary endothelial function in male and female young volunteers by myocardial blood flow (MBF) measurement using coronary sinus (CS) flow quantification by velocity encoded cine cardiovascular magnetic resonance (CMR) at rest and during cold pressor test (CPT). METHODS: Twenty-four healthy volunteers (12 men, 12 women) underwent CMR in a 3 Tesla MR imager. Coronary sinus flow was measured at rest and during CPT using non breath-hold velocity encoded phase contrast cine-CMR. Myocardial function and morphology were acquired using a cine steady-state free precession sequence. RESULTS: At baseline, mean MBF was 0.63 ± 0.23 mL·g⁻¹·min⁻¹ in men and 0.79 ± 0.21 mL·g⁻¹·min⁻¹ in women. During CPT, the rate pressure product in men significantly increased by 49 ± 36% (p < 0.0001) and in women by 52 ± 22% (p < 0.0001). MBF increased significantly in both men and women by 0.22 ± 0.19 mL·g⁻¹·min⁻¹ (p = 0.0022) and by 0.73 ± 0.43 mL·g⁻¹·min⁻¹ (p = 0.0001), respectively. The increase in MBF was significantly higher in women than in men (p = 0.0012). CONCLUSION: CMR coronary sinus flow quantification for measuring myocardial blood flow revealed a higher response of MBF to CPT in women than in men. This finding may reflect gender differences in endothelial-dependent vasodilatation in these young subjects. This non invasive rest/stress protocol may become helpful to study endothelial function in normal physiology and in physiopathology.
    Mots-clés : Adolescent, Adult, Blood Flow Velocity, Blood Pressure, Cold Temperature, Coronary Circulation, Coronary Sinus, crmbm, Endothelium, Vascular, Female, France, Hand, Heart Rate, Humans, Immersion, Magnetic Resonance Imaging, Cine, Male, Myocardial Perfusion Imaging, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Sex Factors, Ventricular Function, Left, Young Adult.

  • VIALLON M., JACQUIER A., ROTARU C., DELATTRE B. M. A., MEWTON N., VINCENT F., CROISILLE P. “Head-to-head comparison of eight late gadolinium-enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: from bench to bedside.”. Journal of magnetic resonance imaging: JMRI [En ligne]. 2011. Vol. 34, n°6, p. 1374-1387. Disponible sur : < http://dx.doi.org/10.1002/jmri.22783 > (consulté le no date)
    Résumé : PURPOSE: To compare-theoretically and experimentally-clinically available two-dimensional/three-dimensional (2D/3D), breathhold and non-breathhold, inversion-recovery (IR) gradient-echo (GRE) sequences used to differentiate between nonviable injured and normal myocardium with late gadolinium-enhanced techniques (IR-GRE2D sequence is used as a reference), and to evaluate their respective clinical benefit. MATERIALS AND METHODS: Six breathhold (2D-IR-GRE, 3D-IR-GRE, balanced steady-state free precession 2D-IR-bSSFP and 3D-IR-bSSFP, phase-sensitive 2D-PSIR-GRE, and 2D-PSIR-bSSFP) and two non-breathhold late gadolinium-enhanced techniques (single-shot 2D-ssbSSFP and 2D-PSIR-ssbSSFP) were consecutively performed in 32 coronary artery disease patients with chronic myocardial infarction. Qualitative assessment and manual planimetry were performed by two independent observers. Quantitative assessment was based on percentage signal intensity elevation between injured and normal myocardium and contrast-to-noise ratio. Theoretical simulations were compared with experimental measurements performed on phantoms with various concentrations of gadolinium. RESULTS: The 3D-IR-GRE image quality appeared better than the other 2D and 3D sequences, showing better delineation of complex nontransmural lesions, with significantly higher percentage signal intensity and contrast-to-noise ratio. PSIR techniques appeared more limited in differentiating sub-endocardial lesions and intracavity blood pool, but in all other cases were comparable to the other techniques. Single-shot PSIR-ssbSSFP appeared to be a valuable alternative technique when breathhold cannot be achieved. CONCLUSION: We recommend 3D-IR-GRE as the method of choice for late gadolinium-enhanced cardiac magnetic resonance imaging in clinical practice.
    Mots-clés : Gadolinium, Myocardial Infarction, Myocardium, Observer Variation, Phantoms, Imaging.

  • VIDAL V., JACQUIER A., GIORGI R., PINEAU S., MOULIN G., PETIT P., GIRARD N., BARTOLI J. - M., GORINCOUR G. “[Radiology as seen by medical students].”. Journal de radiologie [En ligne]. 2011. Vol. 92, n°5, p. 393-404. Disponible sur : < http://dx.doi.org/10.1016/j.jradio.2011.02.025 > (consulté le no date)
    Résumé : PURPOSE: To determine the impact of exposing medical students to medical imaging during the first year of the second cycle of medical school (DCEM1) on their perception of this medical specialty and the acquisition of its basic concepts. MATERIALS AND METHODS: All students in the 2007-2008 graduation class entering into the first year of the second cycle of medical school were anonymously enrolled into this project that included pre-rotation and post-rotation questionnaires, theory classes followed by clinical rotations with clearly predetermined objectives. RESULTS: A total of 108 students were enrolled, with 70% being females. The parents of the students had a medical or paramedical profession in 46.3% of cases. Before the rotation, 61.6% of students perceived a difference between a hospital-based practice and private practice. Fifty-two percent of students had a clear idea of their professional future prior to the rotation. Five students (4.7%) believed prior to the rotation that it might have an impact on their professional future, versus 63% after the rotation (P<0.0001). The students whose parents work in the medical or paramedical field do not have a better defined idea of their professional future; on the other hand, they have more interest for radiology (73.6% with high or very high interest versus 52.8%, P=0.03). After the rotation, there was a significant increase in the number of students with high or very high interest for radiology (77.8% versus 66.7%, P=0.023). A student noted that he would redirect his career to radiology. There was also a significant increase in the number of students perceiving a difference between a hospital-based practice and private practice (82.2% versus 61.6%, P=0.003). With regards to radiology knowledge before and after the rotation, there was a significant increase of mean scores (P<0.001). Eighty-eight percent of students were satisfied or very satisfied with the radiology rotation. Overall, the students believe that 70% of the objectives were achieved. The only criticism from the students was that the clinical instructors were overworked. CONCLUSION: Early exposure of medical students to radiology increases their level of interest for the specialty and increases the perception of differences between a hospital-based practice and private practice. The overall knowledge of students about radiology was improved, but the workload of clinical instructors impaired the quality of the rotation.
    Mots-clés : Attitude, Education, Medical, Radiology, Students, Medical.

2010

Journal Article

  • AMABILE N., JACQUIER A., GAUDART J., SARRAN A., SHUAIB A., PANUEL M., MOULIN G., BARTOLI J. - M., PAGANELLI F. “Value of a new multiparametric score for prediction of microvascular obstruction lesions in ST-segment elevation myocardial infarction revascularized by percutaneous coronary intervention.”. Archives of cardiovascular diseases [En ligne]. 2010. Vol. 103, n°10, p. 512-521. Disponible sur : < http://dx.doi.org/10.1016/j.acvd.2010.09.005 > (consulté le no date)
    Résumé : BACKGROUND: Despite improvement in revascularization strategies, microvascular obstruction (MO) lesions remain associated with poor outcome after ST-segment elevation myocardial infarction (STEMI). AIMS: To establish a bedside-available score for predicting MO lesions in STEMI, with cardiac magnetic resonance imaging (CMR) as the reference standard, and to test its prognostic value for clinical outcome. METHODS: Patients with STEMI of<12 hours' evolution treated by percutaneous coronary intervention (PCI) were included. CMR was performed 4-8 days later, to measure myocardial infarction (MI) extent, left ventricular ejection fraction (LVEF) and volumes, and to identify MO lesions. An MO score was built from multivariable logistic regression results and included clinical, angiographic and electrocardiographic criteria. Adverse cardiovascular events were recorded prospectively after STEMI. RESULTS: We analysed data from 112 patients. MO lesions were found in 63 (56%) patients and were associated with larger MI as assessed by higher peak creatine phosphokinase (3755 ± 351 vs 1467 ± 220 IU, p<0.001), lower LVEF (46.7 ± 1.5 vs 53.4 ± 1.6%, p<0.01) and larger MI extent (18.7 ± 1.2 vs 9.0 ± 1.3% LV, p<0.001) on CMR. MO score>4 accurately identified microcirculatory injuries (sensitivity 84%; specificity 82%) and independently predicted the presence of MO lesions on CMR. MO score>4 predicted adverse cardiovascular events during the first year after STEMI (relative risk 2.60 [1.10-6.60], p=0.03). CONCLUSIONS: MO lesions are frequent in PCI-treated STEMI and are associated with larger MIs. MO score accurately predicted MO lesions and identified patients with poor outcome post-STEMI.
    Mots-clés : Angioplasty, Balloon, Coronary, Biological Markers, Chi-Square Distribution, Coronary Angiography, Coronary Artery Disease, Coronary Circulation, Creatine Kinase, Electrocardiography, France, Health Status Indicators, Kaplan-Meier Estimate, Logistic Models, Magnetic Resonance Imaging, Cine, Microcirculation, Myocardial Infarction, Predictive Value of Tests, Proportional Hazards Models, Risk Assessment, Risk Factors, Severity of Illness Index, Stroke Volume, Ventricular Function, Left.

  • GAUBERT J. - Y., COHEN F., VIDAL V., LOUIS G., MOULIN G., BARTOLI J. - M., JACQUIER A. “[Imaging of mediastinal tumors].”. Revue de pneumologie clinique [En ligne]. 2010. Vol. 66, n°1, p. 17-27. Disponible sur : < http://dx.doi.org/10.1016/j.pneumo.2009.12.011 > (consulté le no date)
    Résumé : Imaging of mediastinal tumors is an important part of the diagnostic workup in patients presenting symptoms suggestive of compression of one or more of the mediastinal components. In other cases, lesions growing within the mediastinum remain asymptomatic and are diagnosed when chest X-ray or CT are routinely performed for other indications. CT remains the most available and reliable tool among the different imaging methods. Due to its permanent technical improvements, it can be used as the one-step answer to all the requirements of the pretherapeutic evaluation of a mediastinal mass. Chest plain film is still needed as the first line examination in order to carefully select the acquisition protocol for CT. MR did not demonstrate any superiority to CT except for the preoperative workup of lesions arising in the posterior part of the mediastinum. MR remains an interesting tool for tissue characterisation. Topography of mediastinal lesions (based upon the definition of mediastinal compartments) is one of the guides through the diagnostic pathway in imaging these tumors. The other one is their main tissue component, so that cystic, fatty and soft tissue masses can be differentiated.
    Mots-clés : Lymphatic Metastasis, Lymphoma, Mediastinal Diseases, Mediastinal Neoplasms, Mediastinum, Neoplasms, Germ Cell and Embryonal, Thymoma, Thymus Neoplasms, Tomography, X-Ray Computed.
  • JACQUIER A., BARTOLI B., FLAVIAN A., VAROQUAUX A., GAUBERT J. Y., COHEN F., VIDAL V., BARTOLI J. M., MOULIN G. “[Delayed myocardial enhancement: Optimizing the MR imaging protocol].”. Journal de radiologie. 2010. Vol. 91, n°5 Pt 2, p. 598-601.
    Résumé : The purpose of this article is to 1) review the basic models characterizing myocardial enhancement on MR and CT, 2) review the main characteristics of available iodinated and Gadolinium-based contrast agents and, 3) review the literature on emerging MR contrast agents to assess myocardial viability. The intensity of enhancement following infarction is the result of two processes: 1) the increased interstitial space (15 + or - 2% in normal myocardium and 80 + or - 3% in necrotic tissue) secondary to cell necrosis and 2) perfusion abnormalities secondary to absent revascularization or impaired microvascularization. The equation described by Kety was used to create models of contrast material kinetics within myocardium or enhancement of the different components of the myocardium (viable myocardium, necrosed myocardium, fibrosis, with no-reflow zone, hibernating or stunned myocardium).
    Mots-clés : Contrast Media, Image Enhancement, Myocardial Infarction.
  • JACQUIER A., REVEL D., CROISILLE P., GAUBERT J. Y., SAEED M. “[Mechanisms of delayed myocardial enhancement and value of MR and CT contrast materials in the evaluation of myocardial viability].”. Journal de radiologie. 2010. Vol. 91, n°7-8, p. 751-757.
    Résumé : The purpose of this article is to present a brief theoretical review of the models characterizing delayed myocardial enhancement applicable to both MR and CT imaging, review the different characteristics of commercially available gadolinium-based and iodinated contrast materials, and summarize the literature on the potential value of dedicated MR imaging contrast currently in development for the diagnosis of myocardial viability. The intensity of myocardial enhancement following infarction is related to two factors: expansion of the interstitial volume (15+/-2% in normal myocardium and 80+/-3% within necrosis) secondary to cell necrosis and perfusion abnormalities due to the absence of revascularization or lesions to the microcirculation. A kinetic model of contrast material properties within myocardium could be constructed from Kety's equation with regards to enhancement within the different myocardial tissues (viable myocardium, necrotic myocardium, fibrosis, no-reflow zones, stunned or hibernating myocardium). This model can be applied to both CT and MR since clinically available contrast agents are extracellular, inert and kinetically comparable. The development of dedicated contrast agents for viability and necrosis or molecular contrast agents open new horizons for preclinical research.
    Mots-clés : Contrast Media, Electrocardiography, Gadolinium, Gadolinium DTPA, Image Enhancement, Injections, Intravenous, Manganese, Models, Cardiovascular, Myocardial Infarction, Myocardial Ischemia, Radiographic Image Enhancement, Tomography, X-Ray Computed.

  • JACQUIER A., THUNY F., JOP B., GIORGI R., COHEN F., GAUBERT J. - Y., VIDAL V., BARTOLI J. M., HABIB G., MOULIN G. “Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction.”. European heart journal [En ligne]. 2010. Vol. 31, n°9, p. 1098-1104. Disponible sur : < http://dx.doi.org/10.1093/eurheartj/ehp595 > (consulté le no date)
    Résumé : AIMS: To describe a method for measuring trabeculated left ventricular (LV) mass using cardiac magnetic resonance imaging and to assess its value in the diagnosis of left ventricular non-compaction (LVNC). METHODS AND RESULTS: Between January 2003 and 2008, we prospectively included 16 patients with LVNC. During the mean period, we included 16 patients with dilated cardiomyopathy (DCM), 16 patients with hypertrophic cardiomyopathy (HCM), and 16 control subjects. Left ventricular volumes, LV ejection fraction, and trabeculated LV mass were measured in the four different populations. The percentage of trabeculated LV mass was almost three times higher in the patients with LVNC (32 +/- 10%), compared with those with DCM (11 +/- 4%, P < 0.0001), HCM (12 +/- 4%, P < 0.0001), and controls (12 +/- 5%, P < 0.0001). A value of trabeculated LV mass above 20% of the global mass of the LV predicted the diagnosis of LVNC with a sensitivity of 93.7% [95% confidence interval (CI), 71.6-98.8%] and a specificity of 93.7% (95% CI, 83.1-97.8%; kappa = 0.84). CONCLUSION: The method described is reproducible and provides an assessment of the global amount of LV trabeculation. A trabeculated LV mass above 20% of the global LV mass is highly sensitive and specific for the diagnosis of LVNC.
    Mots-clés : Heart Ventricles, Isolated Noncompaction of the Ventricular Myocardium, Magnetic Resonance Angiography, Ventricular Dysfunction, Left.
  • MULLER C., JACQUIER A., VAROQUAUX A., COHEN F., LOUIS G., GAUBERT J. Y., MOULIN G., BARTOLI J. M., VIDAL V. “[Urokinase in the management of occluded PICC lines].”. Journal de radiologie. 2010. Vol. 91, n°3 Pt 1, p. 287-291.
    Résumé : PURPOSE: To determine the efficacy and safety of urokinase in the management of occluded PICC lines. MATERIALS AND METHODS: A total of 587 PICC lines were placed over an 11 month period. During this period, 28 PICC lines (4.8%) became occluded: 12 occluded PICC lines were successfully managed by simple flushing with normal saline while 16 PICC lines were thrombolyzed with urokinase. RESULTS: After urokinase, 93.8% (15/16) of occluded PICC lines were completely patent. A single infusion of urokinase, 20,000 IU over 30 minutes, was used in all cases. No secondary occlusion or complication was noted after urokinase. CONCLUSION: Urokinase is effective and safe to restore patency to occluded PICC lines. The procedure is simple, and could be performed at the bedside by nursing staff after medical prescription. It is an alternative to over the wire PICC line exchange, that could reduce the risk of complication related to manipulations, patient discomfort and cost.
    Mots-clés : Catheterization, Central Venous, Catheterization, Peripheral, Catheters, Indwelling, Equipment Design, Fibrinolytic Agents, Polyurethanes, Safety, Silicones, Sodium Chloride, Thrombosis, Urokinase-Type Plasminogen Activator.

  • THUNY F., JACQUIER A., JOP B., GIORGI R., GAUBERT J. - Y., BARTOLI J. - M., MOULIN G., HABIB G. “Assessment of left ventricular non-compaction in adults: side-by-side comparison of cardiac magnetic resonance imaging with echocardiography.”. Archives of cardiovascular diseases [En ligne]. 2010. Vol. 103, n°3, p. 150-159. Disponible sur : < http://dx.doi.org/10.1016/j.acvd.2010.01.002 > (consulté le no date)
    Résumé : BACKGROUND: Two-dimensional echocardiography images obtained at end-diastole and end-systole and cardiac magnetic resonance (CMR) images obtained at end-diastole represent the three imaging methodologies validated for diagnosis of left ventricular non-compaction (LVNC). No study has compared these methodologies in assessing the magnitude of non-compaction. AIMS: To compare two-dimensional echocardiography with CMR in the evaluation of patients with suspected LVNC. METHODS: Sixteen patients (48+/-17 years) with LVNC underwent echocardiography and CMR within the same week. Echocardiography images obtained at end-diastole and end-systole were compared in a blinded fashion with those obtained by CMR at end-diastole to assess non-compaction in 17 anatomical segments. RESULTS: All segments could be analysed by CMR, whereas only 238 (87.5%) and 237 (87.1%) could be analysed by echocardiography at end-diastole and end-systole, respectively (p=0.002). Among the analysable segments, a two-layered structure was observed in 54.0% by CMR, 42.9% by echocardiography at end-diastole and 41.4% by echocardiography at end-systole (p=0.006). Similar distribution patterns were observed with the two echocardiographic methodologies. However, compared with echocardiography, CMR identified a higher rate of two-layered structures in the anterior, anterolateral, inferolateral and inferior segments. Echocardiography at end-systole underestimated the NC/C maximum ratio compared with CMR (p=0.04) and echocardiography at end-diastole (p=0.003). No significant difference was observed between CMR and echocardiography at end-diastole (p=0.83). Interobserver reproducibility of the NC/C maximum ratio was similar for the three methodologies. CONCLUSION: CMR appears superior to standard echocardiography in assessing the extent of non-compaction and provides supplemental morphological information beyond that obtained with conventional echocardiography.
    Mots-clés : Isolated Noncompaction of the Ventricular Myocardium, Magnetic Resonance Imaging, Cine.

  • VIDAL V., MONNET O., JACQUIER A., BARTOLI J. - M., TROPIANO P. “Accessory iliac vein: surgical implications.”. Journal of spinal disorders & techniques [En ligne]. 2010. Vol. 23, n°6, p. 398-403. Disponible sur : < http://dx.doi.org/10.1097/BSD.0b013e3181b26c88 > (consulté le no date)
    Résumé : BACKGROUND: One of the main difficulties in using an anterior retroperitoneal approach in prosthetic lumbar disk replacement surgery is the exposure of the anterior aspect of the spine because of the risk of hemorrhage because of vascular injury when the venous structures are mobilized. PURPOSE: The goal of our study was to use computed tomography (CT) to research for anatomic variations of the ileocaval drainage network, which were likely to complicate this type of procedure. DESIGN: Prospective study. PATIENT SAMPLE: Ninety patients (48 males, 42 females) explored between July 2003 and February 2007. OUTCOME MEASURES: Not applicable. METHODS: All the patients had a CT scan before disk replacement surgery to treat degenerative lumbar disk disease by a microinvasive, anterior retroperitoneal approach. RESULTS: Eighteen of 90 patients presented with variations in their iliocaval drainage network: 3 cases of double inferior vena cava, 1 case of duplication of the inferior vena cava, 5 cases of ectopic internal iliac veins, 9 cases of accessory iliac veins. CONCLUSIONS: Anatomical variations in the iliocaval venous drainage system are fairly frequent but easy to analyze by CT. Even if they have no functional impact, they must be analyzed and described because they can be of great interest in the preoperative workup for retroperitoneal lumbar surgery.
    Mots-clés : Iliac Vein, Intervertebral Disc, Intervertebral Disc Degeneration, Lumbar Vertebrae, Spinal Fusion, Vena Cava, Inferior.

2009

Journal Article

  • COHEN F., AMABILE P., VAROQUAUX A., PIQUET P., BARTOLI J. - M., VIDAL V., JACQUIER A. “Endovascular treatment of circumaortic nutcracker syndrome.”. Journal of vascular and interventional radiology: JVIR [En ligne]. 2009. Vol. 20, n°9, p. 1255-1257. Disponible sur : < http://dx.doi.org/10.1016/j.jvir.2009.05.022 > (consulté le no date)
    Mots-clés : Aorta, Blood Vessel Prosthesis, Heart Valve Diseases, Stents, Syndrome.
  • JACQUIER A., GAUBERT J. - Y., AMABILE N., BARTOLI J. - M., MOULIN G. “Coronary MDCT and cardiac MR imaging: a revolution in radiology?”. Le Journal médical libanais. The Lebanese medical journal. 2009. Vol. 57, n°3, p. 167-177.
    Mots-clés : Cardiovascular Diseases, Magnetic Resonance Imaging, Cine, Myocardium, Tomography, X-Ray Computed.

  • LE CORROLLER T., SEBAG F., VIDAL V., JACQUIER A., CHAMPSAUR P., BARTOLI J. M., MOULIN G. “Sonographic diagnosis of a cervical vagal schwannoma.”. Journal of clinical ultrasound: JCU [En ligne]. 2009. Vol. 37, n°1, p. 57-60. Disponible sur : < http://dx.doi.org/10.1002/jcu.20474 > (consulté le no date)
    Résumé : This case report illustrates the role of high-resolution sonography in the preoperative assessment of a schwannoma of the vagus nerve in the neck. Sonography identified the tumor in the right carotid space and determined its origin from the right vagus nerve, facilitating the surgeon's approach to preserve nerve function.
    Mots-clés : Cranial Nerve Neoplasms, Neurilemmoma, Vagus Nerve Diseases.

  • VIDAL V., COHEN F., CASALONGA F., VAROQUAUX A., GAUBERT J. - Y., MOULIN G., BARTOLI J. - M., JACQUIER A. “[Peripherally inserted central catheter: a therapeutic tool].”. Presse médicale (Paris, France: 1983) [En ligne]. 2009. Vol. 38, n°4, p. 663-665. Disponible sur : < http://dx.doi.org/10.1016/j.lpm.2008.10.007 > (consulté le no date)
    Mots-clés : Ambulatory Care, Antineoplastic Agents, Catheterization, Central Venous, Catheterization, Peripheral, Catheters, Indwelling, Cross Infection, Equipment Design, Equipment Failure, Fluoroscopy, Parenteral Nutrition, Home, Parenteral Nutrition, Total, Risk Factors, Thrombosis, Vena Cava, Superior, Venous Cutdown.

2008

Journal Article
  • COHEN F., MONNET O., CASALONGA F., JACQUIER A., VIDAL V., BARTOLI J. M., MOULIN G. “[Nasopharyngeal carcinoma].”. Journal de radiologie. 2008. Vol. 89, n°7-8 Pt 2, p. 956-967.
    Résumé : Nasopharyngeal carcinoma is relatively common. Undifferentiated Carcinomas of Nasopharyngeal Type (UNCT) are endemic Epstein-Barr virus (EBV)-related tumors. They are mainly radiosensitive. The role of imaging is to assess locoregional extension, TNM classification and adjust the radiation fields. MRI is essential to determine the initial extension. CT is useful to confirm the presence of bone involvement and evaluate nodal status. MRI and CT are necessary for the post-treatment follow-up.
    Mots-clés : Nasopharyngeal Neoplasms, Tomography, X-Ray Computed.

  • JACQUIER A., BOUSSEL L., AMABILE N., BARTOLI J. M., DOUEK P., MOULIN G., PAGANELLI F., SAEED M., REVEL D., CROISILLE P. “Multidetector computed tomography in reperfused acute myocardial infarction. Assessment of infarct size and no-reflow in comparison with cardiac magnetic resonance imaging.”. Investigative radiology [En ligne]. 2008. Vol. 43, n°11, p. 773-781. Disponible sur : < http://dx.doi.org/10.1097/RLI.0b013e318181c8dd > (consulté le no date)
    Résumé : OBJECTIVES: (1) To determine the accuracy of delayed enhancement multidetector computed tomography (MDCT) in measuring the extent of acute myocardial infarct and no-reflow areas using cardiac magnetic resonance imaging (MRI) as standard of reference and (2) to define the optimum timing between injection and MDCT image acquisition to characterize infarcted myocardium and no-reflow areas after reperfusion therapy. MATERIALS AND METHODS: Nineteen patients were prospectively included after acute myocardial infarction and revascularization. Each patient had an MDCT acquisition before and 5 and 10 minutes after injection of 1.5 mL/kg iodinated contrast medium, and a contrast-enhanced MRI at 5 and 10 minutes after injection of 0.2 mmol/kg gadolinium chelate. We assessed image quality and infarct extent using MDCT and MRI, and we measured parameters related to iodinated contrast media kinetics (DeltaHU and DeltaHU ratio). RESULTS: The areas of hyperenhanced myocardium located on the MDCT corresponded to the occluded vessel located on the coronary angiogram (kappa = 0.9). There were strong correlations between the extent of hyperenhanced infarcted myocardium on MDCT and MRI at 5 minutes (20.4% +/- 2.7% of left ventricle (LV) and 20.9% +/- 2.4%, respectively, R = 0.85; P < 0.0001) and 10 minutes after injection (21.0% +/- 2.9% of LV and 19.4% +/- 2.5%, respectively, R = 0.80; P < 0.0001). However, the correlation between the area of hypoenhanced myocardium measured using MDCT and CMR 5 minutes after injection (R = 0.86; P < 0.0001) was better than the measurement obtained 10 minutes after injection (R = 0.64; P = 0.002). On contrast-enhanced MDCT, 5 minutes after injection, the signal-to-noise ratio was significantly higher than at 10 minutes after injection in LV blood (28 +/- 1 to 21 +/- 1, respectively; P = 0.0007), normal myocardium (18 +/- 1 to 15 +/- 1; P = 0.0009), and hyperenhanced infarcted myocardium (24 +/- 1 to 20 +/- 1; P = 0.004). MDCT image quality was significantly better at 5 minutes (3.2 +/- 0.1) than at 10 minutes (2.8 +/- 0.2, P = 0.01, kappa = 0.4). The DeltaHU ratio increased slightly but significantly between 5 minutes (0.83 +/- 0.01) and 10 minutes (0.93 +/- 0.01; P = 0.01), suggesting a slow wash-in and wash-out of contrast medium in infarcted myocardium. CONCLUSION: In ST segment elevation myocardial infarction patients contrast-enhanced MDCT is an accurate method for characterizing and sizing myocardial infarct and no-reflow. Contrast-enhanced MDCT performed 5 minutes after injection yields a higher signal-to-noise ratio and image quality than the 10 minutes time point with no difference in the extent of infarct measurement.
    Mots-clés : Myocardial Infarction, No-Reflow Phenomenon, Reperfusion, Tomography, X-Ray Computed.

  • JACQUIER A., BUCKNOR M., DO L., ROBERT P., COROT C., HIGGINS C. B., SAEED M. “P846, a new gadolinium based low diffusion magnetic resonance contrast agent, in characterizing occlusive infarcts, reperfused ischemic myocardium and reperfused infarcts in rats.”. Magma (New York, N.Y.) [En ligne]. 2008. Vol. 21, n°3, p. 207-218. Disponible sur : < http://dx.doi.org/10.1007/s10334-008-0112-8 > (consulté le no date)
    Résumé : OBJECT: This study has two objectives: (1) to compare the kinetics of low diffusion P846 with Gd-DOTA using inversion recovery echo planar (IR-EPI) magnetic resonance (MR) imaging and (2) to determine the potential of P846 in defining myocardial viability in hearts subjected to various injuries using T1-weighted spin echo (T1-SE). MATERIALS AND METHODS: Rats were subjected to (1) occlusive infarcts (n = 16), (2) reperfused ischemic injuries (n = 8) or (3) reperfused infarcts (n = 16). A dose of 0.05 mmol/kg P846 was compared to 0.1 mmol/kg Gd-DOTA. IR-EPI and T1-SE images were obtained during 60 min. T(1), DeltaR(1) and DeltaR(1) ratio were measured on IR-EPI. Infarct extents were evaluated on T1-SE and compared with histochemical staining. RESULTS: Blood DeltaR(1) was higher at 5 min after P846 (6.36 +/- 0.32 s(-1)) than after Gd-DOTA (1.30 +/- 0.14 s(-1); P < 0.001). With P846, occlusive infarcts appeared as a hypoenhanced region surrounded by a hyperenhanced rim that lasted for 60 min. The increase in the DeltaR(1) ratio value was slower after P846 than with Gd-DOTA in the reperfused infarcts, suggesting low diffusion/convection of P846. Gd-DOTA homogenously enhanced both occlusive and reperfused infarcts at 30 min. CONCLUSION: P846 provides better contrast and extended discrimination between occlusive and reperfused infarcts compared with Gd-DOTA. The gadolinium dose could be reduced with P846.
    Mots-clés : Arterial Occlusive Diseases, Contrast Media, Echo-Planar Imaging, Gadolinium DTPA, Myocardial Infarction, Myocardial Reperfusion, Organometallic Compounds, Rats.

  • JACQUIER A., WENDLAND M., DO L., ROBERT P., COROT C., HIGGINS C. B., SAEED M. “MR imaging assessment of the kinetics of P846, a new gadolinium-based MR contrast medium, in ischemically injured myocardium.”. Contrast media & molecular imaging [En ligne]. 2008. Vol. 3, n°3, p. 112-119. Disponible sur : < http://dx.doi.org/10.1002/cmmi.237 > (consulté le no date)
    Résumé : The objectives of the study were: (1) to compare the kinetics of a new gadolinium-based low-diffusibility magnetic resonance (MR) contrast medium, P846 and Gd-DOTA in left ventricular (LV) blood and in normal and ischemically injured myocardium using inversion recovery echo-planar imaging (IR-EPI) and (2) to compare the enhancement pattern after injection of P846 with Gd-DOTA, using T1-weighted spin-echo imaging (T1-SE). Sixteen rats were subjected to left descending artery (LAD) occlusion for 30 min, followed by 2.5 h reperfusion. MR imaging was performed before and after administration of the contrast medium in two different groups of animals: one group (n = 8) received 0.05 mmol kg(-1) P846 and the other (n = 8) 0.1 mmol kg(-1) Gd-DOTA. A blipped IR-EPI and a multislice T1-SE were performed before injection and for 90 min after injection. T1-values were derived by fitting regional signal intensity on the IR-EPI images, the R1, DeltaR1 (R(1postcontrast) - R(1precontrast)) and DeltaR1 ratios were calculated in LV blood, normal and injured myocardium. On SE-T(1), the signal intensity ratio (SI) and extent of injury were measured. True infarct size was measured using histochemical staining. Changes in DeltaR(1) were 4.8 times greater with 0.05 mmol kg(-1) P846 than with 0.1 mmol kg(-1) Gd-DOTA in LV blood (6.3 +/- 0.9 vs 0.9 +/- 0.1 s(-1), p < 0.0001), normal (1.7 +/- 0.2 vs 0.34 +/- 0.03 s(-1), p < 0.0001) and ischemically injured myocardium (5.4 +/- 0.4 vs 1.6 +/- 0.1 s(-1), p < 0.0001). MR imaging experiments showed that the signal enhancement with P846 is longer (90 min), which might be explained by a lower diffusion of P846 compared with Gd-DOTA (30 min). P846 differentiates viable and nonviable myocardium. Despite lower gadolinium dose, P846 permits differentiation of viable and nonviable myocardium owing to a high contrast and a long imaging window with conventional t1-weighted SE sequence.
    Mots-clés : Contrast Media, Echo-Planar Imaging, Gadolinium, Heart Ventricles, Heterocyclic Compounds, Image Enhancement, Myocardial Ischemia, Organometallic Compounds, Rats, Rats, Sprague-Dawley.
  • MONNET O., COHEN F., LECORROLLER T., VIDAL V., JACQUIER A., GAUBERT J. Y., BARTOLI J. M., MOULIN G. “[Cervical lymph nodes].”. Journal de radiologie. 2008. Vol. 89, n°7-8 Pt 2, p. 1020-1036.
    Résumé : Imaging plays a chief role in the care and monitoring of patients in cervico-facial oncology. The radiologist must know the anatomy of different lymph nodes as well as signs of malignancy (hypertrophy, enhancement, necrosis, capsular rupture, etc.). CT is still the first-line examination because of its high reliability, its accessibility and its ability to make an assessment of the upper aero digestive ways at the same time. Ultrasound is very accuracy, and allows the realization of cytoponction, but does not provide a complete exploration of the neck. MRI does not appear to be indicated for the first intention, but the new rapid sequences (STIR, diffusion) seem interesting. The PET-CT is useful in post-therapeutic management of patients, and probably in the initial staging, but its accessibility is poor.
    Mots-clés : Head and Neck Neoplasms, Lymphatic Metastasis, Otorhinolaryngologic Neoplasms, Tomography, X-Ray Computed, Tonsillar Neoplasms.

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