Learning objectives
Review findings on cardiac magnetic resonance imaging (CMR) of various nonischemic cardiomyopathies (NICM).
After completing this educational exhibit,
the reader will be able (1) to recognize imaging features that characterize and distinguish several important NICMs,
and (2) appreciate the limitations of CMR for NICM.
Background
NICM encompasses a broad spectrum of myocardial diseases.
Cardiomyopathies are often due to genetic factors,
but there is developing evidence that inflammation and injury contribute to their development.
Whereas some cardiomyopathies may have an identifiable etiology,
many can only be classified as idiopathic.
Appropriate clinical management of NICM depends on identifying a specific cause (if possible) and assessing severity.
CMR is a valuable imaging modality to evaluate and follow patients with NICM,
many of which have characteristic imaging findings.
CMR can define cardiomyopathies by their...
Findings and procedure details
Case 1:
1.
Hypertrophic cardiomyopathy (HCM)(is the most common cardiomyopathy)
a.
Imaging features:
There are many different phenotypes of myocardial hypertrophy ranging from asymmetric to concentric to isolated hypertrophy of a papillary muscle.
Criteriafor diagnosis include a wall thickness of ≥15 mm and a wall thickness ratio of ≥1.5 compared to the lateral wall.
The most common phenotype is asymmetric hypertrophy involving the interventricular septum.
Septal hypertrophy involving the left ventricle (LV) base may cause dynamic narrowing of the left ventricular outflow tract (LVOT),
in...
Conclusion
MRI is a valuable tool for evaluating NICMs,
but must be used in combination with other clinical data.
Knowledge of the key imaging features can help to suggest a specific diagnosis or at least narrow the differential diagnosis.
Personal information
Shafik N.
Wassef,
MD
Resident Physician,
PGY4
Vice President,
House Staff Council
University of Iowa
American Board of Radiology,
Initial Certification Advisory Committee
Radiological Society of North America (RSNA),
Resident &Fellow Committee
Society of Interventional Radiology (SIR),Resident Fellow Section
Interest: Interventional and Diagnostic Radiology.
email:shafik.wassef @ gmail.com
John D.
Newell,
Jr.,
MD,
FACR
Professor of Radiology - Division of Cardiovascular and Pulmonary Imaging
Professor of Biomedical Engineering
University of Iowa
Email:
[email protected]
Alan H.
Stolpen,
MD,
PhD,
FACR
Past President,
Iowa Radiological Society
Associate Professor...
References
Abbara S,
Walker TG,
Imbesi SG.
Diagnostic Imaging,
Cardiovascular.
Amirsys Inc.
(2008) ISBN:1416033408.
Akashi YJ,
Goldstein DS,
Barbaro G et-al.
Takotsubo cardiomyopathy: a new form of acute,
reversible heart failure.
Circulation.
2008;118 (25): 2754-62
Azaouagh A,
Churzidse S,
Konorza T et-al.
Arrhythmogenic right ventricular cardiomyopathy/dysplasia: a review and update.
Clin Res Cardiol.
2011;100 (5): 383-94.
Baxi AJ,
Restrepo CS,
Vargas D et-al.
Hypertrophic Cardiomyopathy from A to Z: Genetics,
Pathophysiology,
Imaging,
and Management.
Radiographics.
2016;36 (2): 335-54.
Belloni E,
De cobelli F,
Esposito A et-al....