The Atherothrombotic Cascade: A Molecular Journey to Infarction This... sequence visualizes the critical pathway from a stable but vulnerable coronary plaque to a full acute coronary syndrome. #Atherosclerosis #Cardiology #HeartAttack #Thrombosis #MedEdshow more

Did #aorticDissection with valve sparing #DavidV in young patient... with type A and anomalous right coronary artery from the left coronary sinus. Rei planted the RCA with #Cabrol Vein Graft to Ascending Aorta. Thanks to Corey Herman and the rest of the team for the great help!show more

Here's an amazing 3D Reconstruction from a Coronary CTA... of a 25-year-old woman who suddenly collapsed to the ground in cardiac arrest while running What's the diagnosis?show more

How to handle this LAD, D1& D2. One important... thing to mention there is a small coronary cameral fistula from the distal lad to LV visible at the end of the cine. This can create confusion as wire perforation after intervention.show more

🫀 Seeing Truly Normal Coronary Arteries Dual Source PCCT... + High Iodine = Confidence of Exclusion In coronary CTA, detecting plaque matters. But confidently proving absence of plaque is even more powerful. A truly normal coronary artery should not look “probably normal.” It should look sharp, smooth, motion-free, and perfectly opacified. That level of certainty comes from the combination of: - Photon-Counting CT (PCCT) - High spatial/temporal/contrast resolution - High iodine concentration contrast (400 mg I/mL) 🧠 Why this combination matters Subtle abnormalities can be masked by: - Motion blur - Noise - Partial volume effects - Insufficient intraluminal enhancement Sometimes what we call “normal” is simply underpowered imaging. ⚡ What changes with PCCT + 400 mg I/mL Ultra-high spatial resolution - Clear intima–lumen interface - Distal vessels sharply defined High temporal resolution - Minimal motion artifacts - True coronary borders, even at higher HR High iodine concentration (400 mg I/mL) - Stronger intraluminal signal - Higher contrast-to-noise ratio - Uniform, stable lumen opacification - Subtle wall irregularities no longer hide in low signal Spectral capability - Cleaner iodine–tissue separation - Greater confidence in excluding non-calcified plaque When arteries are truly normal, they appear: ✔️ Smooth ✔️ Thin-walled ✔️ Motion-free ✔️ Intensely and uniformly opacified Not “likely fine.” But objectively pristine. In coronary CTA, technology is not only about finding disease. It’s about confidently saying: There is none. From uncertainty to reassurance. From suspicion to precision. That’s the strength of PCCT with high-iodine coronary imaging. ⚡🫀 #PhotonCountingCT #PCCT #CoronaryCTA #HighIodine #400mgIodine #HighTemporalResolution #UltraHighResolution #CardiacCT #PreventiveCardiology #yesCCTshow more

Some might argue but IMHO this is Takotsubo caused... by ACS caused by spontaneous coronary artery dissection (SCAD) in a 71 yo female. LAD occlusion too distal to cause wall motion abnormality seen here. #CardioTwitter Holger Thiele Holger Nef Dr Roxana Mehran Beat SCAD UK European Society of Cardiologyshow more

PHOTON COUNTING CT AND A NEW CONCEPT OF NORMAL... CORONARY ARTERIES For more than 2 decades we have been performing Cardiac CT with constant improvements in all parameters (spatial, temporal and contrast resolution). The improvements were progressive in certain fields and steep in other (e.g.: the introduction of Dual Source CT that completely changed the range of temporal resolution achievable basically overnight and still is the most important source of flexibility in Cardiac CT scanning after almost 20 years). Spatial resolution instead was improved in a slow and progressive way until the test EID CT generations that achieved a spatial resolution of 250 microns. This allowed us to assess a coronary artery tree and define it as normal when no apprentice changes were visibile up to that value. But we know that the normal thickness of coronary artery walls is quite below that threshold. It is more in the range of 80-200 microns. Therefore, the very early changes in coronary artery wall thickness could not be picked up by EID CT technology. With the introduction of PCCT we can constantly achieve 100 microns spatial resolution which means that we work extol in range in which coronary artery disease starts. It also means that we don't see any thickening of the the coronary artery walls we have a much higher specificity and reliability. This concept is a transformative one because it allows us to shift earlier and earlier the beginning of atherosclerosis in our patients and think even more precisely in terms of cardiovascular prevention and monitoring. Movie: example of normal coronary artery tree with PCCT. A new era is coming into practice and it is the age of Photon Counting CT which pushes this boundaries further away. PCCT is a NEW Imaging Modality. PCCT is changing the game, the field, the language, the priorities and in the end it will change the entire infrastructure of diagnostic medicine. PS: note that PCCT images have to be reduced in resolution when uploaded in social media. #CardiacImaging #MedicalInnovation #StentAssessment #Radiology #PCCT #photoncounting #QuantumHD #CT #computedtomography #yesCCT #coronaryarterydisease #ischemia #naeotomalpha #Peak #Pro #Prime #speed #cardiac #highresolution #siemenshealthinners #CardiacCT #PhotonCountingCT #MedicalImaging #HeartHealth #CardiovascularInnovation #Radiology #AIInMedicineshow more

Coronary slow flow is diagnosed as TIMI-2 flow grade... requiring ≥ 3 cardiac cycles to opacify the vessel or a corrected TIMI frame count (CTFC) greater than 27 frames.show more

A quick 12-second look at the key steps of... Sliding Hip Screw placement: from incision to implant placement and closure. A biomechanically stable fixation is crucial for proper healing. #orthopaedics #orthotwitter #orthoX #trauma #DHS #medicaleducation #mededshow more

A quick 12-second look at the key steps of... Sliding Hip Screw placement: from incision to implant placement and closure. A biomechanically stable fixation is crucial for proper healing. #orthopaedics #orthotwitter #orthoX #trauma #DHS #medicaleducation #mededshow more

🔥 An Absolute Failure. The Coach That Refused to... Play #12 🤡 "That is a critical play. That was a brutal sequence"show more

What is the diagnosis? Opsoclonus myoclonus syndrome. This is... an 'oldie but a goodie.' Teaching phenomenology of movement and neurological disorders today @VUMCneurology. This one was published in Archives of Neurology which later became JAMA Neurology. What is the differential possibilities for causes: A whole bunch of potential causes: Posterior fossa tumors, intracranial hemorrhage, stroke, central nervous system infection, acute cerebellitis, acute cerebellar ataxia, drug intoxication, Guillain-Barré syndrome, and migraine-related. If a fever, opsoclonus and ataxia think about acute infectious encephalitis or meningitis. Could be scrub typhus, mumps or tuberculous meningitis. Don't forget autominune as high on the list and remember to nail the phenomenology before rushing to the diagnosis. Perhaps also there is a neuroblastoma present. #fixelinstituteshow more

Having fun is not a diversion from a successful... life; It is the pathway to it. Martha N. Beckshow more

Rudy Giuliani is hospitalized in critical condition, his spokesman... said on Sunday. The 81-year-old former New York City mayor is critical but stable, spokesman Ted Goodman said in a statement. The statement does not say what led to the hospitalization.show more

Hate to be critical of a Boston sports legend... but this was an ugly performance from Drinkwater.show more

The full journey of #Helene 🌀 From a Tropical... Storm in the Caribbean Sea, to a catastrophic landfall over Florida as a Category 4 Major Hurricane.show more

A 12 hour journey from Toronto to Ohio and... back…For the juiciest haul of 35mm. Some bangers here.. this is not just a hobby for me but a passion…show more

From Previs to Polished Animation 🎥✨ Every sequence begins... as a rough idea, shaped through previs, refined in animation, and perfected in its final stage. This split-screen breakdown reveals the journey from early blocking to the finished shot, showing the precision and artistry behind every frame.show more

Can you imagine? This takes the cat lady syndrome... to a whole new level!show more