Download Free Medical Cardiac MRI PowerPoint Presentation

Cardiac MRI PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Radiology and Imaging, which is titled "Cardiac MRI", to know about Cardiac MRI.

Tags : Radiology, Imaging, Cardiac MRI

Published on : Aug 02, 2021 | Views : 4096 | Downloads : 31

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Cardiac MRI Rahman Ud Din Lecturer Medical Imaging NWIHS
Slide 2-

Introduction CMRI Information to assess the abnormality of heart Anatomical and functional information Acquired or congenital heart diseases Modality of choice ▫ ARVD, ▫ Differentiation from constrictive pericarditis from restrictive pericarditis, aortic dissection ▫ Precise quantification of ventricular dimensions ▫ Myocardial viability and perfusion ARVD
Slide 3-

ECG Gating ECG/EKG gating essential for motion-free image of heart Images are acquired in a particular phase of cardiac cycle in every cardiac cycle To avoid image blur and motion artifacts The image is decided by ECG gating Usually R-wave is used to trigger the acquisition Such data acquired in the diastolic phase Peripheral pulse also used for gating But less effective than ECG gating
Slide 4-

Imaging Sequences Pulse sequences used ▫ Dark-blood sequences ▫ Bright-blood sequences Dark-blood tech Spin-echo seq; that show the flowing blood as flow void Seqs; include breath-hold turbo or FSE (TSE, FSE) Single shot FSE Double inversion recovery FSE (Double-IR-FSE)
Slide 5-

Bright blood technique GRE seq: based shows blood bright Seqs; include spoiled GRE ▫ (turboFLASH/SPGR/T1-FSE) ▫ Balanced SSFP (TrueFISP/FIESTA/balanced TFE) Balanced TFE is mainstay seq; in CMRI Motion loop is obtained rapid cine imaging (RCI) Used RCI used ventricular function To calculate EF, SV as well as valvular & RWM Phase contrast useful in velocity & flow direction Initial CMRI starts from black blood than bright blood techniques used to assess functions
Slide 6-

Imaging planes Orthogonal planes (axial, sagittal and coronal) Used for chest imaging and not suitable in CMRI Because cardiac axes are not parallel to body axes Three axes images are taken and used as localiser
Slide 7-

1. Vertical long-axis plan (two chamber view) Axial image Large oblique diameter image of LV Chambers; LA and LV
Slide 8-

2. Horizontal long-axis (Four Chamber view) Planned on two chamber view By a drawing line passing through LA, MV & LV All four chambers, MV and TV assessed Cine GRE images obtained on this plane to assess function of MV, TV, AV and LV, RV wall motion
Slide 9-

3. Short-axis plane Multiple cross sections are obtained perpendicular to LV long axis as seen on a two-chamber view Sections are taken from the base to the apex of the heart Cine GRE images allow visualization and quantification of systolic myocardial wall thickening Images in this plane are used for calculating ventricle volume, mass and EF by postprocessing
Slide 10-

ppt slide no 10 content not found
Slide 11-

4. Five-Chamber view View obtained parallel to the line passing through the LV apex and aortic outflow tract on coronal images Apart from all four chambers, this view also shows aortic root This describe MV and AV
Slide 12-

5. RVOT Plane passing through the RV outflow tract
Slide 13-

Clinical Applications of CMRI 1. Congenital Heart Disease (CHD) Complex information about heart anatomy When echocardiography fail ASD, VSD detected with high sensitivity & specificity Calculate shunt size Conditions like ▫ TGA (transposition of Greater Arteries) ▫ Truncus arteriosus ▫ Many anomalies CMRI in children are having limitation
Slide 14-

ASD Truncus arteriosus
Slide 15-

2. Valvular Heart Disease (VHD) Arrhythmogenic right ventricular dysphagia Enlargement and dilatation of RV Thinning of wall, area of dyskinesia, focal bulging of free wall in systole Decreased EF and impair ventricular filling during diastole HCM (Hypertrophied) ▫ Echo detect but RV involvement is checked CMRI RCM (Restrictive) vs Constrictive ▫ Constrictive calcified pericardium, WT + 4mm Hemochromatosis ▫ Myocardial iron deposition i.e. Thalasemia ▫ Quantified by T2*-w seq;
Slide 16-

4. Ventricular Function CMRI more accurate than Echo It measure EF, EDV & ESV (end systolic vol) Done on short axis image using software Balanced SSFP, good contrast b/w blood pool and myocardium
Slide 17-

5. Coronary artery assessment Not good enough for visualisation of coronary arteries and its branches Presently it is used for such purpose, to find anomalies, aneurysms and bypass grafting patency GRE seq; balanced SSFP C+ or C-
Slide 18-

6. Myocardial perfusion and viability IV Gd T1-weighted GRE seq; turboFLASH Low signal areas of underperfusion on these images correspond with regions of ischemia or infarct Myocardial viability ▫ Viability seq; run after 10-15 minutes after Gd contrast ▫ T1-w GRE or inversion recovery balanced SSFP seq ▫ IR pulse used to suppress myocardium to get LV info ▫ Proper TI is important ▫ Infracted area on viability imaging shows enhancement ▫ This imaging is ‘Bright is dead’ ▫ Answer feasibility revascularisation procedure like angioplasty and bypass or not ▫ CMRI viability is superior compared to the PET
Slide 19-

7. Cardiac and Pericardial masses CMRI accurate method for cardiac and pericardial masses evaluation Thrombus the most common filling defect in cardiac chamber Gd enhancement differentiate b/w mass or thrombus Most cardiac neoplasm are metastatic Primary neoplasm are rare and 80% benign
Slide 20-

8. Pericardial disease Visualised with spin echo or GRE images Normal pericardium seen on SE images As a line of low signal intensity located b/w high signals of pericardial and epicardial fat Normal thickness 1-2 mm; more than 4 mm is considered thickening