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and specificity. Whereas sensitivity and positive predictive value werehigher in a per-patient-in comparison to a per-segment-based analysis,specificity, negative predictive value and interobserver agreement did notdiffer considerably between both analyzing methods.

Quantitative assessment of left ventricular systolic wall thickeningusing multidetector computed tomographyKristensen TS, Kofoed KF, Møller DV, Ersbøll M, Kühl T, von der Recke P,Køber L, Nielsen MB, Kelbæk H (Department of Radiology, 2023Diagnostic Centre, Rigshospitalet, University of Copenhagen, Begdamsvej9, DK-2100 Copenhagen, Denmark). Eur J Radiol 2009;72:92–97.

Background: Multidetector computed tomography (MDCT) of the heartprovides both anatomical and functional information. The objective of thisstudy was to evaluate the accuracy of quantitative assessment of leftventricular contractile function in relation to two-dimensional transthoracicechocardiography (TTE).Materials and methods: Sixty-four patients with known or suspectedcoronary artery disease underwent ECG-gated 64-slice MDCT and TTE.Regional left ventricular contractile function was measured by percentsystolic wall thickening (SWT) in 16 myocardial segments using MDCT,and compared with visual evaluation of wall motion score (WMS) by TTE.Global SWT by MDCTwas calculated as the mean SWTof all myocardialsegments and compared with wall motion index (WMI) by TTE.Results: Eight hundred and eleven segments (81%) were classified asnormokinetic, 142 (14%) as hypokinetic, 41 (4%) as akinetic and 5 (0.5%) asdyskinetic by TTE. A significant inverse linear trend was found betweenregional SWT by MDCT and WMS by TTE (Pb.001). Sensitivity andspecificity for the identification of regional abnormalities of contractilefunction were 76% and 78%, respectively. A linear correlation betweenglobal SWT by MDCT and WMI by TTE was found (r=−0.8, Pb.001).Sensitivity and specificity for the identification of WMIN1.5 using globalSWTwas 91% and 94%, respectively.Conclusion: Quantification of systolic wall thickening by MDCT providesfunctional information, which is well correlated to visual assessment ofglobal left ventricular contractile function by TTE.

Comparison of 64 MDCTcoronary CTA and coronary angiography inthe detection of coronary artery stenosis in low risk patients with stableangina and acute coronary syndrome [in French]Cazalas G, Sarran A, Amabile N, Chaumoitre K, Marciano-Chagnaud S,Jacquier A, Paganelli F, Panuel M (Service dimagerie Medicale, CHU deMarseille, Hopital Nord, F-13915 Marseilles Cedex 20, France). J Radiol2009:90:1055–1066.

Purpose: To determine the accuracy of 64 MDCT coronary CTA (CCTA)compared to coronary angiography in low-risk patients with stable anginaand acute coronary syndrome and determine the number of significantcoronary artery stenoses (N50%) in these patients.Materials and methods: Fifty-five patients underwent CCTA using a 32MDCT unit with z flying focus allowing the acquisition of 64 slices of 0.6mm thickness as well as coronary angiography (gold standard). Ninepatients were excluded due to prior coronary artery, bypass surgery (n=4),insufficient breath hold (n=3), calcium scoringN1000 (n=1) and delaybetween both examinations, over 4 months (n=l): Forty-six patients: 27males and 19 females were included. CCTA results were compared tocoronary angiography per segment and artery with threshold detection ofstenoses≥50%. The degree of correlation between both examinations wasperformed using a regression analysis with a Pearson correlationcoefficientb0.05 considered significant.Results: The overall accuracy of CCTAwas 90%; limitations related to thepresence of calcifications, motion artifacts or insufficient vessel opacifica-tion. The correlation for all analyzed segments was 96.4%. Thirty-eight of50 significant stenoses seen on coronary angiography were correctlydetected on CCTA. Sensitivity, specificity, PPVC and NPV for detection of

stenoses N50% were76%, 98.3%, 80.3% and 97.7% respectively. Evaluationper segment had a NPVof .96.8% (inter-ventricular and diagonal segments)to 100% (main trunk).Conclusion: Our results for specificity and NPVare similar to reports fromthe literature. This suggests that CCTA in this clinical setting may replacecoronary angiography.

Juxtapapillary duodenal diverticula: MDCT findings in 1010 patientsand proposal of a new classificationWiesner W, Beglinger Ch, Oertli D, Steinbrich W (Clinic Stephanshorn,Bauerstrasse 95, 9016 St. Gallen, Switzerland). J Belge Radiol2009;92:191–194.

The aim of this study is to analyze the MDCT findings of juxtapapillaryduodenal diverticula (JPDD) and to propose a new radiological classification.

CT-examinations of 1010 consecutive patients, all examined by 16-rowMDCTof the abdomen over a time period of 20 months were retrospectivelyanalyzed. All study patients were examined by triple phase CT (native,arterial and portal venous CTscan) of the abdomen and all received positiveoral contrast prior to the examination. Thirty-three patients showed ajuxtapapillary duodenal diverticulum, which could be seen on all CT scans,but usually was depicted most clearly on the thin collimated arterial phaseCT images. Size of diverticula range from 4 mm to 4.5 cm (mean 1.7 cm). In17 cases the diverticulum was located ventrally to the vaterian sphinctercomplex, extending less or more into the pancreas at the site where the dorsaland the ventral anlage of the pancreas have fused (type I). 12 diverticulawere located dorsally to the sphincter complex (type II).Three patientspresented with a bilobated juxtapapillary diverticulum extending to bothsides, ventrally and dorsally (type III) and one patient showed a littlediverticulum ventrally to the minor papilla (type IV).Three patientspresented with food impaction in the diverticulum but only one of thesepatients with a large IPDD showed a Lemmel-syndrome, whereas the otherthree patients with non-calculous extrahepatic cholostasis showed largerdiverticula without food impaction. MDCTallows to identify four differenttypes of juxtapapillary duodenal diverticula and using the proposedclassification may be helpful for a more exact, anatomy based radiologicaldescription of this CT finding.

Color Doppler sonography of small bowel wall changes in 21consecutive cases of acute mesenteric ischemiaDanse EM, Kartheuser A, Paterson HM, Laterre P-F (Department ofRadiology, St. Luc University Hospital, Avenue Hippocrate 10, B-1200Brussels, Belgium) J Belge Radiol 2009;92:202–206.

Aim of the study: To describe the small bowel wall changes observed withcolor Doppler sonography in acute mesenteric ischemia with comparisonwith its outcome.Material and methods: We reviewed the sonographic findings of 21patients with a final diagnosis of acute mesenteric ischemia (12 acute arterialforms and 9 acute venous forms). These examinations included identifica-tion of non peristaltic thin-walled fluid-filled intestinal loops (with orwithout pneumatosis), thickened intestinal wall (N3 mm) (noted as stratifiedor not), and preserved or absent mural flow assessed with color Doppler.Sonographic findings were compared with the surgical data (n=16) or withthe clinical outcome (n=5).Results: In acute arterial ischemia, non-peristaltic thin-walled intestinalloops were detected with sonography in five cases, with visualization ofpneumatosis in one. Bowel infarction was diagnosed in four of these fivepatients including one patient with pneumatosis. Thickened bowel loopswere sonographically detected in four cases, of which 3 required resection.Conservative therapy was performed in the remaining case having preservedwall stratification and mural flow with color Doppler. In acute venousischemia, thickened bowel loops were detected with sonography in six cases.Conservative therapy was performed in three cases for whom preservedmural flow was noted. Stratification was present in two of these three cases.