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Cardiac magnetic resonance (MR) imaging with late gadolinium enhancement (LGE) is used to detect and assess the myocardial damage seen with a variety of cardiomyopathies. Gadolinium-based contrast material accumulates in the expanded interstitial space of the myocardium. Areas with LGE correspond to replacement fibrosis, fibrofatty change, epithelioid granuloma, inflammatory cell infiltration, cardiomyocyte necrosis, and amyloid deposition-conditions that represent a focal increase in interstitial space. Areas without LGE correspond to interstitial or plexiform fibrosis, mildly degenerated cardiomyocytes, inflammatory cell infiltration, and diffuse amyloid deposition-conditions that represent diffuse increases in interstitial space. LGE MR imaging cannot depict these diffuse changes and does not enable quantitative evaluation of this increased interstitial space because on inversion-recovery MR images, the inversion time is adjusted to null the signal from normal-appearing or the least enhancing regions of the myocardium. Thus, the absence of LGE does not always indicate normal myocardial tissue. The use of current T1 mapping techniques enables one to overcome these drawbacks of LGE imaging, detect diffuse myocardial abnormalities, and perform quantitative analysis of the interstitial space. The authors describe the histopathologic and corresponding cardiac MR imaging findings of hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, cardiac sarcoidosis, giant cell myocarditis, and cardiac amyloidosis-mainly those seen on LGE MR images-as assessed by using whole-heart specimens obtained from autopsy or transplantation. © RSNA, 2017.

Purpose: To evaluate the uterine kinetics in each phase of the menstrual cycle when observed in detail using cine‐mode magnetic resonance imaging (MRI) of sagittal and transverse plane images. Methods: Seven volunteers with a history of multiple natural pregnancies and deliveries were enrolled from January 2017 to May 2017. The kinetic parameters (depth, frequency, and direction) of uterine muscle contractions were evaluated in cine‐mode MRI. Results: Strong contractions from the uterine cornua to cervix were detected during menstruation. In the late follicular phase, the frequency of opposing contractions from the cervix and uterine cornua increased. Immediately before ovulation, contractions from the cervix reached the uterine fundus. After ovulation, opposing contractions returned. These contractions gradually decreased in the mid‐luteal phase, while fine contractions from the cervix to the middle of the uterine body were frequently observed until 7 days after ovulation. Few contractions were observed in the implantation phase. Conclusions: Our data suggest that the uterine kinetics change in each phase of the menstrual cycle in accordance with the purpose of the uterus in each phase. Further, cine‐mode MRI studies of each phase are needed to assess the relationships between uterine kinetics and infertility. [ABSTRACT FROM AUTHOR]

Background: Published results for carotid endarterectomy (CEA) in symptomatic and asymptomatic severe carotid stenosis with diabetes mellitus (DM) are contradictory. To evaluate perioperative and long-term results of CEA in patients with DM, we retrospectively analyzed data of patients with or without DM who underwent CEA in our institute. Methods: Between January 2005 and December 2010, 281 consecutive CEAs were performed in 268 patients under general anesthesia. All patients were subject to cardiac work-ups before surgery, and coronary revascularization was performed prior to CEA if patients were diagnosed with significant coronary artery stenosis. Lesion characteristics were assessed by a duplex ultrasound scan, computed tomography angiography (CTA), and plaque imaging on magnetic resonance imaging (MRI) before surgery, and patients were followed-up by a duplex ultrasound scan at three, six, and 12 months, then yearly, after surgery. Results: Of 281 cases, 136 had DM (48 %). Diabetic patients more frequently had a history of coronary artery disease than non-diabetic patients (48.5 % vs. 36.6 %, P = 0.042). Coronary intervention prior to CEA was more frequently performed in diabetic patients than in non-diabetic patients (22.1 % vs. 11.0 %, P = 0.013). The incidence of perioperative (30 day) stroke ( P = 1.000), death ( P = 1.000), and cardiac complications ( P = 0.484) did not differ among groups. Follow-up was available in 77.2 % of patients, with a median duration of 50 months (interquartile range, 32.1-67.2 months). The incidence of ipsilateral stroke ( P = 0.720), death ( P = 0.351), and severe restenosis (peak systolic velocity > 230 cm/sec) ( P = 0.905) were not different between groups. Conclusions: DM does not increase the risk of perioperative complications and does not influence long-term outcomes after CEA if preexisting vascular risk factors and cardiac diseases are appropriately evaluated and treated before surgery. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the accuracy of cardiac function measured with real-time true fast imaging with steady-state precession (True-FISP) cine without breath-hold compared with those measured from segmented True-FISP cine with breath-hold. Methods. Eighteen consecutive patients and six healthy volunteers were enrolled in the study group. Both real-time multislice True-FISP cine imaging without breath-hold and single-slice segmented True-FISP cine imaging with multiple breath-holds were performed in short-axis imaging sections to encompass the entire ventricles. Vertical long-axis cine imaging using real-time True-FISP cine sequence without breath-hold was performed to evaluate heart motion during respiration in 13 subjects. Ventricular volume and mass were evaluated by four observers independently with manual tracing. Results. Real-time True-FISP cine quality was sufficient for contour detection in all 24 subjects. Cardiodynamic measurements based on real-time True-FISP cine correlated well with those based on segmented True-FISP cine [left ventricular (LV) end-diastolic volume: r = 0.98; LV end-systolic volume: r = 0.98; LV ejection fraction: r = 0.91; LV mass: r = 0.96; right ventricular (RV) end-diastolic volume: r = 0.89; RV end-systolic volume: r = 0.94; RV ejection fraction: r = 0.79]. Intra- and interobserver variability were sufficiently small in real-time True-FISP cine without breath-hold. Heart motion during respiration along the long axis of the left ventricle (2.2 mm to 3.7 mm) was much less than the slice interval (10 mm), confirming that misregistration of slice position during respiration was low. Conclusion. Real-time True-FISP cine without breath-hold has high reproducibility and is applicable to patients with severe cardiac dysfunction and/or arrhythmias. [ABSTRACT FROM AUTHOR]

The article reports on the diagnosis given to an 84-year-old man who suffered from sensory disturbance in his hand's right ulnar and antebrachial region and C8 nerve root area. Based on the conducted magnetic resonance imaging (MRI), the patient was found to have small cortical infarction in his left hand. However, cervical lesion was not observed in the patient.

Objectives: The purpose of this study was to determine whether high-intensity carotid plaques visualized by a noncontrast T1-weighted imaging technique, magnetization-prepared rapid acquisition with gradient echo (MPRAGE), predict future coronary events in patients with clinically stable coronary artery disease (CAD). Background: Coronary plaque vulnerability to rupture can be assessed by examining for the presence of atherosclerosis and measuring intima media thickness (IMT) in surrogate vessels such as the carotid arteries. We previously showed that MPRAGE successfully identifies vulnerable carotid plaques as high-intensity signals. It remains unclear, however, if the presence of carotid high-intensity plaques (HIP) is associated with an increased risk of coronary events. Methods: We examined the signal intensity of carotid plaques in 217 patients with clinically stable CAD using MPRAGE with magnetic resonance imaging and measured IMT with ultrasonography. A carotid HIP was defined as a signal >200% that of the adjacent muscle. All patients were divided into 2 groups according to the presence or absence of HIP, namely, the HIP group (n = 116) and the non-HIP group (n = 101), and were followed up for as long as 72 months. Results: The presence of HIP was significantly associated with cardiac events compared to the non-HIP group (log-rank p < 0.0001). Furthermore, multivariate Cox regression analysis identified the presence of HIP as the strongest independent predictor of cardiac events (hazard ratio: 3.15; 95% confidence interval: 1.93 to 5.58, p < 0.0001) compared with IMT (hazard ratio: 1.62, 95% confidence interval: 0.97 to 2.44, p = 0.055) and other coronary risk factors. Conclusions: Characterization of carotid plaques using magnetic resonance imaging with MPRAGE provides more clinically relevant information for the risk assessment of CAD patients than IMT. [Copyright &y& Elsevier]

ObjectiveTo evaluate the preoperative diagnostic usefulness of magnetic resonance imaging (MRI) combined with hysteroscopy, for the assessment of myometrial invasion in endometrial carcinoma. DesignProspective observational study. SettingDepartment of Obstetrics and Gynaecology, The Ryukyu University Hospital, Okinawa, Japan. Subjects73 patients with untreated endometrial carcinoma. InterventionsThe findings of myometrial tumour invasion preoperatively observed by MRI and hysteroscopy were compared with the histopathological findings from surgical specimens. Main outcome measuresThe sensitivity and specificity of MRI combined with hysteroscopy in diagnosing myometrial tumour invasion. ResultsIn diagnosing myometrial tumour invasion (absence or presence of myometrial invasion), the sensitivities and specificities were 82.0% and 100% in MRI, 80.0% and 95.7% in hysteroscopy, and 92.0% and 95.7% in MRI combined with hysteroscopy. The sensitivity in MRI combined with hysteroscopy was significantly higher, with a false-negative rate of only 8.0%, than that of the other two methods (P = 0.025; P = 0.014). The differences in specificity were not statistically significant among these three methods (P > 0.05). MRI had a 87.8% accuracy in assessing the depth of myometrial invasion. ConclusionThese results indicate that MRI combined with hysteroscopy is an excellent diagnostic approach, superior to MRI or hysteroscopy alone, for the evaluation of myometrial tumour invasion, because MRI and hysteroscopy combined can compensate for the disadvantage or defect in each diagnostic procedure. [ABSTRACT FROM AUTHOR]