By Anitha Varghese MBBS BSc MRCP, Dudley J. Pennell MD FRCP FACC
This identify presents an simply digestible and conveyable synopsis of the process as a way to swimsuit the desires of cardiologists and cardiothoracic surgeons wishing to acquaint themselves with what CMR can do, and what it can't. starting with an summary of a few of the fundamental ideas of MRI, the subsequent chapters be aware of the cardiac aspect of CMR with a later part on its extra validated vascular makes use of.
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Extra info for Cardiovascular Magnetic Resonance Made Easy
1 mmol/kg by rapid hand injection into a peripheral vein. Inversion time for EGE imaging is set at 440 milliseconds (ms) and reduced to around 320 ms for LGE imaging to commence. 7). 8). This is known as phase-swapping. So in the setting of MI, CMR can: 1. Evaluate global and regional cardiac function; 2. Demonstrate wall thickness and contractility; and 3. Highlight zones of MVO (or thrombus) and transmurality of infarction with EGE and LGE. 6 Four-chamber LGE image showing CSF ghosting (white arrows) along the phase encode axis.
Assessment of atherosclerotic plaque in carotid artery/aorta III 16. Assessment of pulmonary veins I 17. Endothelial function Inv Contraindications and issues of safety CMR is noninvasive and uses no ionizing radiation. Contrast agents Gadolinium have very low nephrotoxicity but some agents have been linked to systematic ﬁbrosis in renal failure. Patients with prosthetic heart valves, sternal wires, joint replacements, retained epicardial pacing leads and intracoronary stents can be safely scanned.
Gadolinium accumulates within abnormal interstitium in the myocardium affected by acute or chronic MI. In the acute setting gadolinium distributes into necrotic tissue, and in the chronic setting gadolinium is found in ﬁbrosis of the infarct scar. Gadolinium accumulation reduces T1 and therefore increases signal on T1W images. This principle along with an ECG-gated, inversion recovery fast GE sequence underlies the LGE technique. An important additional feature of this technique is the inversion time delay set by the operator to optimize contrast between normal myocardium and infarcted tissue.