1.Recent Progress of Cardiac MRI for Nuclear Medicine Professionals
Yeon Hyeon CHOE ; Sung Mok KIM
Nuclear Medicine and Molecular Imaging 2024;58(7):431-448
Recent technical innovation enables faster and more reliable cardiac magnetic resonance (CMR) imaging than before.Artificial intelligence is used in improving image resolution, fast scanning, and automated analysis of CMR. Fast CMR techniques such as compressed sensing technique enable fast cine, perfusion, and late gadolinium-enhanced imaging and improve patient throughput and widening CMR indications. CMR feature-tracking technique gives insight on diastolic function parameters of ventricles and atria with prognostic implications. Myocardial parametric mapping became to be included in the routine CMR protocol. CMR fingerprinting enables simultaneous quantification of myocardial T1 and T2. These parameters may give information on myocardial alteration in the preclinical stages in various myocardial diseases. Four-dimensional flow imaging shows hemodynamic characteristics in or through the cardiovascular structures visually and gives quantitative values of vortex, kinetic energy, and wall-shear stress. In conclusion, CMR is an essential modality in the diagnosis of various cardiovascular diseases, especially myocardial diseases. Recent progress in CMR techniques promotes more widespread use of CMR in clinical practice. This review summarizes recent updates in CMR technologies and clinical research.
2.Recent Progress of Cardiac MRI for Nuclear Medicine Professionals
Yeon Hyeon CHOE ; Sung Mok KIM
Nuclear Medicine and Molecular Imaging 2024;58(7):431-448
Recent technical innovation enables faster and more reliable cardiac magnetic resonance (CMR) imaging than before.Artificial intelligence is used in improving image resolution, fast scanning, and automated analysis of CMR. Fast CMR techniques such as compressed sensing technique enable fast cine, perfusion, and late gadolinium-enhanced imaging and improve patient throughput and widening CMR indications. CMR feature-tracking technique gives insight on diastolic function parameters of ventricles and atria with prognostic implications. Myocardial parametric mapping became to be included in the routine CMR protocol. CMR fingerprinting enables simultaneous quantification of myocardial T1 and T2. These parameters may give information on myocardial alteration in the preclinical stages in various myocardial diseases. Four-dimensional flow imaging shows hemodynamic characteristics in or through the cardiovascular structures visually and gives quantitative values of vortex, kinetic energy, and wall-shear stress. In conclusion, CMR is an essential modality in the diagnosis of various cardiovascular diseases, especially myocardial diseases. Recent progress in CMR techniques promotes more widespread use of CMR in clinical practice. This review summarizes recent updates in CMR technologies and clinical research.
3.Recent Progress of Cardiac MRI for Nuclear Medicine Professionals
Yeon Hyeon CHOE ; Sung Mok KIM
Nuclear Medicine and Molecular Imaging 2024;58(7):431-448
Recent technical innovation enables faster and more reliable cardiac magnetic resonance (CMR) imaging than before.Artificial intelligence is used in improving image resolution, fast scanning, and automated analysis of CMR. Fast CMR techniques such as compressed sensing technique enable fast cine, perfusion, and late gadolinium-enhanced imaging and improve patient throughput and widening CMR indications. CMR feature-tracking technique gives insight on diastolic function parameters of ventricles and atria with prognostic implications. Myocardial parametric mapping became to be included in the routine CMR protocol. CMR fingerprinting enables simultaneous quantification of myocardial T1 and T2. These parameters may give information on myocardial alteration in the preclinical stages in various myocardial diseases. Four-dimensional flow imaging shows hemodynamic characteristics in or through the cardiovascular structures visually and gives quantitative values of vortex, kinetic energy, and wall-shear stress. In conclusion, CMR is an essential modality in the diagnosis of various cardiovascular diseases, especially myocardial diseases. Recent progress in CMR techniques promotes more widespread use of CMR in clinical practice. This review summarizes recent updates in CMR technologies and clinical research.
4.Recent Progress of Cardiac MRI for Nuclear Medicine Professionals
Yeon Hyeon CHOE ; Sung Mok KIM
Nuclear Medicine and Molecular Imaging 2024;58(7):431-448
Recent technical innovation enables faster and more reliable cardiac magnetic resonance (CMR) imaging than before.Artificial intelligence is used in improving image resolution, fast scanning, and automated analysis of CMR. Fast CMR techniques such as compressed sensing technique enable fast cine, perfusion, and late gadolinium-enhanced imaging and improve patient throughput and widening CMR indications. CMR feature-tracking technique gives insight on diastolic function parameters of ventricles and atria with prognostic implications. Myocardial parametric mapping became to be included in the routine CMR protocol. CMR fingerprinting enables simultaneous quantification of myocardial T1 and T2. These parameters may give information on myocardial alteration in the preclinical stages in various myocardial diseases. Four-dimensional flow imaging shows hemodynamic characteristics in or through the cardiovascular structures visually and gives quantitative values of vortex, kinetic energy, and wall-shear stress. In conclusion, CMR is an essential modality in the diagnosis of various cardiovascular diseases, especially myocardial diseases. Recent progress in CMR techniques promotes more widespread use of CMR in clinical practice. This review summarizes recent updates in CMR technologies and clinical research.
5.Recent Progress of Cardiac MRI for Nuclear Medicine Professionals
Yeon Hyeon CHOE ; Sung Mok KIM
Nuclear Medicine and Molecular Imaging 2024;58(7):431-448
Recent technical innovation enables faster and more reliable cardiac magnetic resonance (CMR) imaging than before.Artificial intelligence is used in improving image resolution, fast scanning, and automated analysis of CMR. Fast CMR techniques such as compressed sensing technique enable fast cine, perfusion, and late gadolinium-enhanced imaging and improve patient throughput and widening CMR indications. CMR feature-tracking technique gives insight on diastolic function parameters of ventricles and atria with prognostic implications. Myocardial parametric mapping became to be included in the routine CMR protocol. CMR fingerprinting enables simultaneous quantification of myocardial T1 and T2. These parameters may give information on myocardial alteration in the preclinical stages in various myocardial diseases. Four-dimensional flow imaging shows hemodynamic characteristics in or through the cardiovascular structures visually and gives quantitative values of vortex, kinetic energy, and wall-shear stress. In conclusion, CMR is an essential modality in the diagnosis of various cardiovascular diseases, especially myocardial diseases. Recent progress in CMR techniques promotes more widespread use of CMR in clinical practice. This review summarizes recent updates in CMR technologies and clinical research.
6.The Prognostic Impact of Coronary Artery Disease and Aortic Aneurysm:Insights From CT Protocol for Simultaneous Evaluation of Coronary Artery and Aorta
Hoyoung KIM ; Jihoon KIM ; Yeon Hyeon CHOE ; Sung Mok KIM
Journal of Korean Medical Science 2023;38(45):e379-
Background:
There is a strong correlation between risk factors for coronary artery disease (CAD) and aortic aneurysm (AA). We aimed to investigate the prevalence and prognostic impact of CAD and AA in patients who underwent coronary aorta computed tomography (CACT) protocol, which allowed simultaneous evaluation of coronary artery and aorta.
Methods:
Between 2010 and 2021, 1,553 patients who underwent CACT were enrolled from a tertiary center. The presence and location of AA and the presence of CAD were identified from CT. The primary outcome was a composite of cardiovascular death, acute coronary syndrome requiring urgent revascularization, and stroke at 3 years after the index CT scan.
Results:
Out of 1,553 enrolled patients, 179 (11.5%) had AA. The prevalence of CAD was significantly higher in patients with AA than those without (47.5% vs. 18.3%, P < 0.001). Among patients with AA, the prevalence of comorbid CAD was higher in those with abdominal AA than thoracic AA (57.3% vs. 37.8%, P = 0.014), respectively. In multivariable analysis, the presence of CAD was an independent predictor of primary outcome at 3 years (hazard ratio [HR], 2.58; 95% CI, 1.47–4.51; P = 0.001), while AA was not (HR, 1.00; 95% CI, 0.48–2.07; P = 0.993).
Conclusion
In this cohort of patients undergoing simultaneous evaluation of coronary artery and aorta using CACT protocol, patients with AA had an increased risk of comorbid CAD compared to those without AA. CAD was independently associated with adverse clinical outcomes at 3 years.
7.Open-heart surgery using Del-Nido cardioplegia in two dogs: partial atrioventricular septal defect and mitral repair
Won-Jong LEE ; Chang-Hwan MOON ; Wonkyoung YOON ; Mihyung KIM ; Woo-Jin KIM ; Kyung-Min KIM ; Haebeom LEE ; Seong-Mok JEONG ; Jae Hyeon YU ; Dae-Hyun KIM
Journal of Veterinary Science 2023;24(3):e47-
Del-Nido cardioplegia (DNc) is a single-dose cardioplegia that is widely used in human medicine because of its long duration. In this report, we describe two cases of open-heart surgery with cardiopulmonary bypass (CPB) using DNc. One dog was diagnosed with partial atrioventricular septal defect, and the other dog was diagnosed with myxomatous mitral valve disease stage D. Both dogs were treated with open-heart surgery with DNc to induce temporary cardiac arrest. No complications from DNc were observed, and the patients were discharged. Veterinary heart surgeons should consider DNc as an option for temporary cardiac arrest during open-heart surgery with CPB.
8.Determinants of Exercise Capacity in Patients With Hypertrophic Cardiomyopathy
Ji-won HWANG ; Sang-Chol LEE ; Darae KIM ; Jihoon KIM ; Eun Kyoung KIM ; Sung-A CHANG ; Sung-Ji PARK ; Sung Mok KIM ; Yeon Hyeon CHOE ; Joong Hyun AHN ; Seung Woo PARK
Journal of Korean Medical Science 2022;37(8):e62-
Background:
Reduced exercise capacity reflects symptom severity and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM). The present study aimed to identify factors that may affect exercise capacity in patients with HCM.
Methods:
In 294 patients with HCM and preserved left ventricular (LV) ejection fraction, we compared peak oxygen consumption (peak VO2 ) evaluated by cardiopulmonary exercise testing as a representative parameter of exercise tolerance with clinical and laboratory data, including N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP), diastolic parameters on echocardiography, and the grade of myocardial fibrosis on cardiac magnetic resonance imaging (CMR).
Results:
Median peak VO2 , was 29.0 mL/kg/min (interquartile range [IQR], 25.0–34.0). Age (estimated β = −0.140, P < 0.001), female sex (β = −5.362, P < 0.001), NT-proBNP (β = −1.256, P < 0.001), and E/e′ ratio on echocardiography (β = −0.209, P = 0.019) were significantly associated with exercise capacity. Peak VO2 was not associated with the amount of myocardial fibrosis on CMR (mean of late gadolinium enhancement 12.25 ± 9.67%LV).
Conclusion
Decreased exercise capacity was associated with age, female sex, increased NTproBNP level, and E/e′ ratio on echocardiography. Hemodynamic changes and increased filling pressure on echocardiography should be monitored in this population for improved outcomes.
9.A Primary Neuroendocrine Tumor Mimicking a Thrombus in the Left Atrial Appendage
Myoung Kyoung KIM ; Sung Mok KIM ; Eun Kyoung KIM ; Dong Seop JEONG ; Yeon Hyeon CHOE
Journal of the Korean Radiological Society 2022;83(2):444-449
Most cardiac tumors are metastases, and primary cardiac tumors are rare; even among primary cardiac tumors, primary cardiac neuroendocrine tumors (NETs) are extremely rare. Herein, we report a case of a patient presenting a left atrial mass without past medical history. Because of the location and movement of the mass, as well as the patient's cerebral infarction episode, the mass was initially suspected to be a thrombus. However, the mass was surgically diagnosed as NET.
10.A New Method for Aortic Valve Planimetry with High-Resolution 3-Dimensional MRI and Its Comparison with Conventional Cine MRI and Echocardiography for Assessing the Severity of Aortic Valvular Stenosis
Hae Jin KIM ; Yeon Hyeon CHOE ; Sung Mok KIM ; Eun Kyung KIM ; Mirae LEE ; Sung-Ji PARK ; Joonghyun AHN ; Keumhee C. CARRIERE
Korean Journal of Radiology 2021;22(8):1266-1278
Objective:
We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique.
Materials and Methods:
We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation.
Results:
The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm2 , 0.82 ± 0.34 cm2 , and 0.80 ± 0.26 cm2 , respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94–0.97) and 0.87 (95% CI, 0.82–0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96–0.98) and 0.98 (95% CI, 0.97–0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89–0.94) and 0.91 (95% CI, 0.88–0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82–0.91) vs. 0.85 (95% CI, 0.79–0.89).
Conclusion
High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.

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