Plein / Greenwood Cardiovascular MR Manual

1. Auflage 2010
ISBN: 978-1-84996-362-6
Verlag: Springer-Verlag
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 487 Seiten

The aim of this book is to provide a compact text for practicing physicians and cardiologists or radiologists in training that contains all aspects of cardiovascular magnetic resonance imaging relevant for the appropriate use of this imaging modality in clinical practice. In a tutorial style, the book provides an overview of the relevant physics that govern CMR imaging and provide details on commonly accepted indications for referral. The book also provides the necessary background information to get trainees prepared for training in a CMR center. The emphasis of the book will be on practical, hands-on information in a format small enough to be carried about for ease of use. The book will be a dense but extremely portable reference for all cardiologists involved in using or requesting MRI of their cardiac patients. This will be an all-in-one resource and of great clinical value.

Autoren/Hrsg.

Plein, Sven

Greenwood, John

Inhaltsverzeichnis

1;Cardiovascular MR Manual;2
1.1;Copyright Page;3
1.2;Foreword;4
1.3;Contents;6
1.4;Contributors;17
1.5;Part I:How Does CMRWork?;19
1.5.1;Chapter 1: What’s Inside the Magnet and Why?;20
1.5.1.1;1.1 The Main Magnet;21
1.5.1.2;1.2 The Gradient Coil Assembly;23
1.5.1.3;1.3 Integral Radiofrequency (RF) Body Transmitter Coil;25
1.5.1.4;1.4 Receiver Coil;26
1.5.1.5;Summary;27
1.5.2;Chapter 2: The MRI Environment;28
1.5.2.1;2.1 The Examination Room and RF Shielding;28
1.5.2.2;2.2 The Magnetic Fringe Field Hazard and the Controlled Area;28
1.5.2.3;2.3 Active and Passive Magnetic Shielding;31
1.5.2.4;Summary;32
1.5.3;Chapter 3: Protons and Spins: The Origin of the MRI Signal;33
1.5.3.1;3.1 MRI Images: What Are We Looking At?;33
1.5.3.2;3.2 Proton Spin and Net Magnetization;33
1.5.3.3;3.3 What Determines the Size of the Net Magnetization?;34
1.5.3.4;Summary;36
1.5.4;Chapter 4: Generating a Signal: RF Pulses and Echoes;37
1.5.4.1;4.1 How Do We Generate a Signal?;37
1.5.4.2;Is the Larmor Frequency the Same for Other Nuclei?;38
1.5.4.3;4.2 What Does the RF Pulse Do to the Magnetization?;38
1.5.4.4;4.3 Longitudinal and Transverse Components of Magnetization;40
1.5.4.5;4.4 Flip Angle and Common RF pulses;40
1.5.4.5.1;4.4.1 Variable-Flip Angle RF Excitation Pulse;40
1.5.4.5.2;4.4.2 90° RF Excitation Pulse;41
1.5.4.5.3;4.4.3 180° RF Pulse (Refocusing Pulse);43
1.5.4.5.4;4.4.4 180° RF Pulse (Inversion Pulse);43
1.5.4.6;4.5 What Does the MRI Signal Look Like?;44
1.5.4.7;Summary;46
1.5.5;Chapter 5: Relaxation Times, Gradient Echoes, and Spin Echoes;47
1.5.5.1;5.1 Relaxation: What Happens After the RF Excitation Pulse?;47
1.5.5.1.1;5.1.1 What is T1 Relaxation?;47
1.5.5.1.2;5.1.2 Transverse Relaxation and MRI Signal Decay;49
1.5.5.1.3;What’s the Significance of the T1 Value?;49
1.5.5.1.4;5.1.3 What is T2 Relaxation?;50
1.5.5.1.5;What’s the Significance of T2 Value?;51
1.5.5.1.6;5.1.4 What is T2* Relaxation?;51
1.5.5.2;5.2 MR Echoes;53
1.5.5.2.1;5.2.1 Gradient Echoes;53
1.5.5.2.2;5.2.2 Spin Echoes;55
1.5.5.3;Summary;59
1.5.6;Chapter 6: Making an Image: Locating and Encoding Signals in Space;60
1.5.6.1;6.1 Selecting an Image Slice;60
1.5.6.2;6.2 Encoding the MR Signal Within the Slice;62
1.5.6.3;6.3 Phase Encoding;62
1.5.6.4;6.4 Frequency Encoding;64
1.5.6.5;6.5 How is the Frequency-Encoded Signal Decoded?;66
1.5.6.6;6.6 How do we make sure that the Gradients we apply for Imaging don’t destroy the signal?;69
1.5.6.7;6.7 Why isn’t a Single Phase and Frequency Encoded Signal enough to Reconstruct an Image?;70
1.5.6.8;6.8 Field of View in the Phase Encoding Direction;71
1.5.6.9;6.9 Phase Encoding, Image Matrix, and Acquisition Time;72
1.5.6.10;Summary;74
1.5.7;Chapter 7: Image Space and k-Space;75
1.5.7.1;How is a Data Point in k-Space Related to the MR Signal?;80
1.5.7.2;Summary;81
1.5.8;Chapter 8: Imaging Parameters and Image Attributes;82
1.5.8.1;8.1 Spatial Resolution and Image Acquisition Time;82
1.5.8.2;8.2 Noise and Signal-to-Noise Ratio;83
1.5.8.3;8.3 Factors That Determine Image Quality;84
1.5.8.3.1;8.3.1 Intrinsic Signal Amplitude;84
1.5.8.3.2;8.3.2 Signal Averaging;85
1.5.8.3.3;The Nomenclature of Signal Averaging;85
1.5.8.3.4;8.3.3 SNR and Receiver Bandwidth;86
1.5.8.4;8.4 Imaging Parameters: Practical Examples;87
1.5.8.5;Summary of Factors Affecting Image Quality (SNR);90
1.5.8.6;8.5 2D and 3D Imaging;92
1.5.8.7;Summary;94
1.5.9;Chapter 9: Improving SNR with Surface Coils and Array Coils;95
1.5.9.1;RF Coils for Pediatric CMR;97
1.5.9.2;Summary;98
1.5.10;Chapter 10: Pulse Sequences and Image Contrast;99
1.5.10.1;10.1 Dependence of the MR Signal on TR and TE;99
1.5.10.2;10.2 Image Contrast and Weighting;102
1.5.10.3;10.3 Long TR and Short TE;104
1.5.10.4;10.4 Short TR, Short TE;105
1.5.10.5;10.5 Long TR, Long TE;106
1.5.10.6;10.6 Short TR, Long TE;107
1.5.10.7;Summary;108
1.5.11;Chapter 11: Gradient Echo Versus Spin Echo;109
1.5.11.1;Summary;114
1.5.12;Chapter 12: Black Blood Versus Bright Blood Imaging;115
1.5.12.1;12.1 Black Blood (Spin Echo Pulse Sequence);115
1.5.12.2;12.2 Black Blood – Double Inversion Preparation Pulses;117
1.5.12.3;Signal Voids and Vessel Patency;119
1.5.12.4;12.3 Bright Blood (Gradient Echo Pulse Sequence);119
1.5.12.5;Summary;122
1.5.13;Chapter 13: Dealing with Cardiac Motion: How Do We Image the Beating Heart?;123
1.5.13.1;13.1 Still Imaging;124
1.5.13.2;13.2 Cine Imaging;126
1.5.13.3;13.3 Triggering Versus Gating for Cine Imaging;127
1.5.13.4;13.4 Prospective Versus Retrospective ECG Gating;129
1.5.13.5;13.5 Spoiled Gradient Echo versus bSSFP;130
1.5.13.6;Summary;134
1.5.14;Chapter 14: Dealing with Respiratory Motion;135
1.5.14.1;14.1 Respiratory Compensation (Respiratory Gating);135
1.5.14.2;14.2 Respiratory Gating using Navigator Echoes;137
1.5.14.3;Summary;138
1.5.15;Chapter 15: Fast Imaging: How Do We Speed Up the Image Acquisition?;139
1.5.15.1;15.1 Turbo (or Fast) Spin Echo;139
1.5.15.2;15.2 Turbo (or Fast) Gradient Echo;141
1.5.15.3;15.3 Echo Planar-Imaging (EPI);143
1.5.15.4;15.4 Reducing the Total Number of Phase Encoding Steps Acquired for Each Image;145
1.5.15.5;15.5 Parallel Imaging;147
1.5.15.6;Summary;149
1.5.16;Chapter 16: Special Pulse Sequences for Cardiac Imaging;150
1.5.16.1;16.1 Selective Tissue Saturation;150
1.5.16.2;16.2 Frequency Selective Fat Suppression;152
1.5.16.2.1;16.2.1 Pros and Cons of Frequency Selective Fat Suppression (cf. STIR);154
1.5.16.3;16.3 STIR and Turbo STIR;154
1.5.16.3.1;16.3.1 Pros and Cons of STIR (cf. Frequency Selective Fat Suppression);156
1.5.16.4;16.4 Black Blood FSE/TSE (Double Inversion);156
1.5.16.5;16.5 Black Blood turboSTIR (Triple Inversion Recovery);158
1.5.16.6;16.6 Inversion Recovery Fast/Turbo Gradient Echo;160
1.5.16.7;16.7 Navigator-Gated 3D Fast/Turbo Gradient Echo (Coronary Artery Imaging);162
1.5.16.7.1;16.7.1 Key Features of a Navigator-Gated 3D Coronary Artery Imaging Sequence;164
1.5.16.8;16.8 Cine Gradient Echo;164
1.5.16.9;16.9 Velocity Encoded Cine Gradient Echo (Velocity Mapping);166
1.5.16.10;16.10 Myocardial Tagging (Binomial Pulses);170
1.5.16.11;16.11 Saturation Recovery, Single-Shot Fast Gradient Echo for Dynamic, Contrast-Enhanced Myocardial Perfusion Imaging;173
1.5.16.12;Summary;176
1.5.17;Chapter 17: Common Artifacts;177
1.5.17.1;17.1 Image Aliasing;177
1.5.17.2;Why Doesn’t Aliasing Occur in the Frequency Encoding Direction?;178
1.5.17.3;17.2 Aliasing Artifacts with Parallel Imaging;179
1.5.17.4;17.3 Ghosting Artifacts from Motion (Respiratory);181
1.5.17.5;17.4 Ghosting Artifacts from Motion (Pulsatile Flow);182
1.5.17.6;What is Flow Compensation?;184
1.5.17.7;17.5 Flow-Related Signal Loss and Flow Jets;184
1.5.17.8;17.6 Chemical Shift Artifact;185
1.5.17.9;17.7 Magnetic Susceptibility Artifacts;188
1.5.17.10;17.8 Metallic Artifact;190
1.5.17.11;17.9 Radiofrequency Interference Artifacts;192
1.5.17.12;Summary;193
1.6;Part II:How CMRis Performed;194
1.6.1;Chapter 18: The Basics of a CMR Study;195
1.6.1.1;18.1 The Referral;195
1.6.1.2;Key Points;196
1.6.1.2.1;The CMR Referral Form;196
1.6.1.3;Tips and Tricks for Referrals;196
1.6.1.4;18.2 Indications for CMR;197
1.6.1.5;The 10 Most Common Indications for CMR;198
1.6.1.6;18.3 Contraindications/Safety;198
1.6.1.6.1;18.3.1 Screening;199
1.6.1.6.2;18.3.2 Contraindications to CMR Scanning;200
1.6.1.6.2.1;18.3.2.1 Medical Devices;202
1.6.1.6.2.2;18.3.2.2 Heating Effects;203
1.6.1.6.2.3;18.3.2.3 Contrast Agents and Nephrogenic Systemic Fibrosis;203
1.6.1.6.2.4;18.3.2.4 Performing Stress Examinations in CMR;205
1.6.1.6.2.5;18.3.2.5 Other Safety Issues;205
1.6.1.7;Key Messages for CMR Safety;206
1.6.1.8;Common Devices that are NOT Contraindications for MR Imaging (Considered as “MR Conditional”);206
1.6.1.9;18.4 Setting Up a CMR Study;207
1.6.1.9.1;18.4.1 Equipment;207
1.6.1.9.2;18.4.2 ECG Signals;208
1.6.1.9.3;Tips and Tricks for ECG Positioning;210
1.6.1.9.4;18.4.3 Patient Preparation;209
1.6.1.9.5;18.4.4 Commencing the Scan;210
1.6.1.10;References;211
1.6.2;Chapter 19: Components of CMR Protocols;212
1.6.2.1;Key Points;212
1.6.2.2;19.1 Introduction;212
1.6.2.3;19.2 Localizing Images and Simple Planning;213
1.6.2.3.1;19.2.1 Interactive Planning;218
1.6.2.4;19.3 Anatomical and Morphological Imaging;218
1.6.2.4.1;19.3.1 T1-Weighted (Black Blood) Imaging;219
1.6.2.4.2;Tips and Tricks;221
1.6.2.4.3;19.3.2 T2-Weighted (Black Blood) Imaging;221
1.6.2.4.4;Edema Module;222
1.6.2.4.5;Tips and Tricks;223
1.6.2.4.6;19.3.3 T2* Relaxometry;223
1.6.2.4.7;T2* Module;224
1.6.2.4.8;Tips and Tricks;225
1.6.2.5;19.4 Cine Imaging (Including Real-Time Cine Imaging);225
1.6.2.5.1;19.4.1 Real-Time Cine Imaging;226
1.6.2.5.2;19.4.2 Quantitation;227
1.6.2.6;LV Function Module;228
1.6.2.7;RV Function Module;229
1.6.2.8;Tips and Tricks;230
1.6.2.9;19.5 Myocardial Tagging;230
1.6.2.10;Tagging Module;232
1.6.2.11;Tips and Tricks Tagging;232
1.6.2.12;19.6 Phase Contrast Velocity Encoding;232
1.6.2.13;Phase-Contrast Velocity-Encoding Module;234
1.6.2.14;Tips and Tricks Velocity-Encoded Imaging;235
1.6.2.15;19.7 Contrast-Enhanced MR Angiography (Excluding Coronary Arteries);235
1.6.2.16;MR Angiography Module;237
1.6.2.17;Tips and Tricks MR Angiography;238
1.6.2.18;19.8 Myocardial Perfusion CMR;238
1.6.2.18.1;19.8.1 Reproducible Planning of Three Short Axis Slices;240
1.6.2.18.2;Perfusion Module;242
1.6.2.18.3;19.8.2 Dark Rim Artifact;242
1.6.2.18.4;19.8.3 Interpretation of CMR Myocardial Perfusion Images;243
1.6.2.18.4.1;19.8.3.1 Visual Assessment;243
1.6.2.18.4.2;19.8.3.2 Quantitative/Semi-Quantitative Assessment;244
1.6.2.19;Tips and Tricks;246
1.6.2.20;19.9 Early and Late Gadolinium Enhancement;246
1.6.2.20.1;19.9.1 Protocol for Early and Late Gadolinium Enhancement Imaging;248
1.6.2.21;Early and Late Gadolinium Enhancement Module;249
1.6.2.22;Tips and Tricks;250
1.6.2.23;19.10 Coronary Artery Imaging;251
1.6.2.23.1;19.10.1 Whole Heart Technique;252
1.6.2.23.2;19.10.2 Targeted Technique;255
1.6.2.24;Coronary Artery Imaging Module;256
1.6.2.25;Tips and Tricks;257
1.6.3;Chapter 20: Anatomy by CMR;258
1.6.3.1;20.1 Cross-sectional Anatomy;258
1.6.3.2;20.2 Customized Views;266
1.6.3.3;20.3 Comparison with Other Imaging Modalities;266
1.6.3.4;Tips and Tricks;266
1.6.4;Chapter 21: The CMR Report;267
1.6.4.1;21.1 A Structured Approach to Reporting a CMR Study;267
1.6.4.2;21.2 The Report;269
1.6.4.3;Reference;270
1.7;Part III:Clinical Indicationsfor CMR Imaging;271
1.7.1;Chapter 22: Diseases of the aorta;272
1.7.1.1;The Role of CMR in Aortic Disease;272
1.7.1.2;CMR Protocol in Aortic Disease;272
1.7.1.3;22.1 Introduction;273
1.7.1.4;22.2 CMR versus Other Imaging Modalities;273
1.7.1.5;22.3 CMR in the Assessment of Aortic Atherosclerosis and Dissection;274
1.7.1.5.1;22.3.1 Acute Intramural Hematoma;274
1.7.1.5.2;22.3.2 Penetrating Atherosclerotic Ulcer;275
1.7.1.5.3;22.3.3 Aortic Dissection;276
1.7.1.6;22.4 Aortic Aneurysm;277
1.7.1.7;CMR Report in Aortic Disease;282
1.7.1.8;Key Points CMR in Aortic Disease;281
1.7.1.9;Tips and Tricks;281
1.7.2;Chapter 23: Cardiomyopathies;283
1.7.2.1;23.1 General Overview;283
1.7.2.2;23.2 Dilated Cardiomyopathy (DCM);284
1.7.2.2.1;CMR Protocol in DCM;284
1.7.2.2.2;23.2.1 Introduction;284
1.7.2.2.3;23.2.2 CMR versus Other Imaging Modalities in DCM;285
1.7.2.2.4;The Role of CMR in DCM;285
1.7.2.2.5;23.2.3 Findings on CMR;286
1.7.2.2.6;23.2.4 Differential Diagnosis;286
1.7.2.2.7;23.2.5 Case Example;287
1.7.2.3;Tips and Tricks;286
1.7.2.4;Key Points of CMR in DCM;287
1.7.2.5;CMR Report in DCM;288
1.7.2.6;23.3 Hypertrophic Cardiomyopathy (HCM);288
1.7.2.6.1;CMR Protocol in HCM;288
1.7.2.6.2;23.3.1 Introduction;288
1.7.2.6.3;23.3.2 CMR versus Other Imaging Modalities;289
1.7.2.6.4;The Role of CMR in HCM;289
1.7.2.6.5;23.3.3 Findings on CMR;289
1.7.2.6.6;23.3.4 Differential Diagnosis;290
1.7.2.6.6.1;Tips and Tricks;290
1.7.2.6.6.2;Key Points of CMR in HCM;290
1.7.2.6.7;23.3.5 Case Example;291
1.7.2.7;CMR Report in HCM;293
1.7.2.8;23.4 Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC);294
1.7.2.8.1;CMR Protocol in ARVC;294
1.7.2.8.2;23.4.1 Introduction;294
1.7.2.8.3;23.4.2 CMR versus Other Imaging Modalities;296
1.7.2.8.4;The Role of CMR in ARVC;296
1.7.2.8.5;23.4.3 Findings on CMR;297
1.7.2.8.6;23.4.4 Differential Diagnosis;297
1.7.2.8.6.1;Tips and Tricks;298
1.7.2.8.6.2;Key Points of CMR in ARVC;298
1.7.2.8.7;23.4.5 Case Example;298
1.7.2.9;CMR Report in ARVC;301
1.7.2.10;23.5 Left Ventricular Non-Compaction Cardiomyopathy (LVNC);302
1.7.2.10.1;CMR Protocol in LVNC;302
1.7.2.10.2;23.5.1 Introduction;302
1.7.2.10.3;23.5.2 CMR versus Other Imaging Modalities;302
1.7.2.10.4;23.5.3 Role of CMR in LVNC;302
1.7.2.10.5;23.5.4 Findings on CMR;303
1.7.2.10.6;23.5.5 Differential Diagnosis;303
1.7.2.10.7;Tips and Tricks;303
1.7.2.10.8;Key Points of CMR in LVNC;303
1.7.2.10.9;23.5.6 Case Example;304
1.7.2.11;CMR Report in LVNC;306
1.7.2.12;23.6 Inflammatory Diseases: Myocarditis;306
1.7.2.12.1;CMR Protocol in Myocarditis;306
1.7.2.12.2;23.6.1 Introduction;306
1.7.2.12.3;23.6.2 CMR versus Other Imaging Modalities;307
1.7.2.12.4;Role of CMR in Myocarditis;307
1.7.2.12.5;23.6.3 Findings on CMR;308
1.7.2.12.6;23.6.4 Differential Diagnosis;308
1.7.2.12.7;Tips and Tricks;309
1.7.2.12.8;Key Points CMR in Myocarditis;309
1.7.2.12.9;23.6.5 Case Example;308
1.7.2.13;CMR Report in Myocarditis;312
1.7.2.14;23.7 Inflammatory Diseases: Sarcoidosis;313
1.7.2.14.1;CMR Protocol in Sarcoidosis;313
1.7.2.14.2;23.7.1 Introduction;313
1.7.2.14.3;The Role of CMR in Sarcoidosis;313
1.7.2.14.4;23.7.2 Findings on CMR;313
1.7.2.14.5;23.7.3 Differential Diagnosis;314
1.7.2.14.6;Tips and Tricks;314
1.7.2.14.7;Key Points CMR in Sarcoidosis;314
1.7.2.14.8;23.7.4 Case Example;314
1.7.2.15;CMR Report in Sarcoidosis;317
1.7.2.16;23.8 Inflammatory Diseases: Vasculitis (Churg–Strauss Syndrome);318
1.7.2.16.1;CMR Protocol in Churg–Strauss Syndrome;318
1.7.2.16.2;23.8.1 Introduction;318
1.7.2.16.3;The Role of CMR in Churg–Strauss Syndrome;318
1.7.2.16.4;23.8.2 Findings on CMR;318
1.7.2.16.5;23.8.3 Differential Diagnosis;319
1.7.2.16.6;Tips and Tricks;319
1.7.2.16.7;Key Points CMR in Churg–Strauss Syndrome;319
1.7.2.16.8;23.8.4 Case Example;319
1.7.2.17;CMR Report in Churg–Strauss Syndrome;320
1.7.2.18;23.9 Infiltrative/Storage Diseases: Amyloidosis;321
1.7.2.18.1;CMR Protocol in Amyloidosis;321
1.7.2.18.2;23.9.1 Introduction;321
1.7.2.18.3;The Role of CMR in Amyloidosis;321
1.7.2.18.4;23.9.2 Findings on CMR;321
1.7.2.18.5;23.9.3 Differential Diagnosis;322
1.7.2.18.6;Tips and Tricks;322
1.7.2.18.7;Key Points of CMR in Amyloidosis;323
1.7.2.18.8;23.9.4 Case Example;323
1.7.2.19;CMR Report in Amyloidosis;325
1.7.2.20;23.10 Infiltrative/Storage Diseases: Siderotic Cardiomyopathy;326
1.7.2.20.1;CMR Protocol in Siderotic Cardiomyopathy;326
1.7.2.20.2;23.10.1 Introduction;326
1.7.2.20.3;23.10.2 CMR versus Other Imaging Modalities;326
1.7.2.20.4;The Role of CMR in Siderotic Cardiomyopathy;327
1.7.2.20.5;23.10.3 Findings on CMR;327
1.7.2.20.6;23.10.4 Differential Diagnosis;327
1.7.2.20.7;Tips and Tricks;327
1.7.2.20.8;Key Points CMR in Siderotic Cardiomyopathy;328
1.7.2.20.9;23.10.5 Case Example;328
1.7.2.21;CMR Report in Siderotic Cardiomyopathy;330
1.7.2.22;23.11 Tako-Tsubo Cardiomyopathy;331
1.7.2.22.1;CMR Protocol in Tako-Tsubo Cardiomyopathy;331
1.7.2.22.2;23.11.1 Introduction;331
1.7.2.22.3;23.11.2 CMR versus Other Imaging Modalities;331
1.7.2.22.4;The Role of CMR in Tako-Tsubo Cardiomyopathy;332
1.7.2.22.5;23.11.3 Findings on CMR;332
1.7.2.22.6;23.11.4 Differential Diagnosis;332
1.7.2.22.7;Tips and Tricks;333
1.7.2.22.8;Key Points CMR in Tako-Tsubo Cardiomyopathy;333
1.7.2.22.9;23.11.5 Case Example;333
1.7.2.22.10;CMR Report in Tako-Tsubo Cardiomyopathy;335
1.7.2.23;References;335
1.7.3;Chapter 24: Pericardial Disease;337
1.7.3.1;24.1 Pericardial Effusion;337
1.7.3.1.1;CMR Protocol in Pericardial Effusion;337
1.7.3.1.2;24.1.1 Introduction;337
1.7.3.1.3;24.1.2 CMR versus Other Imaging Modalities;338
1.7.3.1.4;24.1.3 Findings on CMR;338
1.7.3.1.4.1;24.1.3.1 Black Blood Images (Spin Echo Sequence);338
1.7.3.1.4.2;24.1.3.2 CINE Imaging (b-SSFP);339
1.7.3.1.4.3;24.1.3.3 Targeted Sequences;340
1.7.3.1.5;The Role of CMR in Pericardial Effusion;340
1.7.3.1.6;24.1.4 Case Example;340
1.7.3.1.7;Tips and Tricks;343
1.7.3.2;CMR Report in Pericardial Effusion;343
1.7.3.3;Key points CMR in Pericardial Effusion;343
1.7.3.4;24.2 Constrictive Pericarditis;344
1.7.3.4.1;CMR Protocol in Constrictive Pericarditis;344
1.7.3.4.2;24.2.1 Introduction;344
1.7.3.4.3;24.2.2 CMR versus Other Imaging Modalities;345
1.7.3.4.4;24.2.3 Findings on CMR;345
1.7.3.4.4.1;24.2.3.1 Pericardial Thickening;345
1.7.3.4.4.2;24.2.3.2 Indirect Signs of Constrictive Physiology;346
1.7.3.4.4.3;Tips and Tricks;346
1.7.3.4.4.4;The Role of CMR in Constrictive Pericarditis;346
1.7.3.4.5;24.2.4 Case Example;347
1.7.3.5;CMR Report in Pericardial Constriction;350
1.7.3.6;Key Points CMR in Constrictive Pericarditis;350
1.7.3.7;24.3 Pericardial Tumors;351
1.7.3.7.1;CMR protocol in pericardial tumors;351
1.7.3.7.2;24.3.1 Introduction;351
1.7.3.7.3;24.3.2 CMR versus Other Imaging Modalities;351
1.7.3.7.4;24.3.3 Findings on CMR;352
1.7.3.7.4.1;24.3.3.1 CINE Imaging (b-SSFP);352
1.7.3.7.4.2;24.3.3.2 Myocardial Tagging;353
1.7.3.7.4.3;24.3.3.3 Black Blood Images (TSE);353
1.7.3.7.4.4;24.3.3.4 First-Pass Perfusion Imaging;353
1.7.3.7.4.5;24.3.3.5 Post-Contrast T1 TSE and Delayed Enhanced Images;353
1.7.3.7.4.6;The Role of CMR in Pericardial Tumors;354
1.7.3.7.4.7;24.3.3.6 Case Example 1;354
1.7.3.7.4.8;24.3.3.7 Case Example 2;354
1.7.3.7.4.9;CMR Report in Pericardial Tumors;358
1.7.3.8;Key Points CMR in Pericardial Tumors;358
1.7.3.9;24.4 Congenital Abnormalities of the Pericardium;359
1.7.3.9.1;CMR Protocol in Congenital Abnormalities of the Pericardium;359
1.7.3.9.2;24.4.1 Introduction;359
1.7.3.9.3;24.4.2 CMR versus Other Imaging Modalities;360
1.7.3.9.4;24.4.3 Findings on CMR;360
1.7.3.9.5;The Role of CMR in Congenital Abnormalities of the Pericardium;361
1.7.3.9.6;24.4.4 Case Example;361
1.7.3.9.7;CMR Report in Congenital Pericardial Abnormalities;364
1.7.3.9.8;Key Points: CMR in Congenital Pericardial Abnormalities;364
1.7.4;Chapter 25: Cardiac Masses;365
1.7.4.1;The Role of CMR in the Diagnosis of Cardiac Masses is;365
1.7.4.2;CMR Protocol for Cardiac Masses;365
1.7.4.3;25.1 Introduction;366
1.7.4.4;25.2 Benign Cardiac Tumors;368
1.7.4.4.1;25.2.1 Myxoma;368
1.7.4.4.2;25.2.2 Lipoma;368
1.7.4.4.3;25.2.3 Papillary Fibroelastoma;370
1.7.4.4.4;25.2.4 Fibroma;370
1.7.4.4.5;25.2.5 Rhabdomyoma;372
1.7.4.4.6;25.2.6 Hemangioma;372
1.7.4.5;25.3 Malignant Cardiac Tumors;372
1.7.4.5.1;25.3.1 Sarcoma;372
1.7.4.5.2;25.3.2 Lymphoma;373
1.7.4.5.3;25.3.3 Metastatic Tumors;374
1.7.4.6;25.4 Other Masses and Tumors;374
1.7.4.6.1;25.4.1 Thrombus;374
1.7.4.6.2;25.4.2 Cysts;376
1.7.4.6.3;25.4.3 Pseudotumors;377
1.7.4.7;Tips and Tricks;377
1.7.4.8;Key Points: CMR in Diagnosis of Cardiac Masses;377
1.7.4.9;Standard CMR Report for Cardiac Masses;378
1.7.4.10;Further Readings;378
1.7.5;Chapter 26: Valvular Heart Disease;379
1.7.5.1;CMR Protocol in Valvular Heart Disease;379
1.7.5.2;26.1 Introduction;380
1.7.5.3;26.2 CMR Versus Other Imaging Modalities;380
1.7.5.4;Role of CMR in Valvular Heart Disease;380
1.7.5.5;26.3 Congenital;382
1.7.5.6;26.4 Regurgitation;383
1.7.5.7;26.5 Stenosis;384
1.7.5.8;26.6 Prosthetic Valves;386
1.7.5.9;26.7 Vegetations;386
1.7.5.10;26.8 Paravalvular Abscesses;386
1.7.5.11;Key Points CMR in Valvular Heart Disease;388
1.7.5.12;Tips and Tricks;388
1.7.5.13;CMR Report in Valvular Heart Disease;389
1.7.6;Chapter 27: Ischemic Heart Disease;390
1.7.6.1;27.1 Introduction;390
1.7.6.2;27.2 Stress Myocardial Perfusion Imaging for the Detection of Myocardial Ischemia;391
1.7.6.2.1;CMR Protocol for Stress Perfusion CMR;391
1.7.6.2.2;27.2.1 Introduction;392
1.7.6.2.3;27.2.2 Myocardial Perfusion CMR Versus Other Imaging Modalities;392
1.7.6.2.4;27.2.3 Diagnostic Performance;394
1.7.6.2.5;27.2.4 Prognostic Performance;396
1.7.6.2.6;The Role of Myocardial Perfusion CMR in IHD;396
1.7.6.2.7;27.2.5 How to Perform a Myocardial Perfusion CMR Study;397
1.7.6.2.8;Vasodilator Stress Agents;398
1.7.6.2.9;27.2.6 Safety Considerations;400
1.7.6.2.10;Safety Considerations;400
1.7.6.2.11;Additional Equipment;401
1.7.6.2.12;27.2.7 Analysis of CMR Perfusion Images;401
1.7.6.2.13;Tips and Tricks;403
1.7.6.2.14;Key Points Myocardial Perfusion CMR in IHD;403
1.7.6.2.15;27.2.8 Case Examples;403
1.7.6.2.15.1;27.2.8.1 Case 1;403
1.7.6.2.15.2;27.2.8.2 Case 2;405
1.7.6.2.15.3;27.2.8.3 Case 3;406
1.7.6.3;CMR Report for Myocardial Perfusion;407
1.7.6.4;27.3 CMR Stress Wall Motion Imaging for the Detection of IHD;408
1.7.6.4.1;Dobutamine Stress CMR Protocol;408
1.7.6.4.2;27.3.1 Introduction;408
1.7.6.4.3;27.3.2 CMR Versus Other Imaging Modalities;408
1.7.6.4.4;27.3.3 Diagnostic Performance;409
1.7.6.4.5;27.3.4 Prognostic Performance;409
1.7.6.4.6;The Role of Dobutamine Stress CMR;410
1.7.6.4.7;27.3.5 Method;411
1.7.6.4.8;27.3.6 Safety Considerations;411
1.7.6.4.9;Dobutamine;412
1.7.6.4.10;Atropine;412
1.7.6.4.11;27.3.7 Analysis;413
1.7.6.4.12;Tips and Tricks;414
1.7.6.4.13;27.3.8 Case Example;415
1.7.6.4.13.1;27.3.8.1 Case 4;415
1.7.6.4.14;Dobutamine Stress CMR Report;416
1.7.6.4.15;27.3.9 Which Stress Modality Should I Choose?;416
1.7.6.5;27.4 CMR for Assessment of Viability;417
1.7.6.5.1;CMR Protocol for Viability Assessment;417
1.7.6.5.2;27.4.1 Introduction;417
1.7.6.5.3;27.4.2 CMR Versus Other Imaging Modalities;417
1.7.6.5.4;27.4.3 CMR Methods for Viability Assessment;418
1.7.6.5.5;The Role of CMR for Viability Assessment;421
1.7.6.5.6;27.4.4 Case Examples;421
1.7.6.5.6.1;27.4.4.1 Case 5;421
1.7.6.5.6.2;27.4.4.2 Case 6;422
1.7.6.6;CMR Report for Viability;424
1.7.6.7;27.5 CMR in Acute Coronary Syndromes;425
1.7.6.7.1;27.5.1 Introduction;425
1.7.6.7.2;CMR Protocol for Acute Myocardial Infarction;425
1.7.6.7.3;27.5.2 CMR Versus Other Imaging Modalities;425
1.7.6.7.4;27.5.3 Methods;426
1.7.6.7.4.1;27.5.3.1 Cine and LGE-CMR;426
1.7.6.7.4.2;27.5.3.2 Edema Imaging for Area at Risk Assessment;426
1.7.6.7.4.3;27.5.3.3 Myocardial Salvage;427
1.7.6.7.4.4;27.5.3.4 Microvascular Obstruction;427
1.7.6.7.4.5;27.5.3.5 Complications of AMI;428
1.7.6.7.5;Tips and Tricks;428
1.7.6.7.6;The Role of CMR in ACS;429
1.7.6.7.7;27.5.4 Case Examples;429
1.7.6.7.7.1;27.5.4.1 Case 7;429
1.7.6.7.7.2;27.5.4.2 Case 8;431
1.7.6.7.7.3;27.5.4.3 Case 9;432
1.7.6.7.7.4;27.5.4.4 Case 10;433
1.7.6.7.7.5;27.5.4.5 Case 11;434
1.7.6.8;27.6 Positive Cardiac Enzymes and Normal Coronary Arteries;434
1.7.6.8.1;27.6.1 Example Case;436
1.7.6.8.1.1;27.6.1.1 Case 12;436
1.7.6.9;27.7 Potential Future Developments;437
1.7.6.9.1;27.7.1 Hardware Development;437
1.7.6.9.2;27.7.2 Software Development;437
1.7.6.9.3;27.7.3 New Methods;438
1.7.6.9.3.1;27.7.3.1 Noninvasive Arterial Wall Imaging;438
1.7.6.9.3.2;27.7.3.2 Myocardial Perfusion Imaging without Contrast?;438
1.7.6.9.3.3;27.7.3.3 Targeted (Molecular) Contrast Agents;438
1.7.6.9.4;Key Points CMR in IHD;439
1.7.6.10;References;439
1.7.7;Chapter 28: Basic Adult Congenital Heart Disease (ACHD);442
1.7.7.1;Basic Protocol in ACHD;442
1.7.7.2;28.1 Introduction;443
1.7.7.3;28.2 CMR Versus Other Imaging Modalities;443
1.7.7.4;Tips and Tricks;444
1.7.7.5;28.3 Coarctation of the Aorta;444
1.7.7.6;28.4 Tetralogy of Fallot;447
1.7.7.7;28.5 Transposition of the Great Arteries;451
1.7.7.8;28.6 Coronary Anomalies;454
1.7.7.9;28.7 Partial Anomalous Pulmonary Venous Return (PAPVR);455
1.7.7.10;28.8 Summary;457
1.7.7.11;CMR Report in ACHD;458
1.7.7.12;Key Points CMR in ACHD;459
1.7.8;Chapter 29: Pulmonary Vein Assessment;460
1.7.8.1;CMR Protocol for Pulmonary Vein Assessment;460
1.7.8.2;29.1 Introduction;460
1.7.8.3;29.2 CMR Versus Other Imaging Modalities;461
1.7.8.4;29.3 CMR Protocol and Findings;462
1.7.8.5;29.4 CMR Analysis;462
1.7.8.6;CMR Report for Pulmonary Vein Assessment;465
1.7.8.7;Key Points CMR in Pulmonary Vein Assessment;465
1.7.9;Chapter 30: Interventional Cardiovascular Magnetic Resonance Imaging;466
1.7.9.1;30.1 Introduction;466
1.7.9.2;30.2 Interventional MRI Systems;466
1.7.9.2.1;30.2.1 XMR Facility Design;466
1.7.9.3;30.3 MR Visualization Strategies;468
1.7.9.3.1;30.3.1 Performing XMR Procedures;469
1.7.9.3.1.1;30.3.1.1 X-ray Imaging as a Backup During MRI Cardiac Catheterization;469
1.7.9.3.1.2;30.3.1.2 Performing X-ray Fused MR-Guided Interventions;470
1.7.9.3.2;30.3.2 Physiological Information;470
1.7.9.3.3;30.3.3 Early Experiences;472
1.7.9.4;30.4 Future Perspectives;474
1.7.9.5;References;477
1.8;Index;478