Abstract
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.
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.
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.
