Atlas of Practical Applications of Cardiovascular Magnetic Resonance

Transcription

1 Atlas of Practical Applications of Cardiovascular Magnetic Resonance

2 Developments in Cardiovascular Medicine 232. A. Bayes de Luna, F. Furlanello, B.J. Maron and D.P. Zipes (eds.): Arrhythmias and Sudden Death in Athletes J-C. Tardif and M.G. Bourassa (eds): Antioxidants and Cardiovascular Disease J. Candell-Riera, J. Castell-Conesa, S. Aguade Bruiz (eds): Myocardium at Risk and Viable Myocardium Evaluation by SPET M.H. Ellestad and E. Amsterdam (eds): Exercise Testing: New Concepts for the New Century Douglas L. Mann (ed.): The Role of Inflammatory Mediators in the Faihng Heart Donald M. Bers (ed.): Excitation-Contraction Coupling and Cardiac Contractile Force, Second Edition Brian D. Hoit, Richard A. Walsh (eds.): Cardiovascular Physiology in the Genetically Engineered Mouse, Second Edition Pieter A. Doevendans, A.A.M. Wilde (eds.): Cardiovascular Genetics for Clinicians 2001 Stephen M. Factor, Maria A. Lamberti-Abadi, Jacobo Abadi (eds.): Handbook of Pathology and Pathophysiology of Cardiovascular Disease Liong Bing Liem, Eugene Downar (eds): Progress in Catheter Ablation Pieter A. Doevendans, Ste&n Kaab (eds): Cardiovascular Genomics: New Pathophysiological Concepts Daan Kromhout, Alessandro Menotti, Henry Blackburn (eds.): Prevention of Coronary Heart Disease: Diet, Lifestyle and Risk Factors in the Seven Countries Study Antonio Pacifico (ed.), Phihp D. Henry, Gust H. Bardy, Martin Bor^refe, Francis E. Marchhnski, Andrea Natale, Bruce L. Wilkoff (assoc. eds): Implantable Defibrillator Therapy; A Clinical Guide Hein J.J. Wellens, Anton P.M. Gorgels, Pieter A. Doevendans (eds.); The ECG in Acute Myocardial Infarction and Unstable Angina: Diagnosis and Risk Stratification Jack Rychik, Gil Wemovsky (eds.): Hypoplastic Left Heart Syndrome Thomas H. Marwick: Stress Echocardiography. Its Role in the Diagnosis and Evaluation of Coronary Artery Disease 2nd Edition. Akira Matsumori: Cardiomyopathies and Heart Failure: Biomolecular, Infectious and Immune Mechanisms Ralph Shabetai: The Pericardium Irene D. Turpie; George A. Heckman (eds.): Aging Issues in Cardiology C.H. Peels; L.H.B. Baur (eds.); Valve Surgery at the Turn of the Millennium Jason X.-J. Yuan (ed.); Hypoxic Pulmonary Vasoconstriction: Cellular and Molecular Mechanisms Francisco J. Villarreal (ed.); Interstitial Fibrosis In Heart Failure 2004 Xander H.T. Wehrens; Andrew R. Marks (eds.): Ryanodine Receptors: Structure, fiinction and dysfiinction in clinical disease Giullem Pons-Llado; Francesc Carreras (eds.): Adas of Practical Applications of Cardiovascular Magnetic Resonance Previous volumes are still available ISBN; X ISBN: ISBN: ISBN: ISBN: ISBN: ISBN X ISBN ISBN ISBN ISBN ISBN X ISBN ISBN ISBN ISBN ISBN ISBN ISBN ISBN X ISBN ISBN ISBN ISBN

3 Atlas of Practical Applications of Cardiovascular IVIagnetic Resonance edited by Guillem Pons-Llado, M.D. Director, Cardiac Imaging Unit Cardiology Department Hospital de la Santa Creu I Sant Pau Universitat Autonoma de Barcelona Barcelona, Spain Francesc Carreras, M.D. Cardiac Imaging Unit Cardiology Department Hospital de la Santa Creu I Sant Pau Universitat Autonoma de Barcelona Barcelona, Spain Springe]

4 GuiHem Pons-Llado, M.D. Director, Cardiac Imaging Unit Cardiology Department Hospital de la Santa Creu I Sant Pau Universitat Autonoma de Barcelona Barcelona, Spain Francesc Carreras, M.D. Cardiac Imaging Unit Cardiology Department Hospital de la Santa Creu I Sant Pau Universitat Autonoma de Barcelona Barcelona, Spain Library of Congress Cataloging-in-Publication Data Atlas of practical applications of cardiovascular magnetic resonance / edited by Guillem Pons-Llado and Francesc Carreras p. ; cm. (Developments in cardiovascular medicine ; 255) Includes bibliographical references and index. ISBN (alk. paper) e-isbn Heart Magnetic resonance imaging ^Adases. I. Pons-Llado, Guillem, II. Carreras, Francesc. III. Developments in cardiovascular medicine ; v [DNLM: 1. Cardiovascular Diseases diagnosis ^Atlases. 2. Magnetic Resonance Imaging methods Atlases. WG 17 A ] RC670.5.M33A ' dc Springer Science -I- Business Media, Inc. AU rights reserved. This work may not be translated or copied in whole or in part without the written permission of the pubusher (Springer Science- -Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now know or hereafter developed is forbidden. The use in this pubucation of trade names, trademarks, service marks and similar terms, even if the are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed in the United States of America SPIN springeroniine.com

5 List of Contributors x introduction 2 Giossary 4 Chapter 1: Basics of Cardiovascular Magnetic Resonance and Normal Views 8 Sandra Pujadas, Oliver Weber 1.1 Definition and historical background Physical basis MR signal: Free Induction Decay Relaxation RF pulse and MR imaging Pulse sequences Classic sequences Spin-Echo Gradient-Echo Velocity-encoded (phase contrast) MR imaging MR angiography New Modalities Fast Spin-Echo o Turbo Spin-Echo Fast Gradient-Echo and Steady State Free Precesion Imaging (SSFP) Inversion-Recovery and Saturation-Recovery Echo-Planar Imaging (EPI) Image formation SHce selection Image reconstruction Frequency-encoding gradient Phase-encode direction K-space Study Methodology and potential problems Technical equipment Medical personnel Patient preparation EGG synchronization Artefacts Safety considerations Normal CMR anatomy Orthogonal planes Oblique planes 20 Ciiapter 2: Ventricular Morphology and Function: Study of Cardiomyopathies 28 Guillem Pons-Llado 2.1 Morphological Study of Heart Chambers 28

6 a. Left ventricle 28 b. Right ventricle Ventricular Function 33 a. Left ventricular function 33 b. Right ventricular function Cardiomyopathies 36 a. Dilated cardiomyopathy (DCM) 36 b. Hypertrophic cardiomyopathy (HCM) 37 c. Restrictive cardiomyopathy (RCM) 39 d. Arrhythmogenic right ventricular cardiomyopathy (ARVC) 42 Chapter 3: Acquired Diseases of the Aorta 46 Guillem Pons-Llado 3.1 Technical Aspects of the Aortic Study by CMR : Imaging the Normal Aorta Aortic Aneurysm Aortic Dissection and Related Entities 47 a. Strategy for the study of aortic dissection by CMR 47 b. Differential diagnosis of aortic dissection by CMR 54 c. Post-operative or follow-up studies Study of the atherosclerotic plaque by CMR 58 Chapter 4: Study of Valvular Heart Disease 60 Lufs J. Jimenez Borreguero 4.1 Introduction Velocity Calculation and Flow^ Quantitation Anatomic Evaluation Aortic Regurgitation 63 a. Quantitation with cine velocity mapping 63 b. Quantitation of regurgitant volume using Simpson's method 63 c. Evaluation of regurgitation vwth cine gradient echo Mitral and Tricuspid Regurgitation 63 a. Quantitation with cine velocity mapping 63 b. Quantitation of regurgitant volume using Simpson's method 64 c. Evaluation with cine gradient echo Pulmonary Regurgitation Pulmonary Hypertension Valvular Stenosis 64 a. Quantitation with cine velocity mapping 64 b. Cine gradient echo Prosthetic valves 66 Chapter 5: Cardiovascular Magnetic Resonance of Ischemic Heart Disease 70 Sandra Pujadas, Francesc Carreras 5.1 Introduction Study of Ventricular Function 70 a. Global ventricular function 71 b. Regional ventricular fiinction 71

7 c. Myocardial tagging Assessment of myocardial ischemia by stress CMR 73 a. Myocardial perfiision by contrast first-pass CMR study 73 Practice of a CMR perfiision study 74 b. Wall motion study by dobutamine-cmr 74 Image analysis Acute and Chronic Myocardial Infection Comphcations of Myocardial In&rction 78 a. Ventricular aneurysm 78 b. Subacute ventricular rupture and ventricular pseudoaneurysm 78 c. Intraventricular thrombosis 78 d. Mitral regurgitation Assessment of myocardial viability 78 Practice of a delayed contrast-enhanced study Imaging of Coronary Arteries 83 Chapter 6: Cardiac and Paracardiac fulasses 92 Francesc Carreras 6.1 Introduction Technical Aspects in the Evaluation of Masses with CMR Malignant Primary Cardiac Tumors 94 a. Angiosarcoma 97 b. Myxosarcoma Benign Primary Cardiac Tumors 97 a. Myxoma 97 b. Fibroma 99 c. Lipoma 99 d. Pericardial masses and tumors Secondary Cardiac Tumors 99 a. Mediastinal lymphomas 99 b. Lung carcinoma 102 c. Melanoma 102 d. Pericardial secondary tumors Benign Paracardiac Masses or Pseudotumors Intracavitary Thrombi 102 Chapter 7: Diseases of tlie Pericardium Guillem Pons-Llado no 7.1 The Normal Pericardium Acute Pericarditis Pericardial EfHision Constrictive Pericarditis Congenital Pericardial Diseases 115 Chapter 8: Congenital Heart Disease 120 Maite Subirana, Xavier Borras 8.1 Segmental Study of Congenital Heart Disease Study of Atria and Venous connections 120

8 8.3 Atrioventxicular Connections Ventriculoarterial Connexions Smdy of Shunts Atrial Septal Defect Ventricular Septal Defect Atrioventricular Defects Patent Ductus Arteriosus Obstructive Lesions 132 a. Right ventricular outflow tract obstruction 132 b. Valvular and supravalvular pulmonary stenosis 132 c. Subvalvular and supravalvular aortic stenosis 132 d. Coarctation of the aorta Complex Congenital Heart Diseases 133 a. Tetralogy of Fallot 133 b. Truncus arteriosus 137 c. Complete transposition of the great arteries 137 d. Tricuspid atresia 140 e. Single ventricle 144 f. Double oudet right ventricle Postoperative Studies 145 a. Surgical arteriovenous fistulas 145 b. Banding of the pulmonary artery 149

9 Xavier Borras, MD. Cardiac Imaging Unit. Cardiology Department, Hospital de la Santa Creu i Sant Pau, Associate Professor of Medicine, Universitat Autonoma de Barcelona. Barcelona, Spain. Francesc Carreras, MD. Cardiac Imaging Unit. Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona. Barcelona, Spain. Luis J. Jitnenez-Borreguero, MD. Cardiology Department. Hospital Principe de Asturias, Alcala de Henares, Madrid, Spain. Guilletn Pons-Llado, MD. Director, Cardiac Imaging Unit. Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona. Barcelona, Spain. Sandra Pujadas, MD. Cardiac Imaging Unit. Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona. Barcelona, Spain. Maite Subirana, MD. Director, Unit of Congenital Heart Diseases. Cardiology Department, Hospital de la Sant Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain. Oliver M. Weber, PhD. Department of Radiology, University of California, San Francisco, CaUfomia, USA. CO o o O CO