Cardiovascular magnetic resonance evaluation of effusive and constrictive physiologies

<p>This thesis presents an exploration of cardiovascular magnetic resonance (CMR) in the evaluation of effusive and constrictive heart conditions. Central to the thesis is advanced CMR as a diagnostic tool in pericardial effusion and constrictive pericarditis.</p><p>Studies I and II concern the application of T1 mapping for the characterization of pleural and pericardial effusions and attempts to enhance the understanding of the dynamics of extracellular gadolinium-based contrast agents (GBCA) in effusion fluid. Study II establishes normal T1 values at 1.5 T in the pericardial fluid of healthy individuals, providing a benchmark for future studies. Studies III and IV concern ventricular interdependence, a crucial aspect in evaluating constrictive physiology. Ventricular interdependence is measured by quantifying the respiratory variation in peak early transvalvular blood flow velocities. In Study III, an open-source software tool to perform semi-automated image analysis of real-time phase contrast (RT-PC) images is developed, and normal values are established. In Study IV, the repeatability and reproducibility of the method are tested.</p><p>This thesis concludes that CMR can become a valuable tool in evaluating pericardial effusion and constrictive pericarditis. Both molecular imaging evaluation of effusive fluids and hemodynamic assessment of ventricular interdependence are feasible using CMR.</p><h3>List of scientific papers</h3><p>I. Thalén S, Maanja M, Sigfridsson A, Maret E, Sörensson P, Ugander M. The dynamics of extracellular gadolinium-based contrast agent excretion into pleural and pericardial effusions quantified by T1 mapping cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2019;21(1):71. <br><a href="https://doi.org/10.1186/s12968-019-0580-1">https://doi.org/10.1186/s12968-019-0580-1</a><br><br> </p><p>II. Thalén S, Ramos JG, Engblom H, Sigfridsson A, Sörensson P, Ugander M. Normal values for native T1 at 1.5 T in the pericardial fluid of healthy volunteers. European Heart Journal - Imaging Methods and Practice. 2023;1(2):qyad028. <br><a href="https://doi.org/10.1093/ehjimp/qyad028">https://doi.org/10.1093/ehjimp/qyad028</a><br><br></p><p>III. Thalén S, Heiberg E, Sörensson P , Giese D, Sigfridsson A, Ugander M. Normal values for mitral and tricuspid early inflow blood flow velocity variation using real time phase contrast cardiovascular magnetic resonance. [Submitted]</p><p>IV. Thalén S, Wieslander B, Sigfridsson S, Giese D, Sörensson P, Ugander M. Test-retest repeatability and inter-observer reproducibility of ventricular interdependence measured using semi-automatic analysis of real time phase contrast cardiovascular imaging. [Manuscript]</p>