By Anitha Varghese MBBS BSc MRCP, Dudley J. Pennell MD FRCP FACC
This name offers an simply digestible and conveyable synopsis of the method to be able to swimsuit the wishes 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 elemental ideas of MRI, the subsequent chapters be aware of the cardiac facet of CMR with a later part on its extra confirmed vascular makes use of.
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Extra resources for Cardiovascular Magnetic Resonance Made Easy
This may be associated with a posteriorly directed jet of mitral regurgitation (MR). Treatment is mainly with beta-blockers but surgical myomectomy or alcohol ablation can be performed. Alcohol ablation involves injection of alcohol into the ﬁrst septal artery causing infarction of the myocardium in that territory and relieving the obstruction. Subsequent scar formation and remodelling can be evaluated using CMR. Rarely, a residual ridge of myocardium remains which causes further obstruction and can be evaluated at follow-up CMR.
29 2 2 Ischaemic heart disease Myocardial perfusion Resting coronary blood ﬂow increases with exercise or other stress. This increase in coronary blood ﬂow is the coronary ﬂow reserve (Flowstress /Flowrest = CFR) with a normal range of approximately 4. 12). Perfusion CMR can identify this perfusion defect and there is good correlation with myocardial scintigraphy. However, compared to scintigraphy, CMR allows improved resolution with no ionizing radiation. The optimal imaging sequence for perfusion CMR is currently multislice, single-shot hybrid GE using imaging acceleration during the ﬁrst pass of a bolus of gadolinium.
1 mmol/kg at a rate of 7 ml/s followed by 15 ml of normal saline at the same rate via a large bore cannula in the right antecubital vein) given after 2 minutes and at the commencement of the perfusion sequence. Typically three ventricular short-axis slices are acquired in a breath-hold at end-expiration over the ﬁrst cardiac cycles of the ﬁrst pass. Image acquisition is over 60 seconds and patients are instructed to breathe gently when needed. Rest perfusion is delayed for 20 minutes after stress perfusion in order to reduce gadolinium levels, and is performed using the same doses and rates of gadolinium and saline as those for stress but without the adenosine.
Cardiovascular Magnetic Resonance Made Easy by Anitha Varghese MBBS BSc MRCP, Dudley J. Pennell MD FRCP FACC