الفهرس | Only 14 pages are availabe for public view |
Abstract Ischemic heart disease (IHD) accounts for about 2/3 of cases of congestive heart failure and LV dysfunction which is often not the result of irreversible scar but rather caused by functional impairment of still viable-myocytes, with the opportunity for improved function if coronary blood flow is restored. Those patients benefit from revascularization by percutaneous coronary intervention (PCI) or coronary bypass graft surgery (CABG) so; it is important to identify viable myocardium in those patients to improve their long-term survival. Currently available cardiac MRI techniques are able to fulfill the aims of imaging in IHD patients: on one hand, anatomic imaging with visualization of coronary artery disease (CAD) and on the other hand, ischemia imaging with evaluation of the consequences of CAD to the heart, particularly myocardial perfusion, function and depiction of irreversible myocardial damage. Due to its superiority over MRI, cardiac computed tomography is used nowadays for mere visualization of coronary artery stenoses, cardiac MRI being primarily focused on the assessment of the ischemic consequences of CAD. It is a non-invasive modality with good spatial resolution, high reproducibility and myocardial tissue characterization capabilities, thereby aiding in the diagnosis, guiding clinical decision making and improving risk stratifications. In clinical practice, various cMRI techniques are used to detect myocardial viability and accordingly predict regional wall motion improvement after revascularization therapy. They include: - Cine imaging for regional and global systolic function. - T2-weighted imaging with fat suppression for myocardial edema and area at risk. - Late gadolinium enhanced imaging for detection and quantification of myocardial scarring and fibrosis. |