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The article discusses the potential use of liver T1 mapping derived from cardiac magnetic resonance imaging (MRI) as a prognostic marker in patients with idiopathic dilated cardiomyopathy (DCM). DCM is characterized by left ventricular or biventricular dilation and impaired systolic function. The study found that liver T1 maps and extracellular volume (ECV) maps in the liver are correlated with right ventricular function and myocardial fibrosis extents in patients with DCM. The authors suggest that including these additional cardiac MRI parameters may improve the management of patients with DCM in the future. However, there are limitations to the study, such as the lack of quantification of late gadolinium enhancement (LGE) and the lack of correlation of liver ECV with liver histopathology. Further research is needed to understand the relationship between hepatic remodeling and DCM and to assess the therapeutic efficacy of new treatment strategies. [Extracted from the article]

The article offers guidance for implementing a high-quality virtual cardiovascular magnetic resonance (CMR) training program to complement in-person training options for physicians. Topics covered include recommendations designed to maintain high quality CMR level II training and keep the standards that are currently established for the in-person training, guidance for the use of innovative educational approaches, and stipulations of high-quality virtual experience.

Myocardial fibrosis (MF) is defined as excessive production and deposition of extra-cellular matrix proteins that result in pathologic myocardial remodeling. Three types of MF have been identified: replacement fibrosis from tissue necrosis, reactive fibrosis from myocardial stress, and infiltrative interstitial fibrosis from progressive deposition of nondegradable material such as amyloid. Although echocardiography, nuclear medicine, and CT play important roles in the assessment of MF, MRI is pivotal in the evaluation of MF, with the late gadolinium enhancement (LGE) technique used as a primary end point. The LGE technique focuses on the pattern and distribution of gadolinium accumulation in the myocardium and assists in the diagnosis and establishment of the cause of both ischemic and nonischemic cardiomyopathy. LGE MRI also aids prognostication and risk stratification. In addition, LGE MRI is used to guide the management of patients considered for ablation for arrhythmias. Parametric mapping techniques, including T1 mapping and extracellular volume measurement, allow detection and quantification of diffuse fibrosis, which may not be detected by LGE MRI. These techniques also allow monitoring of disease progression and therapy response. This review provides an update on the imaging of MF, including prognostication and risk stratification tools, electrophysiologic considerations, and disease monitoring.

Competing Interests: Conflict of interest: A.V.R. is on the Scientific Advisory Board for CLEERLY. All other authors declared no conflict of interest.

Background: Tetralogy of Fallot (ToF) is the most common form of cyanotic congenital heart disease, where right ventricular (RV) function is an important determinant of subsequent intervention., Objective: In this study, we evaluate the feasibility of fast strain-encoding (fastSENC; a one-heartbeat sequence) magnetic resonance imaging (MRI) for assessing regional cardiac function in ToF., Method: FastSENC was implemented to characterize regional circumferential (Ecc) and longitudinal (Ell) strains in the left ventricle (LV) and RV in post-repair ToF. Data analysis was conducted to compare strain measurements in the RV to those in the LV, as well as to those generated by the MRI Tissue-Tracking (MRI-TT) technique, and to assess the relationship between strain and ejection fraction (EF)., Results: Despite normal LVEF (55±8.5%), RVEF was borderline (46±6.4%), but significantly lower than LVEF. RV strains (RV-Ell=-20.2±2.9%, RV-Ecc=-15.7±6.4%) were less than LV strains (LV-Ell=-21.7±3.7%, LV-Ecc=-18.3±4.7%), and Ell was the dominant strain component. Strain differences between fastSENC and MRI-TT were less significant in RV than in LV. There existed moderate and weak correlations for RV-Ecc and RV-Ell, respectively, against RVEF. Compared to LV strain, RV strain showed regional heterogeneity with a trend for reduced strain from the inferior to anterior regions. Inter-ventricular strain delay was larger for Ell (64±47ms) compared to Ecc (36±40ms), reflecting a trend for contraction dyssynchrony., Conclusion: FastSENC allows for characterizing subclinical regional RV dysfunction in ToF. Due to its sensitivity for evaluating regional myocardial contractility patterns and real-time imaging capability without the need for breath-holding, fastSENC makes it more suitable for evaluating RV function in ToF., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Pulmonary CTA is a ubiquitous study interpreted by radiologists with different levels of experience in a variety of practice settings. Pulmonary embolism (PE) can range from an incidental and clinically insignificant finding to a clinically significant thrombus that can be managed on an outpatient basis to a potentially fatal condition requiring immediate medical or invasive management. Accordingly, a clear and concise pulmonary CTA report should effectively communicate the most pertinent findings to help the treating medical team diagnose or exclude PE and provide information to guide appropriate management. In this Expert Panel Narrative Review, we discuss the purpose of the radiology report for pulmonary CTA, the optimal report format, and the relevant findings that need to be addressed and their clinical significance.