Computed Tomography and Magnetic Resonance of the Thorax by Monvadi B. Srichai MD, Visit Amazon's David P. Naidich Page,

By Monvadi B. Srichai MD, Visit Amazon's David P. Naidich Page, search results, Learn about Author Central, David P. Naidich, , W. Richard Webb MD, Nestor L. Muller, Ioannis Vlahos MB BS BSc, Glenn A. Krinsky MD

The completely revised, up-to-date Fourth variation of this vintage reference offers authoritative, present instructions on chest imaging utilizing cutting-edge applied sciences, together with multidetector CT, MRI, puppy, and built-in CT-PET scanning. This variation incorporates a brand-new bankruptcy on cardiac imaging. large descriptions of using puppy were further to the chapters on lung melanoma, focal lung sickness, and the pleura, chest wall, and diaphragm. additionally integrated are contemporary PIOPED II findings at the position of CT angiography and CT venography in detecting pulmonary embolism. Complementing the textual content are 2,300 CT, MR, and puppy scans made at the latest-generation scanners.

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Because stunned or hibernating myocardium may normalize after revascularization of the involved regions, as opposed to regions with myocardial infarction, the distinction between these myocardial states is an important one (71–73). Currently, functional imaging can be performed using gated SPECT or PET, contrast stress echocardiography, and MR, and depending on the imaging protocol utilized, an assessment of perfusion and/or function can be made at rest and during stress conditions. In addition to evaluation for inducible ischemia, distinction between dysfunctional but viable (stunned or hibernating) myocardium and dysfunctional, nonviable (scarred) myocardium can be assessed with all these techniques, depending on the imaging protocol.

Hypoperfused regions on resting first pass perfusion studies have also been used to assess myocardial viability. As previously mentioned, areas with inadequate blood supply will often not enhance as normal myocardium. Dysfunctional regions that display hypoenhancement on resting first pass perfusion imaging showed high specificity (89%) but low sensitivity (19%) for predicting functional recovery after revascularization (91–93). Myocardial contrast hyperenhancement of infarct regions, defined as increased signal intensity on delayed resting T1-weighted MR images acquired more than 5 minutes after intravenous administration of contrast, was first described more than 20 years ago.

Traditionally, viability assessment was performed using nuclear imaging techniques (SPECT and PET) to assess myocardial metabolism, perfusion, cell membrane and mitochondrial integrity, and echocardiography to assess contractile reserve. Given the high spatial resolution provided by MR, which allows distinction between subendocardial and transmural processes, as well as the additional information needed to optimize revascularization strategies (LV function, volumes, aneurysms, intracavitary thrombus, concomitant mitral regurgitation), viability assessment by MR has become a valuable tool for the evaluation of patients with ischemic cardiomyopathy.

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