Cardiac Imaging: Part 1, MR Pulse Sequences, Imaging Planes, and Basic Anatomy
ABSTRACT OBJECTIVE: MRI is a well-established modality for evaluating congenital and acquired cardiac diseases. This article reviews the latest pulse sequences used for cardiac MRI. In addition, the standard cardiac imaging planes and corresponding anatomy are described and illustrated. CONCLUSION: Familiarity with the basic pulse sequences, imaging planes, and anatomy pertaining to cardiac MRI is essential to formulate optimal protocols and interpretations.
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ABSTRACT: As survival rates continue to increase for patients with childhood and adult malignancies, imaging utilization in these patients will likely increase substantially. It is important to detect disease recurrence and to recognize the potential complications that occur after treatment with oncologic medications and therapeutic radiation. The most common cardiotoxic side effect of the anthracycline drug class is a dose-dependent decline in ejection fraction, which may result in dilated cardiomyopathy. Multiple-uptake gated acquisition (MUGA) scanning plays an important role in diagnosis of this subclinical cardiac dysfunction. Other less common cardiotoxic side effects of chemotherapeutic medications include arrhythmia, myocarditis, coronary artery disease, tamponade, pericarditis, and pericardial effusion. Radiation therapy can also lead to cardiotoxicity when the heart or pericardium is included in the radiation portal. Radiation-induced conditions include pericardial disease, coronary artery disease, valvular disease, and cardiomyopathy. Many of these side effects are asymptomatic until late in the course of the disease. With imaging, these pathologic conditions can often be diagnosed before symptom onset, which may allow early intervention. Radiologists should be familiar with the current knowledge and pathophysiology regarding cardiac complications related to chemotherapy and radiation therapy of malignant neoplasms and the appearances of treatment-related cardiotoxicity that can be found at radiography, nuclear medicine examinations, and cross-sectional imaging. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.336125005/-/DC1. © RSNA, 2013.Radiographics 10/2013; 33(6):1801-1815. DOI:10.1148/rg.336125005 · 2.73 Impact Factor
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ABSTRACT: Advances in computed tomography have led to continuous improvement in cardiac imaging. Dedicated postprocessing capabilities, faster scan times, and cardiac gating methods reveal details of normal cardiac anatomy and anatomic variants that can mimic pathologic conditions. This article will review normal cardiac anatomy and variants that can mimic disease. Radiologists should be familiar with normal cardiac anatomy and anatomic variants to avoid misinterpretation of normal findings for pathologic processes.01/2015; 4(1):2047981614562443. DOI:10.1177/2047981614562443
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ABSTRACT: OBJECTIVE. The purpose of this study was to compare cardiac MRI-derived parameters of left ventricular (LV) diastolic function between uncomplicated type 2 diabetes mellitus (DM2) and normoglycemic control subjects and to evaluate whether these parameters of LV diastolic function are related to coronary atherosclerosis. SUBJECTS AND METHODS. We prospectively studied 41 subjects with DM2 and 21 normoglycemic control subjects (30 women and 32 men; mean age, 57.2 ± 7.1 [SD] years) with no evidence of overt cardiovascular disease. We used cardiac MRI to measure LV volumes, LV peak filling rate (PFR), and transmitral flow and CT to determine coronary artery calcium scores. RESULTS. Absolute values of the peak filling rate (PFR) were significantly lower in DM2 patients than in control subjects (mean ± SD, 293.2 ± 51.7 vs 375.7 ± 102.8 mL/s, respectively; p < 0.001). Mitral peak E velocities (mean ± SD, 42.8 ± 10.7 vs 48.8 ± 10.4 cm/s; p = 0.040) and peak E velocity-to-peak A velocity ratios (0.88 ± 0.3 vs 1.1 ± 0.3; p = 0.002) were also lower in DM2 patients compared with control subjects. DM2 patients with coronary artery calcification showed a lower PFR normalized to stroke volume (SV) (mean ± SD, 4.4 ± 1.0 vs 5.3 ± 1.4, respectively; p = 0.038) and lower mitral peak E velocities (40.1 ± 11.3 vs 48.0 ± 7.3 cm/s; p = 0.024) than DM2 patients without coronary calcification. PFR normalized to SV was independently associated with the presence of coronary artery calcification (β = -1.5, p = 0.005). CONCLUSION. DM2 decreases cardiovascular MRI-derived parameters of LV diastolic function. Patients with DM2 and coronary atherosclerosis show a more impaired LV diastolic function than patients without coronary atherosclerosis.American Journal of Roentgenology 06/2014; 202(6):1207-14. DOI:10.2214/AJR.13.11325 · 2.74 Impact Factor