Uloga magnetske rezonancije srca u dijagnostičkoj obradi bolesnika s kardiomiopatijama

master's thesis

• Title (english): The role of cardiac magnetic resonance imaging in diagnostic work-up of patients with cardiomyopathies
• Author: Dora Zelić
• Mentor: Maja Hrabak Paar (mentor)
• Committee member: Ivica Sjekavica (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: Maja Hrabak Paar (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Magnetska rezonancija srca je neinvazivna dijagnostička metoda kojom se dobiva detaljan uvid u morfologiju i funkciju srca. Visoko je reproducibilna i iznimno precizna. Kardiovaskularne bolesti vodeći su uzrok smrti u svijetu. Kardiomiopatije definiramo kao poremećaj miokarda u kojem je miokard strukturalno i funkcionalno abnormalan u odsutnosti koronaropatije, hipertenzije, bolesti zalistaka i kongenitalnih bolesti srca koja bi uzrokovala toliki poremećaj. Uzevši u obzir da su kardiomiopatije često asimptomatske te da prvi simptom može biti iznenadna srčana smrt, jasna je potreba za točnom i pravovremenom dijagnozom. Pravovremeno liječenje može znatno produljiti životni vijek i kvalitetu života bolesnika. Danas je magnetska rezonancija srca postala nezaobilazni dio dijagnostike i praćenja liječenja bolesnika s kardiomiopatijama. Osim dijagnostike i praćenja, magnetska rezonancija srca može ukazati na etiologiju i prognozu same bolesti. Danas su u upotrebi različite tehnike snimanja, a temelje se na principima nuklearne magnetske rezonancije. Steady state-free precession cine tehnika omogućava dinamično oslikavanje kretanja stijenki miokarda s jasnom granicom između krvi i endokarda. Kontrastnim sredstvima baziranima na gadoliniju prikazuju se područja fibroze i nekroze. T2 mjerena slika s kratkim inverzijskim vremenom pri obrnutoj relaksaciji koristi se za prikaz edema miokarda. T1 i T2 mapiranjem kvantificira se T1, odnosno T2 vrijeme relaksacije u svakom pikselu. T2* mapiranje omogućuje kvantifikaciju količine nakupljenog željeza u miokardu. U ovom radu prikazana su osnovna načela nuklearne magnetske rezonancije, pregled suvremenih tehnika magnetske rezonancije i njihova uloga u dijagnostici kardiomiopatija.

Abstract (english)

Cardiac magnetic resonance imaging is a noninvasive imaging modality that gives us a better look at cardiac function and morphology. It is highly accurate and reproducible. Cardiovascular diseases are the leading cause of mortality worldwide. Cardiomyopathy is a myocardial disorder in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart disease sufficient to cause the observed myocardial abnormality. Considering that most cardiomyopathies are often asymptomatic and their first manifestation is sometimes sudden cardiac death, the need for accurate and timely diagnosis is obvious. Early management can extend the patients' life expectancy and provide a better quality of life. Today cardiac magnetic resonance is an integral part of diagnosing and monitoring patients with cardiomyopathies. Besides diagnosing and monitoring patients, cardiac magnetic resonance can provide aetiological assessment and prognosis. Multiple imaging techniques are used and are all based on principles of nuclear magnetic resonance. Steady state-free precession cine imaging allows dynamic imaging of cardiac wall motion with superior blood-endocardial border definition. Gadolinium based contrast agents highlight areas of myocardial fibrosis and necrosis. T2-weighted short-tau inversion recovery imaging shows increased signal in the presence of myocardial oedema. T1 and T2 mapping provide a pixel-by-pixel method of quantifying T1 and T2 relaxation time, respectively. T2* mapping allows quantification of myocardial tissue iron levels. This graduate thesis explains basic principles of nuclear magnetic resonance, reviews modern cardiac magnetic resonance imaging modalities and their role in the diagnostic work-up of patients with cardiomyopathy.

• Keywords: magnetska rezonancija; kardiomiopatije; kasna imbibicija gadolinijem; nekompaktna lijeva klijetka; T1 mapiranje; T2 mapiranje; slikovna dijagnostika
• Keywords (english): cardiac magnetic resonance; cardiomyopathies; late gadolinium enhancement; left ventricular non-compaction; T1 mapping; T2 mapping; diagnostic imaging
• Language: croatian
• URN:NBN: urn:nbn:hr:105:781380
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-09-02 07:53:00