The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Dec 2010
ReviewMRI of complex cyanotic congenital heart disease: pre- and post surgical considerations.
Evaluation of patients with complex congenital cyanotic heart disease requires a solid knowledge base of the underlying defects and a full understanding of surgical palliative and corrective procedures. As these patients survive into adulthood, understanding common conditions, their associated surgical procedures, and potential surgical complications is paramount for the radiologist. Use of magnetic resonance imaging in evaluation of these patients is a critical tool at the disposal of the radiologist.
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Int J Cardiovasc Imaging · Aug 2010
ReviewThe role of 1.5T cardiac MRI in the diagnosis, prognosis and management of pulmonary arterial hypertension.
Cardiovascular magnetic imaging is a noninvasive, three dimensional tomographic technique that allows for a detailed morphology of the cardiac chambers, the accurate quantification of right ventricle volumes, myocardial mass, and transvalvular flow. It can also determine whether right ventricular diastolic function is impaired through pulmonary hypertension. ⋯ This leaves double lung-heart transplantation as the only therapeutic option. The coexistence of PAH and left ventricle impairment causes worse right ventricle function, leads to a poor prognosis, and may change the therapeutic strategies (for example, PAH associated with left ventricle dysfunction may require a double lung-heart transplant).
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Int J Cardiovasc Imaging · Jun 2010
ReviewReview of Movahed's sign (D shaped left ventricle seen on gated SPECT) suggestive of right ventricular overload.
Recently, D shaped ventricle seen on gated SPECT imaging (Movahed's sign) has shown to correlate with right ventricular overload similar to the D shape ventricle seen on echocardiography. Right ventricle (RV) imaging during gated SPECT studies is challenging because of the low tracer uptake due to relatively smaller right ventricular myocardial mass and lower coronary flow to the RV. ⋯ Furthermore, increased RV volume or pressure load can cause displacement of the septum towards the left ventricle causing septal flattening and a D shaped configuration of the left ventricular septum. This is an important finding that should be a part of nuclear gated SPECT interpretation.
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Int J Cardiovasc Imaging · Oct 2009
ReviewEchocardiographic evaluation of right heart function and pulmonary vascular bed.
The aim of this review was to describe the different ultrasonic modalities to non-invasively evaluate right cardiac chambers and pulmonary vascular bed function. M-Mode, 2-D, conventional pulsed doppler, tissue doppler imaging (TDI), strain rate imaging (SRI) and 3D echocardiography are illustrated in order to obtain both regional and global right heart and pulmonary function. ⋯ The hemodynamic profile obtained consent to anatomically and functionally characterize PH. But, other experiences performed on more wide range of healthy and PH patients are necessary to confirm the described results.
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Int J Cardiovasc Imaging · Mar 2009
ReviewCoronary CT angiography in emergency department patients with acute chest pain: triple rule-out protocol versus dedicated coronary CT angiography.
Immediate coronary catheterization is mandatory for high risk patients with typical chest pain in the emergency department (ED). In contrast, in ED patients with acute chest pain but low to intermediate risk, traditional management protocol includes serial ECG, cardiac troponins and radionuclide perfusion imaging. However, this protocol is time-consuming and expensive, and definite treatment of unstable angina is often delayed. ⋯ In ED patients with atypical chest pain and low to intermediate risk, the triple rule-out protocol may be preferred, especially in older patients who have relatively lower risk of lifelong radiation-induced cancer. However, the increased radiation dose resulting from the extended volume coverage with this protocol should be fully considered prior to performing this protocol. Therefore, in ED patients who have a low clinical suspicion of pulmonary embolism and acute aortic syndrome, especially younger patients, dedicated coronary CT angiography accompanied by modifications to reduce radiation dose is recommended.