Korrelation von spätem Gadolinium Enhancement (LGE) in der kardialen MR-Bildgebung mit serologischen Parametern, myokardialer Wanddicke und histopathologischen Untersuchungen im Myokarditis-Tiermodell

2010 ◽  
Vol 182 (S 01) ◽  
Author(s):  
W Kromen ◽  
H Korkusuz ◽  
S Lindemayr ◽  
T Vogl
Keyword(s):  
Gadolinium Enhancement

Clinical value of amino acid imaging in paediatric brain tumours

2005 ◽  
Vol 44 (04) ◽  
pp. 131-136 ◽  
Author(s):  
K. Lang ◽  
S. Kloska ◽  
R. Straeter ◽  
C. H. Rickert ◽  
G. Goder ◽  
...  
Keyword(s):  
Amino Acid ◽  
Brain Tumours ◽  
Photon Emission ◽  
Diagnostic Tools ◽  
Emission Computed Tomography ◽  
Gadolinium Enhancement ◽  
Tumour Grading ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Paediatric Brain Tumours

Summary Purpose: To evaluate single photon emission computed tomography (SPECT) using the amino acid l-3-[123I]-α-methyl tyrosine (IMT) and contrast enhanced magnetic resonance imaging (MRI) as diagnostic tools in primary paediatric brain tumours in respect of non-invasive tumour grading. Patients, materials, methods: 45 children with primary brain tumours were retrospectively evaluated. IMT uptake was quantified as tumour/nontumour- ratio, a 4-value-scale was used to measure gadolinium enhancement on contrast enhanced MRI. Statistical analyses were performed to evaluate IMT uptake and gadolinium enhancement in low (WHO I/II) and high (WHO III/ IV) grade tumours and to disclose a potential relationship of IMT uptake to disruption of blood brain barrier as measured in corresponding MRI scans. Results: IMT uptake above background level was observed in 35 of 45 patients. IMT uptake was slightly higher in high grade tumours but the difference failed to attain statistical significance. Grading of individual tumours was neither possible by IMT SPECT nor by gadolinium enhanced MRI. Conclusion: IMT is accumulated in most brain tumours in children. Tumour grading was not possible using IMT or contrast enhancement as determined by MRI. Neither morphological nor functional imaging can replace histology in paediatric brain tumours.

MRI with Endorectal Coil in Rectal tumor Staging: Is Gadolinium Enhancement Helpful?

1997 ◽  
Vol 37 (6) ◽  
pp. 1075
Author(s):  
Hyo Jun Kang ◽  
Taik Kun Kim ◽  
Sang Hoon Cha ◽  
Cheol Min Park ◽  
In Ho Cha ◽  
...  
Keyword(s):  
Tumor Staging ◽  
Rectal Tumor ◽  
Gadolinium Enhancement ◽  
Endorectal Coil

scholarly journals Diagnostic Yield of Electroanatomic Voltage Mapping in Guiding Endomyocardial Biopsies

Circulation ◽  
2020 ◽  
Vol 142 (13) ◽  
pp. 1249-1260 ◽  
Author(s):  
Michela Casella ◽  
Antonio Dello Russo ◽  
Marco Bergonti ◽  
Valentina Catto ◽  
Edoardo Conte ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Low Voltage ◽  
Diagnostic Yield ◽  
Gadolinium Enhancement ◽  
Promising Tool ◽  
Voltage Mapping ◽  
Few Data ◽  
New Diagnosis ◽  
Complications Rate

Background: Electroanatomic voltage mapping (EVM) is a promising modality for guiding endomyocardial biopsies (EMBs). However, few data support its feasibility and safety. We now report the largest cohort of patients undergoing EVM-guided EMBs to show its diagnostic yield and to compare it with a cardiac magnetic resonance (CMR)–guided approach. Methods: We included 162 consecutive patients undergoing EMB at our institution from 2010 to 2019. EMB was performed in pathological areas identified at EVM and CMR. CMR and EVM sensitivity and specificity regarding the identification of pathological substrates of myocardium were evaluated according to EMB results. Results: Preoperative CMR showed late gadolinium enhancement in 70% of the patients, whereas EVM identified areas of low voltage in 61%. Right (73%), left (19%), or both ventricles (8%) underwent sampling. EVM proved to have sensitivity similar to CMR (74% versus 77%), with specificity being 70% and 47%, respectively. In 12 patients with EMB-proven cardiomyopathy, EVM identified pathological areas that had been undetected at CMR evaluation. Sensitivity of pooled EVM and CMR was as high as 95%. EMB analysis allowed us to reach a new diagnosis, different from the suspected clinical diagnosis, in 39% of patients. The complications rate was low, mostly related to vascular access, with no patients requiring urgent management. Conclusions: EVM proved to be a promising tool for targeted EMB because of its sensitivity and specificity for identification of myocardial pathological substrates. EVM was demonstrated to have accuracy similar to CMR. EVM and CMR together conferred a positive predictive value of 89% on EMB.

scholarly journals Risk stratification of cardiac metastases using late gadolinium enhancement cardiovascular magnetic resonance: prognostic impact of hypo-enhancement evidenced tumor avascularity

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Angel T. Chan ◽  
William Dinsfriend ◽  
Jiwon Kim ◽  
Brian Yum ◽  
Razia Sultana ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Cancer Etiology ◽  
Enhancement Pattern ◽  
Gadolinium Enhancement ◽  
Lesion Location ◽  
Heterogeneous Enhancement ◽  
Lge Cmr

Abstract Background Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is widely used to identify cardiac neoplasms, for which diagnosis is predicated on enhancement stemming from lesion vascularity: Impact of contrast-enhancement pattern on clinical outcomes is unknown. The objective of this study was to determine whether cardiac metastasis (CMET) enhancement pattern on LGE-CMR impacts prognosis, with focus on heterogeneous lesion enhancement as a marker of tumor avascularity. Methods Advanced (stage IV) systemic cancer patients with and without CMET matched (1:1) by cancer etiology underwent a standardized CMR protocol. CMET was identified via established LGE-CMR criteria based on lesion enhancement; enhancement pattern was further classified as heterogeneous (enhancing and non-enhancing components) or diffuse and assessed via quantitative (contrast-to-noise ratio (CNR); signal-to-noise ratio (SNR)) analyses. Embolic events and mortality were tested in relation to lesion location and contrast-enhancement pattern. Results 224 patients were studied, including 112 patients with CMET and unaffected (CMET -) controls matched for systemic cancer etiology/stage. CMET enhancement pattern varied (53% heterogeneous, 47% diffuse). Quantitative analyses were consistent with lesion classification; CNR was higher and SNR lower in heterogeneously enhancing CMET (p < 0.001)—paralleled by larger size based on linear dimensions (p < 0.05). Contrast-enhancement pattern did not vary based on lesion location (p = NS). Embolic events were similar between patients with diffuse and heterogeneous lesions (p = NS) but varied by location: Patients with right-sided lesions had threefold more pulmonary emboli (20% vs. 6%, p = 0.02); those with left-sided lesions had lower rates equivalent to controls (4% vs. 5%, p = 1.00). Mortality was higher among patients with CMET (hazard ratio [HR] = 1.64 [CI 1.17–2.29], p = 0.004) compared to controls, but varied by contrast-enhancement pattern: Diffusely enhancing CMET had equivalent mortality to controls (p = 0.21) whereas prognosis was worse with heterogeneous CMET (p = 0.005) and more strongly predicted by heterogeneous enhancement (HR = 1.97 [CI 1.23–3.15], p = 0.005) than lesion size (HR = 1.11 per 10 cm [CI 0.53–2.33], p = 0.79). Conclusions Contrast-enhancement pattern and location of CMET on CMR impacts prognosis. Embolic events vary by CMET location, with likelihood of PE greatest with right-sided lesions. Heterogeneous enhancement—a marker of tumor avascularity on LGE-CMR—is a novel marker of increased mortality risk.

Apical hypertrophic cardiomyopathy with subendocardial late gadolinium enhancement in an adolescent

2020 ◽  
pp. 1-3
Author(s):  
Simona Boroni Grazioli ◽  
Marc-Philip Hitz ◽  
Inga Voges
Keyword(s):  
Late Gadolinium Enhancement ◽  
Hypertrophic Cardiomyopathy ◽  
Resonance Imaging ◽  
Gadolinium Enhancement ◽  
Apical Hypertrophic Cardiomyopathy ◽  
T Wave ◽  
Wave Inversion ◽  
Cardiology Department ◽  
History Of ◽  
Rare Diagnosis

Abstract A 17-year-old boy with a history of dyspnea attacks and chest pain was referred to our paediatric cardiology department. Electrocardiogram at presentation showed T-wave inversion in the inferior leads. Cardiovascular magnetic resonance imaging revealed the rare diagnosis of apical hypertrophic cardiomyopathy with subendocardial late gadolinium enhancement, missed by echocardiography.

Aktueller Stellenwert der Kardio-MRT in Diagnostik und Therapie

2021 ◽  
Vol 146 (07) ◽  
pp. 461-465
Author(s):  
Julia M. Vietheer ◽  
Christian W. Hamm ◽  
Andreas Rolf
Keyword(s):  
Late Gadolinium Enhancement ◽  
T2 Mapping ◽  
Strain Imaging ◽  
Gadolinium Enhancement ◽  
Quantitative Parameter ◽  
Diagnostik Und Therapie ◽  
Die Stress

Quantifizierung der links- und rechtsventrikulären Funktion Strain Imaging erweitert die klassische Volumetrie der MRT um einen sehr subtilen globalen und regionalen Funktionsparameter. Strain detektiert sehr frühe Funktionseinbußen beider Ventrikel, die visuell noch nicht erkennbar sind. Insbesondere der longitudinale Strain ist bei ischämischen und nichtischämischen Erkrankungen frühzeitig reduziert. Strain hat über die EF hinaus zusätzliche prognostische Bedeutung. Gewebecharakterisierung T1- und T2-Mapping erweitern die klassische Gewebecharakterisierung mit Late Gadolinium Enhancement (LGE) um sehr subtile quantitative Parameter, die diffuse Fibrose (T1) und Ödem (T1 und T2) widerspiegeln. Ischämiediagnostik Die Perfusions-MRT unter Vasodilatatorstress ist das genaueste Verfahren zur Ischämiediagnostik. Die MR-INFORM-Studie zeigt, dass mithilfe der Stress-MRT fast die Hälfte der Katheteruntersuchungen in einem Kollektiv mit hoher Prätestwahrscheinlichkeit vermieden werden kann. Dabei ist die Stress-MRT der FFR-basierten Strategie nicht unterlegen und genauso sicher.

scholarly journals Implications of multiple late gadolinium enhancement lesions on the frequency of left ventricular reverse remodeling and prognosis in patients with non‐ischemic cardiomyopathy

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Shingo Ota ◽  
Makoto Orii ◽  
Tsuyoshi Nishiguchi ◽  
Mao Yokoyama ◽  
Ryoko Matsushita ◽  
...  
Keyword(s):  
Heart Failure ◽  
Late Gadolinium Enhancement ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Cardiac Events ◽  
Gadolinium Enhancement ◽  
Systolic Volume ◽  
Linear Pattern ◽  
Multiple Lesions

Abstract Background Non-ischemic cardiomyopathy (NICM) is a heterogeneous disease, and its prognosis varies. Although late gadolinium enhancement (LGE)-cardiovascular magnetic resonance (CMR) demonstrates a linear pattern in the mid-wall of the septum or multiple LGE lesions in patients with NICM, the therapeutic response and prognosis of multiple LGE lesions have not been elucidated. This study aimed to investigate the frequency of left ventricular (LV) reverse remodeling (LVRR) and prognosis in patients with NICM who have multiple LGE lesions. Methods This single-center retrospective study included 101 consecutive patients with NICM who were divided into 3 groups according to LGE-CMR results: patients without LGE (no LGE group = 48 patients), patients with a typical mid-wall LGE pattern (n = 29 patients), and patients with multiple LGE lesions (n = 24 patients). LVRR was defined as an increase in LV ejection fraction (LVEF) ≥ 10 % and a final value of LVEF > 35 %, which was accompanied by a decrease in LV end-systolic volume ≥ 15 % at 12-month follow-up using echocardiography. The frequency of composite cardiac events, defined as sudden cardiac death (SCD), aborted SCD (non-fatal ventricular fibrillation, sustained ventricular tachycardia, or adequate implantable cardioverter-defibrillator therapies), and heart failure death or hospitalization for worsening heart failure, were summarized and compared between the groups. Results Among the 3 groups, the frequency of LVRR was significantly lower in the multiple lesions group than in the no LGE and mid-wall groups (no LGE vs. mid-wall vs. multiple lesions: 49 % vs. 52 % vs. 19 %, p = 0.03). There were 24 composite cardiac events among the patients: 2 in patients without LGE (hospitalization for worsening heart failure; 2), 7 in patients of the mid-wall group (SCD; 1, aborted SCD; 1 and hospitalization for worsening heart failure; 5), and 15 in patients of the multiple lesions group (SCD; 1, aborted SCD; 8 and hospitalization for worsening heart failure; 6). The multiple LGE lesions was an independent predictor of composite cardiac events (hazard ratio: 11.40 [95 % confidence intervals: 1.49−92.01], p = 0.020). Conclusions Patients with multiple LGE lesions have a higher risk of cardiac events and poorer LVRR. The LGE pattern may be useful for an improved risk stratification in patients with NICM.

scholarly journals Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 607
Author(s):  
Bibhuti B. Das ◽  
William B. Moskowitz ◽  
Mary B. Taylor ◽  
April Palmer
Keyword(s):  
Symptomatic Relief ◽  
Cross Sectional Study ◽  
Cardiac Complications ◽  
Sectional Study ◽  
Elevated Troponin ◽  
Resonance Imaging ◽  
Gadolinium Enhancement ◽  
Bottom Line ◽  
Cross Sectional ◽  
Inflammatory Drugs

This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance imaging revealed late gadolinium enhancement consistent with myocarditis in 69% of cases. All patients recovered clinically rapidly within 1–3 weeks. Most patients were treated with non-steroidal anti-inflammatory drugs for symptomatic relief, and 4 received intravenous immune globulin and corticosteroids. We speculate a possible causal relationship between vaccine administration and myocarditis. The data from our analysis confirms that all myocarditis and pericarditis cases are mild and resolve within a few days to few weeks. The bottom line is that the risk of cardiac complications among children and adults due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection far exceeds the minimal and rare risks of vaccination-related transient myocardial or pericardial inflammation.

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