MRI evaluation of maternal cardiac displacement in pregnancy: implications for cardiopulmonary resuscitation.

Objective: The purpose of this study was to determine, with the use of cardiac magnetic resonance imaging, whether there is vertical displacement of the heart during pregnancy. Cardiopulmonary resuscitation guidelines during pregnancy recommend placing the hands 2-3 cm higher on the sternum than in nonpregnant individuals. This recommendation is based on the presumption that the heart is displaced superiorly by the diaphragm during the third trimester.

Multimodality cardiac imaging of infective endocarditis.

Multimodality cardiac imaging is useful for the non-invasive characterization of infective endocarditis and its complications prior to surgical intervention.

Detection and localization of bile duct leaks after cholecystectomy using Gd-EOB-DTPA-enhanced MR cholangiography: retrospective study of 16 patients.

Objective: To determine if gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) cholangiography can detect and localize bile duct leaks in postcholecystectomy patients.

Material And Methods: Four blinded independent radiologists performed a retrospective review of 16 consecutive patients who underwent MR cholangiography with intravenous Gd-EOB-DTPA for the evaluation of possible biliary leak. Image quality, ductal opacification, and presence and location of any bile leak were evaluated.

Multimodality imaging of intramyocardial fat in tuberous sclerosis.

Here, we report about a 34-year-old man with tuberous sclerosis. During routine surveillance, a CT scan of the chest incidentally showed a low-attenuation streak within the left ventricle. Cardiac magnetic resonance imaging confirmed intramyocardial lipid deposition within the left ventricle.

Stanford type A aortic dissection with pulmonary arterial intramural hematoma and pulmonary hemorrhage.

A rare complication of a Stanford type A aortic dissection is extension along the pulmonary arteries. We present a case that shows main and right pulmonary artery intramural hematoma and pulmonary hemorrhage in an 80-year-old woman who presented with a type A Stanford aortic dissection. The 11-month follow-up multidetector CT angiogram for this patient showed that the right pulmonary artery had become aneurysmal.

Adult presentation with a bilobed membranous ventricular septal aneurysm.

Membranous ventricular septum aneurysm (MVSA) is an uncommon cardiac abnormality primarily associated with the spontaneous closure of a small membranous ventricular septal defect in childhood. Diagnosis of an idiopathic MVSA in an adult is exceedingly rare. We report on a man, aged 38 years, with a bilobed MVSA diagnosed by transesophageal echocardiography and gated computed tomography, with separate aneurysm sacs extending into the right atrium and right ventricle.

Cardiac lipofibromatosis.

We present a case of cardiac lipofibromatosis associated with atrial fibrillation and complete heart block requiring permanent pacemaker implantation. Multimodality cardiac imaging including transthoracic echocardiography and cardiac magnetic resonance were useful for tissue characterization of this rare cardiac diagnosis.

Spontaneous dissection of the coronary and vertebral arteries post-partum: case report and review of the literature.

Background: Spontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period.

Case Presentation: This report describes a 35-year-old female who presented with an acute inferior ST elevation myocardial infarction 7 months post-partum secondary to spontaneous dissection of the left obtuse marginal coronary artery. Despite appropriate medical therapy with dual anti-platelet therapy, the patient presented four weeks later with a spontaneous dissection of the right vertebral artery.

Multimodality cardiac imaging of a ventricular septal rupture post myocardial infarction: a case report.

Background: Ventricular septal rupture (VSR), a mechanical complication following an acute myocardial infarction (MI), is thought to result from coagulation necrosis due to lack of collateral reperfusion. Although the gold standard test to confirm left-to-right shunting between ventricular cavities remains invasive ventriculography, two-dimensional transthoracic echocardiography (TTE) with color flow Doppler and cardiac MRI (CMR) are reliable tests for the non-invasive diagnosis of VSR.

Case Presentation: A 62-year-old Caucasian female presented with a late case of a VSR post inferior MI diagnosed by multimodality cardiac imaging including TTE, CMR and ventriculography.

Vanishing left ventricular thrombus in a woman with peripartum cardiomyopathy: a case report.

Background: Peripartum cardiomyopathy (PPCM) is a rare cardiac disorder characterized by the development of heart failure in the last month of pregnancy or up to 5 months postpartum in women without other identifiable causes of cardiac failure. The combination of left ventricular (LV) systolic dysfunction and hypercoaguability can cause thromboembolic complications including intra-cardiac thrombi.

Case Presentation: A 25-year-old Caucasian female with PPCM demonstrated multiple thrombi in the LV on transthoracic echocardiography.

The impact of repeated marathon running on cardiovascular function in the aging population.

Background: Several studies have correlated elevations in cardiac biomarkers of injury post marathon with transient and reversible right ventricular (RV) systolic dysfunction as assessed by both transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). Whether or not permanent myocardial injury occurs due to repeated marathon running in the aging population remains controversial.

Objectives: To assess the extent and severity of cardiac dysfunction after the completion of full marathon running in individuals greater than 50 years of age using cardiac biomarkers, TTE, cardiac computed tomography (CCT), and CMR.

Diagnosis of pericardial cysts using diffusion weighted magnetic resonance imaging: A case series.

Introduction: Congenital pericardial cysts are benign lesions that arise from the pericardium during embryonic development. The diagnosis is based on typical imaging features, but atypical locations and signal magnetic resonance imaging sequences make it difficult to exclude other lesions. Diffusion-weighted magnetic resonance imaging is a novel method that can be used to differentiate tissues based on their restriction to proton diffusion.

The utility of cardiac biomarkers, tissue velocity and strain imaging, and cardiac magnetic resonance imaging in predicting early left ventricular dysfunction in patients with human epidermal growth factor receptor II-positive breast cancer treated with adjuvant trastuzumab therapy.

Objectives: The aim of this study was to evaluate whether cardiac biomarkers, tissue velocity (TVI) and strain imaging, and cardiac magnetic resonance imaging can predict early left ventricular (LV) dysfunction in human epidermal growth factor receptor II-positive breast cancer patients treated with trastuzumab in the adjuvant setting.

Background: Early indexes of LV systolic dysfunction with noninvasive cardiac imaging would be useful for addressing the cardiac safety profile of trastuzumab, potentially avoiding the detrimental effects of heart failure.

Methods: We used cardiac biomarkers, TVI and strain imaging, and cardiac magnetic resonance imaging to detect pre-clinical changes in LV systolic function, before conventional changes in left ventricular ejection fraction (LVEF) in human epidermal growth factor receptor II-positive breast cancer patients treated with trastuzumab in the adjuvant setting.

Multimodality imaging of anomalous pulmonary veins.

Partial anomalous pulmonary venous connection (PAPVC) is an extremely rare congenital condition where one or more of the pulmonary veins are connected to the venous circulation. Although initially suspected with unexplained right ventricular enlargement on transthoracic echocardiography (TTE), cardiac MRI is able to delineate the anatomical variant. We present a case of a 65-year-old male diagnosed with left sided PAPVC using multimodality cardiac imaging.

The role of three-dimensional echocardiography in the assessment of right ventricular dysfunction after a half marathon: comparison with cardiac magnetic resonance imaging.

Background: Although marathon running is associated with transient right ventricular (RV) systolic dysfunction as detected by two-dimensional transthoracic echocardiography, quantitative assessment of the right ventricle is difficult because of its complex geometry. Little is known about the use of real-time three-dimensional echocardiography (RT3DE) in the detection of cardiac dysfunction after a half marathon. The aim of this study was to assess the extent of RV dysfunction after the completion of a half marathon using cardiac biomarkers, RT3DE, and cardiac magnetic resonance imaging (CMR).

Multimodality Imaging of a Saphenous Vein Graft Aneurysm.

The use of multimodality cardiac imaging including echocardiography, cardiac computed tomography and cardiac catheterization for the diagnosis of a saphenous vein graft aneurysm is described. (Echocardiography, ****;**:E1-E2).

Role of three-dimensional echocardiography in breast cancer: comparison with two-dimensional echocardiography, multiple-gated acquisition scans, and cardiac magnetic resonance imaging.

Purpose: In patients with breast cancer, the administration of doxorubicin and trastuzumab is associated with an increased risk of cardiotoxicity. Although multiple-gated acquisition (MUGA) scans and two-dimensional transthoracic echocardiography (TTE) are conventional methods for baseline and serial assessment of left ventricular ejection fraction (LVEF) in these patients, little is known about the use of real-time three-dimensional TTE (RT3D TTE) in this clinical setting. The aim of this study was to assess the accuracy of MUGA, 2D TTE, and RT3D TTE for determining LVEF in comparison to cardiac magnetic resonance imaging (CMR).

Utility of balanced steady-state free precession MR venography in the diagnosis of lower extremity deep venous thrombosis.

Objective: The purpose of this study was to determine the sensitivity and specificity of balanced steady-state free precession MR venography in the diagnosis of lower extremity deep venous thrombosis.

Subjects And Methods: After undergoing lower extremity ultrasound because of suspicion of deep venous thrombosis, 64 patients were prospectively recruited to undergo balanced steady-state free precession MR venography with ultrasound as the reference standard. Ultrasound images were independently interpreted by two blinded ultrasound radiologists, and MR venograms were independently interpreted by two blinded MRI radiologists.

Myocardial siderosis due to hemochromatosis in an individual with hypertrophic cardiomyopathy.

A patient with hypertrophic cardiomyopathy (HCM) and transfusion-dependent sideroblastic anemia, who presented with decompensated heart failure, is described. The present case demonstrates the usefulness of cardiac magnetic resonance imaging as a noninvasive imaging modality to assess the etiology of new systolic dysfunction in the setting of HCM. Cardiac magnetic resonance imaging is able to differentiate between the dilated 'burned-out' phase of HCM and a concomitant dilated cardiomyopathy secondary to myocarditis or hemosiderosis.