Medical Lecture Note: Ho: Cardiovascular Imaging (Expert Radiology Consult Series)

The ability to image the cardiovascular system has improved exponentially over the past 20 years. This project began rather modestly but quickly ballooned to a two-volume book of 119 chapters as we began to lengthen our list of the most important cardiovascular imaging techniques and common conditions. We were fortunate to have enlisted an excellent group of highly dedicated experts from the best universities and cardiovascular centers in the world.

Our book consists of two volumes: Cardiac Imaging (Volume I) and Vascular Imaging (Volume II). Section 1 of Volume I begins with an introduction to normal cardiac embryology, anatomy, and physiology. Section 2 reviews the physics and technical considerations for the various cardiac imaging techniques ranging from plain film, echocardiography, and invasive catheterization to advanced cardiac CT, MR, SPECT, and PET/CT. This section is supplemented by special discussions on CT dose reduction strategies, CT and MR contrast agents, MR safety, radiopharmaceuticals, and pharmacologic stress agents. Section 3 is dedicated to cardiac interventions, covering both percutaneous as well as open procedures. In Section 4, coronary artery imaging is reviewed with detailed discussions of imaging of coronary artery calcium, congenital coronary anomalies, obstructive coronary disease, coronary artery aneurysms, and coronary revascularization procedures. Section 5 reviews the wide variety of acyanotic and cyanotic congenital heart disease with special mention of coarctation of the aorta as well as vascular rings and slings. In Section 6, the pathologic basis for ischemic heart disease is reviewed and followed by detailed discussions of myocardial perfusion, function, and viability as determined by CT, MR, and radionuclide imaging. Valvular heart disease is reviewed in Section 7. Section 8 details the various forms of cardiomyopathy (i.e., dilated, restrictive, and hypertrophic), including chapters on arrhythmogenic right ventricular dysplasia and myocarditis. Section 9 provides a brilliant pictorial of cardiac tumors. In Section 10, pericardial diseases are discussed.

Volume II is devoted to vascular imaging and begins with Section 11, which reviews normal arterial and venous anatomy in the thorax, abdomen, pelvis, and extremities. Section 12 provides a technical and clinical discussion of vascular ultrasound, CT angiography (CTA), MR angiography (MRA), CTA/MRA image postprocessing, and vascular applications of nuclear medicine. Section 13 provides a review of the various arterial percutaneous and open procedures. Noninvasive imaging of atherosclerotic plaque (“plaque imaging”) is reviewed in Section 14. In Section 15, carotid artery disease and imaging using ultrasound, CTA, and MRA are reviewed. Section 16 discusses common vascular thoracic conditions such as thoracic aortic aneurysm, acute aortic syndrome, aortic trauma, aortitis, pulmonary thromboembolism, pulmonary arterial hypertension, pulmonary edema and pulmonary hemorrhage, and vasculitis. This is followed by Section 17, which explores imaging considerations for the various abdominal vascular conditions such as abdominal aortic disease, endograft arterial repair, open surgical arterial repair, renal artery hypertension, renal and central venous conditions, hepatic transplantation, and renal and pancreatic transplantation. In Section 18, peripheral arterial disease and lower extremity imaging are described, with inclusion of newer techniques for peripheral CTA and MRA. In Section 19, upper extremity vascular imaging applications, including hemodialysis fistulas, are discussed.

This project is the culmination of many years of experience from a multitude of contributors with a variety of backgrounds. We hope that readers will enjoy reading the chapters as well as appreciate the expert recommendations provided by our contributors.

In addition to the contributing authors, we would like to thank many people at Elsevier—notably Rebecca Gaertner for entrusting this most important portion of the Expert Radiology collection to us, Jennifer Shreiner for providing critical and timely editorial guidance and assistance, and Fran Gunning and Carrie Stetz for providing terrific closure for this project.

-- Vincent B. Ho, MD, MBA, FAHA and Gautham P. Reddy, MD, MPH --

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Contents
Volume I
Part One - An Introduction to the Heart

CHAPTER 1 - Embryologic Basis and Segmental Approach to Imaging of Congenital Heart Disease
CHAPTER 2 - Cardiac Anatomy
CHAPTER 3 - Coronary Anatomy
CHAPTER 4 - Physiology of the Heart

Part Two - Cardiac Imaging Techniques

CHAPTER 5 - Radiology of the Heart: Plain Film Imaging and Diagnosis
CHAPTER 6 - Echocardiography
CHAPTER 7 - Diagnostic Coronary Angiography
CHAPTER 8 - Physics of Cardiac Computed Tomography
CHAPTER 9 - Clinical Techniques of Cardiac Computed Tomography
CHAPTER 10 - Radiation Dose Reduction Strategies in Cardiac Computed Tomography
CHAPTER 11 - Contrast Agents and Medications in Cardiac Computed Tomography
CHAPTER 12 - Image Postprocessing in Cardiac Computed Tomography
CHAPTER 13 - Methods for Cardiac Magnetic Resonance Imaging
CHAPTER 14 - Clinical Techniques of Cardiac Magnetic Resonance Imaging: Morphology, Perfusion, and Viability
CHAPTER 15 - Clinical Techniques of Cardiac Magnetic Resonance Imaging: Function
CHAPTER 16 - Clinical Techniques of Cardiac Magnetic Resonance Imaging: Functional Interpretation and Image Processing
CHAPTER 17 - Magnetic Resonance Evaluation of Blood Flow
CHAPTER 18 - Contrast Agents in Magnetic Resonance Imaging
CHAPTER 19 - Magnetic Resonance Imaging Safety
CHAPTER 20 - Physics and Instrumentation of Cardiac Single Photon Emission Computed Tomography
CHAPTER 21 - Clinical Single Photon Emission Computed Tomography Cardiac Protocols
CHAPTER 22 - Radiopharmaceutical Single Photon Emission Computed Tomography Imaging Agents
CHAPTER 23 - Physics and Instrumentation of Cardiac Positron Emission Tomography/Computed Tomography
CHAPTER 24 - Clinical Techniques of Positron Emission Tomography and PET/CT
CHAPTER 25 - Radiopharmaceuticals and Radiation Dose Considerations in Cardiac Positron Emission Tomography and PET/CT
CHAPTER 26 - Pharmacologic Stress Agents

Part Three - Cardiac Interventions

CHAPTER 27 - Congenital Percutaneous Interventions
CHAPTER 28 - Congenital Cardiac Surgery
CHAPTER 29 - Percutaneous Catheter-Based Treatment of Coronary and Valvular Heart Disease
CHAPTER 30 - Surgery for Acquired Cardiac Disease
CHAPTER 31 - Imaging of Atrial Fibrillation Intervention

Part Four - Coronary Artery Imaging

CHAPTER 32 - Coronary Calcium Assessment
CHAPTER 33 - Congenital Coronary Anomalies
CHAPTER 34 - Indications and Patient Selection in Obstructive Coronary Disease
CHAPTER 35 - Interpretation and Reporting in Obstructive Coronary Disease
CHAPTER 36 - Coronary Artery Aneurysms
CHAPTER 37 - Imaging of Coronary Revascularization: Coronary Stents and Bypass Grafts

Part Five - Congenital Heart Disease

CHAPTER 38 - Coarctation of the Aorta
CHAPTER 39 - Vascular Rings and Slings
CHAPTER 40 - Magnetic Resonance Imaging of the Aorta and Left Ventricular Function in Inherited and Congenital Aortic Disease

Section One - Acyanotic Heart Disease with Increased Vascularity

CHAPTER 41 - Atrial Septal Defect
CHAPTER 42 - Ventricular Septal Defect
CHAPTER 43 - Patent Ductus Arteriosus

Section Two - Cyanotic Heart Disease with Increased Vascularity

CHAPTER 44 - Transposition of the Great Arteries
CHAPTER 45 - Truncus Arteriosus
CHAPTER 46 - Anomalous Pulmonary Venous Connections and Drainage
CHAPTER 47 - Tetralogy of Fallot
CHAPTER 48 - Ebstein Anomaly
CHAPTER 49 - Complex Congenital Heart Disease
CHAPTER 50 - Magnetic Resonance Imaging in the Postoperative Evaluation of the Patient with Congenital Heart Disease

Part Six - Ischemic Heart Disease

CHAPTER 51 - Atherosclerotic Coronary Artery Disease
CHAPTER 52 - Acute Coronary Syndrome
CHAPTER 53 - Magnetic Resonance and Computed Tomographic Imaging of Myocardial Perfusion
CHAPTER 54 - Nuclear Medicine Imaging of Myocardial Perfusion
CHAPTER 55 - Magnetic Resonance and Computed Tomographic Imaging of Myocardial Function
CHAPTER 56 - Nuclear Medicine Imaging of Ventricular Function
CHAPTER 57 - Magnetic Resonance Imaging of Myocardial Viability
CHAPTER 58 - Nuclear Medicine Imaging of Myocardial Viability
CHAPTER 59 - Postoperative Imaging of Ischemic Cardiac Disease

Part Seven - Valvular Heart Disease

CHAPTER 60 - Aortic and Mitral Valvular Disease
CHAPTER 61 - Tricuspid and Pulmonary Valvular Disease

Part Eight - Cardiomyopathies and Other Myocardial Diseases

CHAPTER 62 - Dilated Cardiomyopathy
CHAPTER 63 - Restrictive Cardiomyopathy
CHAPTER 64 - Hypertrophic Cardiomyopathy
CHAPTER 65 - Arrhythmogenic Right Ventricular Dysplasia
CHAPTER 66 - Myocarditis

Part Nine - Tumors and Masses

CHAPTER 67 - Cardiac Tumors

Part Ten - Pericardial Disease

CHAPTER 68 - Pericardial Effusion
CHAPTER 69 - Acute Pericarditis
CHAPTER 70 - Constrictive Pericarditis

Volume II
Part Eleven - Vascular Anatomy and Circulation/Arterial Anatomy

CHAPTER 71 - Arterial Anatomy of the Thorax
CHAPTER 72 - Arterial Anatomy of the Abdomen
CHAPTER 73 - Arterial Anatomy of the Pelvis and Lower Extremities
CHAPTER 74 - Arterial Anatomy of the Upper Extremities
CHAPTER 75 - Venous Anatomy of the Thorax
CHAPTER 76 - Venous Anatomy of the Abdomen and Pelvis
CHAPTER 77 - Venous Anatomy of the Extremities

Part Twelve - Noninvasive Vascular Imaging Techniques

CHAPTER 78 - Vascular Ultrasonography: Physics, Instrumentation, and Clinical Techniques
CHAPTER 79 - Physics of Computed Tomography
CHAPTER 80 - Computed Tomographic Angiography: Clinical Techniques
CHAPTER 81 - Magnetic Resonance Angiography: Physics and Instrumentation
CHAPTER 82 - Magnetic Resonance Angiography: Clinical Techniques
CHAPTER 83 - Basic Three-Dimensional Postprocessing in Computed Tomographic and Magnetic Resonance Angiography
CHAPTER 84 - Advanced Three-Dimensional Postprocessing in Computed Tomographic and Magnetic Resonance Angiography
CHAPTER 85 - Nuclear Medicine: Extrathoracic Vascular Imaging

Part Thirteen - Catheter Angiography and Interventions

CHAPTER 86 - Percutaneous Vascular Interventions
CHAPTER 87 - Vascular Surgery

Part Fourteen - Atherosclerosis

CHAPTER 88 - Noninvasive Imaging of Atherosclerosis

Part Fifteen - The Carotid Arteries

CHAPTER 89 - Carotid Artery Disease
CHAPTER 90 - Ultrasound Evaluation of the Carotid Arteries
CHAPTER 91 - Magnetic Resonance and Computed Tomographic Angiography of the Extracranial Carotid Arteries

Part Sixteen - The Thoracic Vessels

CHAPTER 92 - Thoracic Aortic Aneurysms
CHAPTER 93 - Acute Aortic Syndrome
CHAPTER 94 - Thoracic Aortic Trauma
CHAPTER 95 - Thoracic Aortitis
CHAPTER 96 - Subclavian Steal Syndrome
CHAPTER 97 - Acute Pulmonary Thromboembolic Disease
CHAPTER 98 - Chronic Pulmonary Embolism
CHAPTER 99 - Pulmonary Hypertension
CHAPTER 100 - Pulmonary Edema
CHAPTER 101 - Pulmonary Hemorrhage and Vasculitis

Part Seventeen - The Abdominal Vessels

CHAPTER 102 - The Abdominal Aorta
CHAPTER 103 - Postendograft Imaging of the Abdominal Aorta and Iliac Arteries
CHAPTER 104 - Open Repair of Abdominal Aortic Aneurysms and Postoperative Assessment
CHAPTER 105 - Magnetic Resonance Imaging of Vascular Disorders of the Abdomen
CHAPTER 106 - Renal Artery Hypertension
CHAPTER 107 - Renal Arteries: Computed Tomographic and Magnetic Resonance Angiography
CHAPTER 108 - Renal Artery Scintigraphy
CHAPTER 109 - Sonography of the Renal Vessels
CHAPTER 110 - Inferior Vena Cava and Its Main Tributaries
CHAPTER 111 - Vascular Imaging of Hepatic Transplantation
CHAPTER 112 - Vascular Imaging of Renal and Pancreatic Transplantation

Part Eighteen - The Lower Extremity Vessels

CHAPTER 113 - Peripheral Artery Disease
CHAPTER 114 - Lower Extremity Operations and Interventions
CHAPTER 115 - Computed Tomographic Angiography of the Lower Extremities
CHAPTER 116 - Peripheral Magnetic Resonance Angiography

Part Nineteen - The Upper Extremity Vessels

CHAPTER 117 - Vascular Diseases of the Upper Extremities
CHAPTER 118 - Venous Sonography of the Upper Extremities and Thoracic Outlet
CHAPTER 119 - Hemodialysis Fistulas

About the Authors

Vincent B. Ho, MD, MBA, FAHA, Fellow, American Heart Association; Professor, Uniformed Services University of the Health Sciences; President, North American Society for Cardiovascular Imaging; Guest Researcher, National Institutes of Health; Editorial Board, Circulation: Cardiovascular Imaging, Bethesda, Maryland.
Gautham P. Reddy, MD, MPH, Professor of Radiology; Vice Chair for Education; Director of Thoracic Imaging, Department of Radiology, University of Washington School of Medicine, Seattle, Washington.

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