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In recent years, there has been increasing interest in the clinical applications of coronary angiography techniques. Coronary MRA can be instrumental in the evaluation of congenital coronary artery anomalies, however, the complexity of advanced MR pulse sequences and strategies may be overwhelming to many. Coronary MR Angiography demystifies the art of coronary MRA by providing a text in plain language with clearly illustrated imaging steps and protocols. Designed to bridge the gap between radiology and cardiology, it is written for physicians and scientists planning to incorporate this technique into their research or practice.
It is with pleasure that I write this foreword for the book "Magnetic Resonance Imaging in Coronary Artery Disease", edited by Dr. van der Wall and Dr. de Roos. I am pleased for two reasons. Firstly, as chairman of the Scientific Board of the Interuniversity Cardiology Institute of the Netherlands (ICIN), because ever since the technique became available for use in medicine and biology our Institute has tried and succeeded to promote the introduction and dev- opment of magnetic resonance imaging in cardiology in the Netherlands. ICIN was the first cardiological institute on the European continent to purchase its own nuclear magnetic resonance spectroscope for the study of myocardial metabolism. Secondly, because I have always been infatuated with this noninvasive technique that can produce cardiac images without ionic radiation and at the same time allows for the study of myocardial metabolism as well. And even more so because nuclear magnetic resonance imaging in medicine is one of the shining examples of medical progress as a result of breakthrough discoveries in physics and chemistry.
The significantly updated second edition of this important work provides an up-to-date and comprehensive overview of cardiovascular magnetic resonance imaging (CMR), a rapidly evolving tool for diagnosis and intervention of cardiovascular disease. New and updated chapters focus on recent applications of CMR such as electrophysiological ablative treatment of arrhythmias, targeted molecular MRI, and T1 mapping methods. The book presents a state-of-the-art compilation of expert contributions to the field, each examining normal and pathologic anatomy of the cardiovascular system as assessed by magnetic resonance imaging. Functional techniques such as myocardial perfusion imaging and assessment of flow velocity are emphasized, along with the exciting areas of artherosclerosis plaque imaging and targeted MRI. This cutting-edge volume represents a multi-disciplinary approach to the field, with contributions from experts in cardiology, radiology, physics, engineering, physiology and biochemistry, and offers new directions in noninvasive imaging. The Second Edition of Cardiovascular Magnetic Resonance Imaging is an essential resource for cardiologists and radiologists striving to lead the way into the future of this important field.
This heavily updated textbook focuses on the use of cardiac magnetic resonance (CMR) imaging in pediatric and adult patients with congenital heart disease. Over past two decades, CMR has come to occupy an ever more important place in the assessment and management of patients with congenital heart defects (CHD) and other cardiovascular disorders. The modality offers an ever-expanding amount of information about the heart and circulation, provides outstanding images of cardiovascular morphology and function, is increasingly being used to detect pathologic fibrosis, and has an expanding role in the assessment of myocardial viability. Magnetic Resonance Imaging of Congenital Heart Disease is an excellent foundation for any reader not familiar with the field whether they are imagers or clinicians who deal with cardiovascular disease. It also describes the technical details of MRI techniques to help the clinician understand the most important elements of CMR in assessing and managing their patients. In creating the book, the editors have assembled a world-renowned panel of contributors to review the use of CMR in CHD and make it accessible to those working in the field and to those who use the information derived from CMR in their clinical practice.
Recent years have seen a marked increase in cardiovascular computed tomography (CT) imaging, with the technique now integrated into many imaging guidelines, such as those published by ESC and NICE. Rapid clinical and technological progress has created a need for guidance on the practical aspects of CT image acquisition, analysis and interpretation. The Oxford Specialist Handbook of Cardiovascular CT, now revised for the second edition by practising international experts with many years of hands-on experience, is designed to fulfil this need. The Handbook is a practical guide on performing, analysing and interpreting cardiovascular CT scans, covering all aspects from patient safety to optimal image acquisition to differential diagnoses of tricky images. It takes an international approach to both accreditation and certification, highlighting British, European, and American examinations and courses. The format is designed to be accessible and is laid out in easy to navigate sections. It is meant as a quick-reference guide, to live near the CT scanner, workstation, or on the office shelf. The Handbook is aimed at all cardiovascular CT users (Cardiologists, Radiologists and Radiographers), particularly those new to cardiovascular CT, although even the advanced user should find useful tips and tricks within.
This open access book presents a comprehensive overview of dilated cardiomyopathy, providing readers with practical guidelines for its clinical management. The first part of the book analyzes in detail the disease’s pathophysiology, its diagnostic work up as well as the prognostic stratification, and illustrates the role of genetics and gene-environment interaction. The second part presents current and future treatment options, highlighting the importance of long-term and individualized treatments and follow-up. Furthermore, it discusses open issues, such as the apparent healing phenomenon, the early prognosis of arrhythmic events or the use of genetic testing in clinical practice. Offering a multidisciplinary approach for optimizing the clinical management of DCM, this book is an invaluable aid not only for the clinical cardiologists, but for all physicians involved in the care of this challenging disease.
This extensively illustrated volume has been specifically geared towards optimal use of MRI systems. The text provides essential theoretical background information: Imaging acquisition and potential pitfalls are also examined in detail. Most importantly, structured guidelines are provided on the interpretation of clinical data in the wide range of cardiac pathology that can be encountered.
Although improved treatments have reduced the rates of acute complications from myocardial infarction, sequelae such as heart failure and sudden death threaten the future wellbeing of those patients. Secondary prevention after myocardial infarction is related to cardiovascular risk factors and the effect of the infarct on left ventricular function. Cardiovascular magnetic resonance imaging (CMR) is necessary to determine the size of the infarct scar and can with great precision determine left ventricular volumes, left ventricular ejection fraction, and deformation (strain and torsion). The purpose of this thesis was to improve on CMR methods to facilitate image acquisition and post processing in patients with high risk of coronary artery disease (CAD). In Paper 1, a three-dimensional phase-sensitive inversion-recovery (3D PSIR) sequence was modified to measure T1 during a single breath hold. The measured T1 values were used to extrapolate a map of T1 relaxation, which avoided the time-consuming manual determination of the inversion time. The data collection consisted of phantom experiments, Monte Carlo simulations of the effect of various heart rates, and clinical investigation of 18 patients with myocardial infarction. Scar images created with the modified sequence were compared to those created with the standard sequence. The 3D PSIR sequence was able to measure T1 relaxation with a high accuracy up to 800 ms, which is in the suitable range for scar imaging. Simulated arrhythmias showed that the method was robust and able to tolerate some variation in heart rate. The modified sequence provides measurements of inversion time that can be used to facilitate standard scar imaging or to reconstruct synthetic scar images. Images of infarct scar obtained with the 3D PSIR sequence bore striking similarity to images obtained with the standard sequence. In Paper 2, 125 patients with high risk of CAD were investigated using the displacement encoding with stimulated echoes (DENSE) sequence. Image segments with infarct scar area >50% (transmurality) could be identified with a sensitivity of 95% and a specificity of 80% based on circumferential strain calculated from the DENSE measurements. The DENSE sequence was also applied in other directions, but its sensitivity and specificity to detect scar was lower than when used for circumferential strain. In Paper 3, 90 patients with high risk of CAD were examined by DENSE, tagging with harmonic phase (HARP) imaging and cine imaging with feature tracking (FT), to detect cardiac abnormalities as manifested in end-systolic circumferential strain. Circumferential strain calculated with DENSE had higher sensitivity and specificity than the competing methods to detect infarction with transmurality >50%. Global circumferential strain measured by DENSE correlated better with global parameters such as left ventricular ejection fraction, myocardial wall mass, left ventricular end-diastolic and end-systolic volume; than strain measured by FT or HARP. In Paper 4, myocardial torsion was investigated using DENSE, HARP, and FT in 48 patients with high risk of CAD. Torsion measured by each of the three methods was correlated with other global measures such as left ventricular ejection fraction, left ventricular mass, and left ventricular end-diastolic and end-systolic volumes. The torsion measurements obtained with DENSE had a stronger relationship with left ventricular ejection fraction, left ventricular mass, and volumes than those obtained with HARP or FT. DENSE was superior to the other methods for strain and torsion measurement and can be used to describe myocardial deformation quantitatively and objectively.