Ebook Cardiovascular magnetic resonance: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Cardiovascular magnetic resonance: Part 2
Ebook Cardiovascular magnetic resonance: Part 2
Chapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2umourous masses 224Benign cardiac tumours 226Malignant cardiac tumours 230214 CHAPTER 9 Tumours and massesIntroductionCardiac tumours are rare - 0.1-0.3% at autopsy, many of which may be incidental findings. Benign tumours and other masses are far more common than malignant tumours, and of the malig Ebook Cardiovascular magnetic resonance: Part 2nancies, metastases are many times more common than primary cardiac tumours. Masses in or around the heart can be seen on echocardiography or CT and fEbook Cardiovascular magnetic resonance: Part 2
urther investigation is required to separate artefact and innocent structures from true masses potentially of concern to the patient and clinician.CMRChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2ed on their MR properties, and their response to gadolinium contrast. CMR can differentiate normal from abnormal myocardium, identify the size, location, and anatomy of a mass, and can often provide a likely diagnosis. While CMR may not always provide a definitive pathological diagnosis, it can usua Ebook Cardiovascular magnetic resonance: Part 2lly identify abnormal tissue and determine the likelihood of a tumour based on the characteristics of the mass. It may also guide surgery and/or biopsEbook Cardiovascular magnetic resonance: Part 2
y, if this is deemed appropriate.This page intentionally left blank216 CHAPTER 9 Tumours and massesGeneral scanning techniqueA high degree of adaptabiChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2red. Gadolinium contrast is important for characterizing any mass and should be given unless contra-indicated. If assessment of calcification is needed, consider CT.Basic scanning protocolThere will be significant variability in what images are needed, depending on the nature of the mass. A general Ebook Cardiovascular magnetic resonance: Part 2scheme is provided here (see also Fig.9.1)•Standard orthogonal thoracic imaging: standard body planes (e.g. with a HASTE sequence), covering the entirEbook Cardiovascular magnetic resonance: Part 2
e mediastinum. This provides a good overview of the anatomy and can identify larger masses.•LV and RV function assessment: long axes plus a short axisChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2otion of the mass, impairment of myocardial contraction, or obstruction to flow.•± Thin-slice transaxial cine images: imaging the specific region where a mass is identified/suspected can be helpful in determining the presence of a mass and its motion. Use thin slice (4-6mm) transaxial (icoronal/sagi Ebook Cardiovascular magnetic resonance: Part 2ttal) cine images, without a gap. If necessary, the entire heart can be covered, checking for additional findings (e.g. metastases).•± Other cine imagEbook Cardiovascular magnetic resonance: Part 2
es as required: non-standard image planes are commonly required, to fully visualize the anatomy and extent of a mass. Plan these from existing images Chapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2o spin echo images: acquire Trweighted (with or without fat sat), as well as T2-weighted images (preferably triple inversion recovery, with blood and fat suppression) in the same slice positions as SSFP or in representative slices.•± Tagging: tagging may be applied to further characterize the functi Ebook Cardiovascular magnetic resonance: Part 2onal consequences of tissue infiltration (lack of mobility), if required.•± Perfusion imaging or angiography: administering gadolinium using a perfusiEbook Cardiovascular magnetic resonance: Part 2
on technique can determine the blood supply/vascularityof a suspected cardiac mass. Choose 2 or 3 representative image positions that best demonstrateChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tu Ebook Cardiovascular magnetic resonance: Part 2_______________. -___IGENERAL SCANNING TECHNIQUE217Fig. 9.1 Example of an approach to imaging masses. A large RV tumour is present (a malignant melanoma metastasis), imaged in the RVOT view (left: a,c,e,,g) and the I—I I Af "Tr\r-t r\">rsr\lr (•>QQPP rnniinnmc' tiimríiir ir218 CHAPTER 9 Tumours and Ebook Cardiovascular magnetic resonance: Part 2massesChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tuChapter 9213Tumours and massesIntroduction 214General scanning technique 216Identifying cardiac masses 220CMR features suggesting malignancy 222Non-tuGọi ngay
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