Table 2.
Clinical indication | Contraindication to a Cardiac MRI at the time of Cardiac CT | Myocardial segments with Delayed enhancement | Comparative imaging modality | Myocardial segments on comparative modality | |
---|---|---|---|---|---|
1 |
CAD -- Chest pain and inconclusive cardiac MRI. (MRI was not able to predict the cause of DE) |
Anxiety causing incomplete and inconclusive Cardiac exam |
Inferior wall (Transmural) |
SPECT MRI |
SPECT - Fixed perfusion defect in the inferior wall MRI – Delayed enhancement in Inferior wall. CTA – Obstructive disease in the dominant RCA |
2 |
CM -- Progression of Sarcoidosis (new pacemaker precluded followup MRI) |
Permanent Pacemaker |
Lateral wall Apical LV wall (Patchy foci) |
MRI |
Lateral Apical left ventricular wall (Patchy foci) |
3 |
CAD -- Assessment of ischemic scar |
Permanent Pacemaker |
Basal wall Mid lateral wall |
TTE |
Basal, lateral wall (severe hypokinesis) Apical wall (Hyper-reflective/ Increased echogenicity) |
4 |
CM -- Hypertrophic cardiomyopathy and scar assessment |
AICD |
Basal, Mid inferior, Inferolateral, Anterolateral LV wall |
TTE |
Asymmetric septal hypertrophy. |
5 |
CAD -- Scar mapping for ventricular tachycardia ablation |
AICD |
Basal, Mid inferolateral wall |
TTE |
Basal Mid inferolateral wall (Hyper-reflective/ increased echogenicity) |
6 |
CM -- Idiopathic cardiomyopathy and Worsening ventricular arrhythmias. |
AICD |
Mid to apical anterior, Anteroseptal, Anterolateral LV wall |
TTE |
Apical (Akinesis) Anteroseptal (Akineis) Anterolateral wall (Hypokinesis) Septum and apex (Hyper-reflectivity/Increased echogenicity) |
7 |
CM -- HCM, recurrent AICD shocks |
AICD |
Mid myocardium in anteroseptal Basal wall |
TTE |
Marked asymmetric LV hypertrophy. |
8 |
CM -- Progression of Sarcoidosis |
Permanent |
Subepicardial portion of antero-septal mid ventricular wall Mid myocardial basal, Anteroseptal wall and Sub endocardial mid inferolateral wall. |
TTE |
Mid myocardial wall (Hypokinesis) Inferoposterior (Hyper-reflective/increased echogenicity) |
|
|
Pacemaker |
|
|
|
9 | CAD -- Ventricular tachycardia storm; scar assessment | AICD | Inferior wall and Basal to apical LV, Anterior wall at basal, mid ventricular level. | TTE | Inferior, septal, apical (Akinesis) Inferior and posterior wall. (Hyper-reflective/increased echogenicity) |
AICD = Automated Implantable Cardioverter Defibrillator, CAD = Coronary artery disease, CM = Cardiomyopathy, C-MRI = cardiac MRI, DE = Delayed enhancement, HCM = Hypertrophic cardiomyopathy, LV = Left ventricle, PM = Pace maker, TTE = Transthoracic echocardiogram, VT = Ventricular Tachycardia.