Magnetic Resonance Imaging of Primary Cardiomyopathies

Soler, Rafaela; Rodrı́guez, Esther; Remuiñán, Carmen; Bello, María José; Díaz, Alejandro

doi:10.1097/00004728-200309000-00009

Cited by 30 publications

(18 citation statements)

References 46 publications

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“…DE-CMR is the most powerful non-invasive tool to detect myocardial amyloidosis [11]. The concept of DE-CMR is that the signal from the normal myocardium can be completely nulled about 5-30 min after contrast administration using specialized pulse sequence and differential enhancement patterns between abnormal myocardium which retains contrast and normal nulled myocardium can be studied.…”

Section: Discussionmentioning

confidence: 99%

“…According to some studies, myocardial amyloidosis can be diagnosed with high sensitivity and specificity (93 and 95 % respectively) using DE-CMR if this imaging appearance is seen [11]. This pattern is unlike myocardial infarction that shows subendocardial or transmural DE in coronary distribution and various non-ischemic myocarditis/cardiomyopathies (sarcoidosis, idiopathic dilated cardiomyopathy, hypertrophic cardiomyopathy, myocarditis, chagas disease etc.)…”

Section: Discussionmentioning

confidence: 99%

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Utility of the inversion scout sequence (TI scout) in diagnosing myocardial amyloid infiltration

Pandey

Jambhekar

Shaikh

et al. 2012

Int J Cardiovasc Imaging

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To evaluate the utility of inversion scout (TI-scout) obtained during cardiac magnetic resonance imaging (CMR) in diagnosing myocardial amyloid infiltration. A retrospective analysis of CMR exams in 39 patients (24 males, age range 29–77 years) was performed. Imaging was performed on a 1.5T system, and included steady state cine, post contrast TI-scout and delayed enhancement images. Evaluations included studies in 13 patients with myocardial amyloidosis and 26 patients without myocardial amyloidosis. To characterize abnormal nulling, the time to myocardial nulling on the TI scout was compared to the null times of the blood pool and spleen for each scan. The sensitivity and specificity of different tissue nulling abnormalities for myocardial amyloidosis were computed. The null times of tissues in 18/26 (69 %) patients in the non-amyloid group followed a consistent order with the blood pool null time preceding the myocardial nulling which was equal to that of splenic nulling (Type 1 pattern). This order differed in all 13 patients with myocardial amyloidosis described as three non-mutually exclusive nulling categories: 10 patients had myocardial null time preceding or coincident with blood pool (Type 2 pattern); in 11 patients myocardial null time was non-coincident with splenic nulling (Type 3 pattern); and in 8 patients myocardial null time was non-coincident with both blood pool AND splenic nulling (Type 4 pattern). While no patient exhibited Type 4 nulling pattern in the non-amyloid group, 1/26 patient had a Type 2 and 7/26 patients had a Type 3 nulling pattern. A sensitivity of 100 % was obtained when either Type 2 OR Type 3 nulling was present while a specificity of 100 % was obtained when both Type 2 AND Type 3 nulling were present together (Type 4 pattern). Our study demonstrates that the pattern of nulling on the TI scout sequence CMR has potential diagnostic utility for the presence of myocardial amyloidosis. The temporal pattern of myocardial, blood pool and splenic nulling needs to be carefully evaluated on the TI scout sequence and could prove useful in other infiltrative cardiomyopathies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utility of the inversion scout sequence (TI scout) in diagnosing myocardial amyloid infiltration

Pandey

Jambhekar

Shaikh

et al. 2012

Int J Cardiovasc Imaging

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“…Another minor finding is that the amyloidosis can be accompanied by pleural and pericardial effusion [33]. The T1 value can be quantitatively measured to diagnose cardiac amyloidosis and to evaluate the treatment effect since the T1 value of the myocardium in cardiac amyloidosis is prolonged compared to that of the normal myocardium [31,33,34]. The measurement of the T1 value has become easier through T1 mapping; consequently, the use of T1 mapping for the diagnosis of cardiac amyloidosis has recently been reported.…”

Section: Amyloidosismentioning

confidence: 99%

CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review

Kim

Jung

Kim

et al. 2015

Int J Cardiovasc Imaging

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Cardiac complications with hematologic diseases are not uncommon but it is difficult to diagnose, due to non-specific clinical symptoms. Prompt recognition of these potentially fatal complications by cardiac computed tomography (CT) or cardiac magnetic resonance imaging (MRI) may help to direct clinicians to specific treatments according to causes. Thrombosis is often related to central venous catheter use and is usually located at the catheter tip near the atrial wall. Differentiation of thrombosis from normal structure is possible with CT and, distinction of a thrombus from a tumor is possible on a delayed enhancement MRI with a long inversion time (500-600 ms). Granulocytic sarcoma of the heart is indicated by an infiltrative nature with involvement of whole layers of myocardium on CT and MRI. MRI with T2* mapping is useful in evaluating myocardial iron content in patients with hemochromatosis. Diffuse subendocardial enhancement is typically observed on delayed MRIs in patients with cardiac amyloidosis. T1 mapping is an emerging tool to diagnose amyloidosis. Myocardial abscess can occur due to an immunocompromised status. CT and MRI show loculated lesions with fluid density and concomitant rim-like contrast enhancement. Awareness of CT and MRI findings of cardiac complications of hematologic diseases can be helpful to physicians for clinical decision making and treatment.

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“…Es importante realizar un diagnóstico correcto, ya que la pericarditis constrictiva se puede tratar quirúrgicamente. La RM permite cuantificar en la miocardiopatía restrictiva el grosor del pericardio normal y, en ocasiones, engrosamiento miocárdico 11 . La pericarditis constrictiva se produce como consecuencia de fibrosis y calcificación progresiva del pericardio secundaria a una respuesta inflamatoria (pericarditis infecciosa), neoplasias, enfermedades del tejido conectivo, fracaso renal, cirugía cardíaca, tratamiento radioterápico, etc.…”

Section: Miocardiopatía Restrictivaunclassified

Resonancia magnética cardíaca: aplicaciones clínicas

Bastarrika

Sprengel

Buruaga

et al. 2005

Anales Sis San Navarra

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RESUMENLa enfermedad cardiovascular es la causa más frecuente de mortalidad en los países desarrollados y constituye un grave problema social, económico y sanitario. Aunque existen muy diversas técnicas útiles para diagnosticar las enfermedades cardíacas, con frecuencia es preciso realizar más de una prueba para llegar a un diagnóstico concreto. La resonancia magnéti-ca es una técnica inocua, bien tolerada y segura que actualmente se encuentra disponible en la mayoría de los centros hospitalarios. Esta técnica permite estudiar en una única exploración la anatomía del corazón y valorar de forma cualitativa, semicuantitativa y cuantitativa los parámetros de función cardíaca. Es útil para el estudio de las enfermedades valvulares, miocardiopatías y de la enfermedad pericárdica. Aporta información de la anatomía y función cardíaca y vascular en las cardiopatías congénitas complejas. Además, con la administración de contraste intravenoso, permite conocer la viabilidad miocárdica en la cardiopatía isquémica. Por tanto, la resonancia magnética cardíaca se perfila como una de las técnicas más prometedoras para el estudio de la patología cardíaca congénita y adquirida. Palabras clave. Resonancia magnética. Corazón. Enfermedades cardíacas. ABSTRACTCardiovascular disease is the most frequent cause of mortality in the developed countries and represents a serious social, economic and health problem. Although very diverse, useful techniques exist for diagnosing cardiac diseases, it is frequently necessary to ask for more than one test to reach a specific diagnosis. Magnetic resonance is a harmless, well tolerated and safe technique, which is currently available in the majority of hospitals. This technique makes it possible in a single exploration to study the anatomy of the heart and to make a qualitative, semiquantitative and quantitative assessment of the parameters of cardiac function. It provides information of cardiac and vascular anatomy and function in complex congenital cardiopathies. Besides, with the administration of intravenous contrast, it enables knowledge to be gained of myocardial viability in ischaemic cardiopathy. Hence, cardiac magnetic resonance is emerging as one of the most promising techniques for the study of congenital and acquired cardiac pathology.

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Magnetic Resonance Imaging of Primary Cardiomyopathies

Cited by 30 publications

References 46 publications

Utility of the inversion scout sequence (TI scout) in diagnosing myocardial amyloid infiltration

Utility of the inversion scout sequence (TI scout) in diagnosing myocardial amyloid infiltration

CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review

Resonancia magnética cardíaca: aplicaciones clínicas

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