Abstract
Cardiovascular magnetic resonance imaging plays a central role in the assessment and monitoring of patients with cardiomyopathy. It offers a comprehensive assessment during a single scan setting, with information on ventricular volumes, function and mass as well as tissue characterisation, fibrosis, flow, viability and perfusion. Acute tissue injury (oedema and necrosis) can be distinguished from fibrosis, infiltration and iron overload. It provides information on the cause and prognosis of the cardiomyopathy, and its high measurement accuracy makes it ideal for monitoring disease progression and effects of therapy. The present review highlights the main features of commonly encountered cardiomyopathies in imaging practice.
Highlights
Cardiomyopathies comprise a wide range of myocardial disorders that may be primary heart diseases or a feature of a systemic disease, and which may or may not have a genetic and/or familial component.[1]
The absence of ionising radiation adds to its safety
It is predicted that most patients with heart failure (HF) will eventually undergo Cardiovascular magnetic resonance (CMR) as part of diagnostic work-up and risk stratification.[35]
Summary
Cardiomyopathies comprise a wide range of myocardial disorders that may be primary heart diseases or a feature of a systemic disease, and which may or may not have a genetic and/or familial component.[1]. The absence of ionising radiation adds to its safety This safety feature includes intravenous contrast which allows repeated follow-up imaging, family screening and serial risk stratification. Imaging fibrosis (scar) and infiltration Gadolinium-based contrast agents are utilised. Late gadolinium enhancement (LGE) acquired at 5 min – 20 min detects delayed contrast washout in areas of infarction, fibrosis or inflammation. Fibrosis causes expansion of the interstitial space and results in increased native T1 times, and the increased gadolinium concentration results in shortening of T1 values.[1] T1 mapping is useful for detecting small amounts of fibrosis and cardiomyopathies with diffuse fibrosis.[4] Recently, T2 mapping[5] and T2* mapping[6] has been validated for imaging of myocardial oedema and/or inflammation and iron content, respectively. Flow quantification CMR velocity mapping can provide reproducible assessment of valvular disease, intracardiac shunts and congenital heart disease, and compares well with echocardiography.[7]
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