CMR imaging for diastolic hemodynamic assessment: Fantasy or reality?

摘要

Assessment of pericardial disease by cardiac magnetic resonance (CMR) is a well-established clinical application (1). For the diagnosis of constrictive pericarditis, CMR has focused on morphological features, specifically pericardial thickness (2,3) as well as distorted ventricular contours, dilated hepatic veins, and the inferior vena cava (IVC). Pericardial thickness >4 mm measured by CMR demonstrated 93% accuracy in diagnosing constriction (4), but pericardial thickness measurement is a crude tool with which to assess complex hemody-namics. Studies also have shown that almost 20% of patients with constriction have normal pericardial thickness on histological examination as well as on transesophageal echocardiography and computed tomography (5,6).