Clinical Atlas of Cardiac and Aortic CT and MRI

373 Pages·2019·45.73 MB·English

by  Patricia M. Carrascosa

Clinical Atlas of
Cardiac and Aortic
CCCTTT aaannnddd MMMRRRIII
Patricia M. Carrascosa
Carlos M. Capuñay
Alejandro Deviggiano
Gastón A. Rodríguez-Granillo
Editors
123
Clinical Atlas of Cardiac and Aortic CT and MRI
Patricia M. Carrascosa · Carlos M. Capuñay
Alejandro Deviggiano
Gastón A. Rodríguez-Granillo
Editors
Clinical Atlas of Cardiac
and Aortic CT and MRI
Editors
Patricia M. Carrascosa Carlos M. Capuñay
Department of Cardiovascular Imaging Department of Cardiovascular Imaging
Associate Professor of Radiology Diagnostico Maipú
Buenos Aires University Buenos Aires
Diagnostico Maipú Buenos Aires
Buenos Aires Argentina
Buenos Aires
Argentina Gastón A. Rodríguez-Granillo
Department of Cardiovascular Imaging
Alejandro Deviggiano Department of Research
Department of Cardiovascular Imaging Diagnostico Maipú
Diagnostico Maipú Buenos Aires
Buenos Aires Buenos Aires
Buenos Aires Argentina
Argentina
ISBN 978-3-030-03681-2 ISBN 978-3-030-03682-9 (eBook)
https://doi.org/10.1007/978-3-030-03682-9
Library of Congress Control Number: 2019930252
© Springer Nature Switzerland AG 2019
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is
concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction
on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed
to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty,
express or implied, with respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Illustrations by Daniel Cirigliano: Diagnostico Maipu, Departmento de Investigacion. Av. Maipú 1668, Vicente López
B1602ABQ, Buenos Aires, Argentina
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword
It is just about 20 years ago when the concept of “Advanced Cardiac Imaging” emerged, add-
ing multi-slice cardiac CT and contrast-enhanced cardiac MRI to the curriculum of trainees in
the sub-specialty of cardiovascular medicine and rapidly becoming a subspecialty of interest
for cardiologists and radiologists. It was about that time when I met Patricia Carrascosa, a
radiologist with an unmatched energy level, who over the years has proven excellence as a
clinician and as a clinical investigator. Among her many strengths, Dr. Carrascosa has shown a
vision to move clinical research beyond any limits but focusing on unmet clinical needs, dis-
covered through her collaboration with local and international leaders from both the radiology
and cardiology worlds. I have been fortunate to have the opportunity of participating with her
in many projects, and I am a witness of her creativity and perseverance, both essential qualities
for a leader. Most of the authors and editors of this book have been our colleagues and have
also emerged as leaders in the field, coming together now to produce a comprehensive com-
pendium of images accompanied by a summary of the essential technical and clinical informa-
tion that should be relevant to the practice of advanced cardiac imaging.
This Atlas should be equally useful to those who are involved in the interpretation of car-
diovascular imaging studies, regardless of their technical area of expertise, as well as to clini-
cians who often wonder what the most appropriate method to establish a diagnosis is. Each
chapter has been carefully crafted to cover all clinical aspects of cardiovascular imaging suc-
cinctly and comprehensively at the same time. High-quality images are accompanied by clear
diagrams and tables that will be useful to readers and consultants.
“Now, here, you see, it takes all the running you can do, to keep in the same place. If you
want to get somewhere else, you must run at least twice as fast as that!” – written by Lewis
Carroll in Through the Looking-Glass defines Carrascosa as the Alice in the Wonderland of
Imaging. Congratulations to her and her colleagues in another great accomplishment.
Mario J. Garcia
Division of Cardiology, Medicine and Radiology
Montefiore-Einstein Center for Heart and Vascular Care
New York, NY
USA
v
Preface
In the past few decades, cardiac CT and MRI have rapidly shifted from appealing research
tools, to adjuvant diagnostic strategies, and ultimately to a fundamental role in a wide range of
ischemic and nonischemic diseases. In parallel, structural heart disease, closely related to the
recent surge of several noncoronary percutaneous interventions, has underwent an enormous
growth both in terms of number of procedures and variety of interventions.
Indeed, these imaging techniques are revolutionizing the diagnostic and therapeutic
approach of cardiovascular patients and progressively becoming attractive subspecialties
among radiologists and cardiologists.
In routine clinical practice, cardiac and aortic CT and/or MRI are performed to define diag-
nosis among patients with inconclusive findings, nondiagnostic tests, rare diseases, to improve
characterization of specific entities such as cardiomyopathies, and/or as guidance and surveil-
lance of percutaneous interventions such as transcatheter aortic valve replacement and endo-
vascular aortic repair, among others.
Consequently, cardiologists and/or radiologists involved in the evaluation of these patients
are regularly confronted to challenging unusual cases. Furthermore, such physicians are usu-
ally implicated in both imaging fields.
Based on the abovementioned reasons, rather than extensive and technically detailed text-
books, there is an unmet need for a concise, specific, case-report-based text aimed at describ-
ing the main findings, key features, and most frequent variants that can be found on a daily
basis.
For this purpose, we collected a thorough sample of the most common and uncommon
cases that are evaluated in routine practice of an imaging facility (Diagnostico Maipu, Buenos
Aires, Argentina), provided in their clinical context. Moreover, renowned experts from other
institutions provide additional exceptional cases, particularly involving rare diseases such as
congenital heart disease and cardiac tumors.
Cases are arranged within the following nine main chapters: (1) Cardiac Anatomy and
Coronary Anomalies; (2) Ischemic Cardiomyopathy; (3) Myocardial Infarction with
Nonobstructive Coronary Arteries; (4) Nonischemic Cardiomyopathy; (5) Structural Heart
Disease and Guidance of Percutaneous Procedures; (6) Congenital Heart Disease; (7) Cardiac
Masses and Tumors; (8) Pericardial Disease; and (9) Aortic Disease.
vii
viii Preface
We definitively believe this will become a very useful reference not only for the radiology/
cardiology resident, fellow, or general practitioner, but also for the cardiovascular imaging
specialist.
Each case is placed in its clinical context and has an introductory text discussing key clinical
and imaging features. Furthermore, all cases have a very brief concluding text describing the
pathology, prognosis, and therapeutic options based on the clinical presentation and key CT and
MR imaging features, thus facilitating a more comprehensive pathology-oriented-approach.
Clinical Atlas of Cardiac and Aortic CT and MRI therefore provides a valuable resource for
both specialist and nonspecialist practitioners who are seeking to recognize and understand the
features of a variety of heart and aortic diseases using CT and MR imaging techniques.
Patricia M. Carrascosa
Carlos M. Capuñay
Alejandro Deviggiano
Gastón M. Rodríguez-Granillo
Contents
1 Cardiac Anatomy and Coronary Artery Anomalies . . . . . . . . . . . . . . . . . . . . . . . . 1
Patricia M. Carrascosa and Carlos M. Capuñay
2 Ischemic Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Gastón A. Rodríguez-Granillo, Patricia M. Carrascosa,
and Alejandro H. de la Vega
3 Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA) . . . . 99
Alejandro Deviggiano, Patricia M. Carrascosa,
and Gastón A. Rodríguez-Granillo
4 Nonischemic Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Gastón A. Rodríguez-Granillo, Cesar Nomura, Andrea Maria Giovannini Bercht,
and Alejandro Deviggiano
5 Structural Heart Disease and Guidance of Percutaneous Procedures . . . . . . . . . . 169
Gastón A. Rodríguez-Granillo, Alejandro Zuluaga, Mariano L. Falconi,
and Natalia Aldana Sepulveda
6 Congenital Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Fernando Abramzon, Maria Jose Bosaleh, Pablo Pollono, Ezequiel Levy Yeyati,
Juan Wolcan, and Gastón A. Rodríguez-Granillo
7 Cardiac Masses and Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Patricia M. Carrascosa, Gastón A. Rodríguez-Granillo, Alejandro Deviggiano,
Diego Perez de Arenaza, and Macarena C. De Zan
8 Pericardial Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Patricia M. Carrascosa, Alejandro Deviggiano,
and Gastón A. Rodríguez-Granillo
9 Aortic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Carlos M. Capuñay, Jimena B. Carpio, Fernando Abramzon,
Maria Jose Bosaleh, Gastón A. Rodríguez-Granillo, and Patricia M. Carrascosa
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .365
ix
Contributors
Fernando Abramzon, MD Cardiovascular Imaging, Department of Radiology, Hospital de
Trauma y Emergencias “Dr. Federico Abete”, University of Buenos Aires, Buenos Aires,
Argentina
Maria Jose Bosaleh, MD Department of Pediatrics, Pediatric Cardiology Section, Department
of Radiology, Section of CT and MR, Hospital Nacional Alejandro Posadas, Buenos Aires,
Argentina
Carlos  M.  Capuñay, MD Departments of CT, MR, and Research, Department of
Cardiovascular Imaging, Diagnostico Maipu, Buenos Aires, Argentina
Jimena B. Carpio, MD Department of CT and MR, Diagnóstico Maipú, Buenos Aires,
Argentina
Patricia M. Carrascosa, MD, PhD, FACC, FSCCT Departments of CT, MR, and Research,
Department of Cardiovascular Imaging, Diagnostico Maipu, Buenos Aires, Argentina
University of Buenos Aires, Buenos Aires, Argentina
Latin American Committee of the Society of Cardiovascular Computed Tomography, Buenos
Aires, Argentina
Alejandro H. de la Vega, MD Cardiovascular Imaging, CT and MR of Clinica de Imagenes
and Fundación Médica de Río Negro y Neuquén, Cipolletti, Argentina
Macarena C. De Zan, MD Cardiovascular CT and MR, CEMIC and Fundación Centro
Diagnostico Nuclear, Buenos Aires, Argentina
Alejandro Deviggiano, MD Department of Cardiovascular Imaging, Diagnostico Maipu,
Buenos Aires, Argentina
Cardiac CT and MRI Council of the Argentinian Society of Cardiology, Buenos Aires,
Argentina
Mariano L. Falconi, MD Universidad del Salvador, Buenos Aires, Argentina
Cardiology Specialist Career, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
Cardiovascular Imaging Unit, Cardiology Division, Hospital Italiano of Buenos Aires, Buenos
Aires, Argentina
Andrea Maria Giovannini Bercht, MD Cardiovascular Magnetic Resonance and Computed
Tomography Department, Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
Ezequiel Levy Yeyati, MD Cardiovascular Imaging, Department of Radiology, Hospital
Municipal de Merlo “Eva Perón”, University of Buenos Aires, Buenos Aires, Argentina
Cesar  Nomura, MD Cardiovascular Magnetic Resonance and Computed Tomography
Department, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo,
Brazil
xi
xii Contributors
Diego Pérez de Arenaza, MD Cardiovascular Imaging Section, Department of Cardiology,
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Pablo Pollono, MD Department of Cardiovascular Imaging, Hospital del Cruce, Florencio
Varela, Buenos Aires, Argentina
Gastón A. Rodríguez-Granillo, MD, PhD, FACC Department of Cardiovascular Imaging,
Department of Research, Diagnostico Maipu, Buenos Aires, Argentina
National Council of Scientific and Technical Investigations (CONICET), Buenos Aires,
Argentina
Natalia Aldana Sepulveda, MD Clinical Radiology Universidad CES, Medellín, Colombia
Clinical Radiology Universidad Pontificia Bolivariana, Medellín, Colombia
CEDIMED, Body and Cardiovascular Imaging sections, Medellín, Colombia
Juan Wolcan, MD Department of Cardiovascular Imaging, Hospital del Cruce, Florencio
Varela, Buenos Aires, Argentina
Alejandro  Zuluaga  Santamaría, MD, FSCMR Clinical Radiology Universidad CES,
Medellín, Colombia
Clinical Radiology Universidad Pontificia Bolivariana, Medellín, Colombia
Radiology Residence Universidad Pontificia Bolivariana, Medellín, Colombia
CEDIMED, Body and Cardio-vascular Imaging sections, Medellín, Colombia