By Peter G. Danias

Cardiac Magnetic Resonance (CMR) is a speedily evolving imaging expertise and is now more and more used in sufferer care. Its merits are noninvasiveness, fantastic photograph resolutions, and physique tissue characterization. CMR is now a necessary a part of either cardiology and radiology education and has develop into a part of the exam for Board certification. This publication presents a condensed yet accomplished and reader pleasant academic instrument for cardiology fellows and radiology citizens. It includes a number of selection questions just like board examinations with concise remark and rationalization in regards to the right answer.

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J Nucl Med, 2006;47(5):797–806. 13. Carerj S, Micari A, Trono A, et al. Anatomical M-mode: an old-new technique. Echocardiography, 2003;20(4):357–361. 14. Sondergaard L, Hildebrandt P, Lindvig K, et al. Valve area and cardiac output in aortic stenosis: quantification by magnetic resonance velocity mapping. Am Heart J, 1993;126(5):1156–1164. 15. Chatzimavroudis GP, Oshinski JN, Franch RH, Walker PG, Yoganathan AP, and Pettigrew RI. Evaluation of the precision of magnetic resonance phase velocity mapping for blood flow measurements.

The right ventricle ejects to the pulmonary artery, the right atrium, and, possibly, to the left atrium. The quantities that can be easily quantified include the stroke volume of both right and left ventricles and the ejection and net forward flow into the aorta and pulmonary artery. The net shunt volume is the difference between Qp and Qs, irrespective of how complicated the left-to-right communication is [13, 14]. 8. The following measurements are obtained in a patient with tetralogy of Fallot who underwent a Blalock–Taussig shunt 2 years ago: Left ventricular stroke volume: 58 ml Aortic net forward flow: 50 ml Right ventricular stroke volume: 40 ml Pulmonary artery net forward flow: 35 ml If we know that there are no aortopulmonary collateral vessels and no functioning patent ductus arteriosus, what is the flow through the Blalock–Taussig shunt?

30% E. 40% Correct answer is C. During systole, the heart ejects blood forward in the aorta, and, if mitral valve regurgitation is present, backward into the left atrium. Therefore, left ventricular stroke volume equals aortic systolic forward flow plus mitral regurgitant flow. The left ventricular stroke volume is the end-diastolic minus the end-systolic volume. Accordingly, in this case, the left ventricular stroke volume is 160 − 60 = 100 mL, and the mitral regurgitant flow is 100 − 80 = 20 mL.

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