Troponin raised, no infarct: one CT protocol found a cause in three of four

The edition in brief

A prospective Italian study of 191 emergency patients with raised troponin, acute cardiac symptoms and no myocardial infarction criteria found that coronary CT angiography plus late iodine enhancement and extracellular volume identified obstructive coronary disease in 40%, and among the rest showed myocarditis (30%), Takotsubo (13%), infarction with non-obstructive arteries (8%) and amyloidosis (3%). CT changed the working diagnosis in 48%, agreed with discharge diagnosis in 94%, and no major cardiac events followed a fully negative scan over a median two years. A single-centre study of 418 resected IPMNs found current MRI high-risk stigmata had 83% sensitivity but 67% specificity for malignancy; raising mural nodule and duct cutoffs increased specificity at the cost of sensitivity. A registry analysis of 25,328 supplemental breast ultrasound examinations in dense breasts found automated ultrasound associated with fewer abnormal interpretations and far fewer short-interval follow-ups than handheld, with similar cancer detection. A 48-patient feasibility study found tin-filtered low-dose photon-counting CT used about one-seventh of the standard dose with less than 1% difference in quantified interstitial lung disease patterns.