Here are a number of cases we have recently scanned at The Heart Hospital Imaging Centre.
The cases are regularly updated and if you would like any more details, please do not hesitate to contact us.
Myocarditis.
Troponin positive chest pain, normal coronaries.
Referrer and acknowledgement: Simon Kennon.
History:
33-year-old-male admitted with chest pain, troponin rise, small pericardial effusion, and echo possible anterior hypokinesia. Normal coronaries, good LV gram. Subsequent echo still abnormal.
MRI finding:
Subtle wall motion abnormalities, not typical for coronary artery disease (not territorial). Patchy mid and epicardial late gadolinium enhancement typical of myocarditis.
Referrer and acknowledgement: Simon Kennon.
History:
33-year-old-male admitted with chest pain, troponin rise, small pericardial effusion, and echo possible anterior hypokinesia. Normal coronaries, good LV gram. Subsequent echo still abnormal.
|
|
|---|---|
| Alt: MRI cine of myocarditis (4ch) | Alt: RI cine of myocardiitis (SA) |
MRI finding:
Subtle wall motion abnormalities, not typical for coronary artery disease (not territorial). Patchy mid and epicardial late gadolinium enhancement typical of myocarditis.
|
|
|---|---|
| Alt: MRI late enhancement in myocarditis |
Alt: MRI late enhancement in myocarditis. |
Pericardial mass.
Pericardial mass?
Referrer and Acknowledgement: Simon Kennon.
History:
81 year old, minor lymphadenopathy on CT, polymyalgia rheumatica on steroids,
possible anterior pericardial mass by echocardiography.
MRI finding:
Small hypertensive heart. There is no mass – it is fat (see the fat:fat-sat slow movie), likely prominent from steroids.
Referrer and Acknowledgement: Simon Kennon.
History:
81 year old, minor lymphadenopathy on CT, polymyalgia rheumatica on steroids,
possible anterior pericardial mass by echocardiography.
|
|
|---|---|
| Title | Title |
MRI finding:
Small hypertensive heart. There is no mass – it is fat (see the fat:fat-sat slow movie), likely prominent from steroids.
Perfusion.
Atypical chest pain post inferior MI, RCA stenosis but inferior Q waves and large wall motion abnormality. Is there ischemia?
Referrer and Acknowledgement: Tom Crake.
History:
Atypical chest pain, previous inferior MI with Q waves and large wall motion abnormality. RCA stenoses with retrograde filling.
Question:
Any hibernation/ischaemia?
MRI finding:
1. Inferior wall motion abnormality by only modest thinning.
2. Extensive inferior stress perfusion defect.
3. Only very subtle inferior infarction (<25% transmural)
MRI interpretation:
Just minor infarction, but extensive ischemia and some hibernation.
Outcome:
Patient proceeded to PCI.
Referrer and Acknowledgement: Tom Crake.
History:
Atypical chest pain, previous inferior MI with Q waves and large wall motion abnormality. RCA stenoses with retrograde filling.
Question:
Any hibernation/ischaemia?
|
|
|---|---|
| Alt: CMR inferior perfusion defect | Alt: CMR inferior perfusion defect |
MRI finding:
1. Inferior wall motion abnormality by only modest thinning.
2. Extensive inferior stress perfusion defect.
3. Only very subtle inferior infarction (<25% transmural)
|
|
|---|---|
| Alt: CMR hibernation | Alt: CMR subtle 25% inferior infarction |
MRI interpretation:
Just minor infarction, but extensive ischemia and some hibernation.
Outcome:
Patient proceeded to PCI.