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Does magnetic resonance change clinical management in...

Non-Invasive Imaging


The purpose of this session was to demonstrate the clinical value of magnetic resonance imaging (MRI) in different clinical scenarios.
Prof. Mavrogeni (Athens, GR) highlighted the usefulness of MRI in patients with rheumatic disease. Complexity of a broad range of different rheumatic diseases with involvement of myocardium, pericardium, large and small arteries including coronaries requires multimodality imaging in the hands of clinically experienced centers and investigators in order to cover the demand to depict inflammation, ischemia and infiltrative changes in a comprehensive scan procedure. Diagnostic findings may translate into a change in therapy.
Next, Prof Sheridd (New York, US) discussed how MRI could be used to overcome limitations of echocardiography among patients with hypertrophic cardiomyopathy (HCM), i.e. differentiation of HCM from non-compaction cardiomyopathy (CMP), overlap of cardiomyopathy phenotype, amyloidosis, Anderson-Fabry disease and athlete’s heart. Another strength of MRI is the better reading and quantification of LV hypertrophy and detection of late gadolinium enhancement, which carries important prognostic information.
Prof. Lombardi (Pisa, Italy) expanded on the detection of arrhythmogenic right ventricular dysplasia, which is an ideal disease for MRI as the right ventricle can be visualized far better, i.e. detection of fibrofatty degeneration, fibrosis, global heart function, regional wall motion abnormalities and biventricular size. However, he also discussed the difficulties establishing an MRI-based diagnosis.
Finally, Prof. Schulz-Menger (Berlin, Germany) pointed out the advantages and techniques of contrast-enhanced MRI for detection of myocarditis and the need to discriminate myocardial infarction, cardiac involvement in systemic sarcoidosis, and dilated cardiomyopathy. She discussed updated recommendations for more restricted use of myocardial biopsies for myocarditis and the emerging role of MRI in establishing diagnosis and monitoring of these patients.

 

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Does magnetic resonance change clinical management in...

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.