Myocardial Inflammation—Are We There Yet?

Several exogenous or endogenous factors can lead to inflammatory heart disease. Beside infectious myocarditis, other systemic inflammatory disorders such as sarcoidosis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Churg-Strauss syndrome, and rheumatoid arthritis can affect the myocardium. Myocardial inflammation may have a major impact on the outcome of these patients, resulting in sudden cardiac death, severe arrhythmias, or end-stage heart failure. The current gold standard for definite confirmation of inflammatory heart disease is endomyocardial biopsy (EMB), but is invasive and suffers low sensitivity and specificity due to sampling errors. Thus, non-invasive methods for detecting the extent and changes over time of the inflammatory myocardial disease are needed. Cardiac magnetic resonance (CMR) is such a non-invasive method. We will describe and discuss different approaches for CMR assessment of inflammatory myocardial disease including early gadolinium enhancement (EGE), T2-weighted imaging, late gadolinium enhancement (LGE), the newer mapping proton relaxation techniques (T1 pre-contrast, T1 post-contrast, T2 mapping), and the hybrid PET/MRI technique

Magnetic Resonance Imaging in Medicine: Quantitative Tissue Characterization

The medical community has long practiced the art of nondestructive evaluation in its various diagnostic imaging branches. Only within about the last decade, however, has there been an attempt to provide quantitative information to the clinical radiologist. The most important example of a system providing such information is the computed x-ray tomography (CT) scanner. The resulting digitally created images portray maps of an approximation to the electron density at discrete sampling points within the subject. Density resolution of the order of 0.1% and spatial resolution reaching 0.5 mm have become readily available.</p

Nuclear magnetic resonance:Its implications for the anaesthetist

The theory and practice of clinical nuclear magnetic resonance (NMR) imaging is reviewed. Problems which the anaesthetist will encounter are considered, and recommendations are proposed. Possible uses of NMR in anaesthesia are discussed