Cardiac function and myocardial strain analysis at 7T using B1 shimming in comparison to 3T magnetic resonance imagingJung, Bernd; Hundertmark, Moritz; Peters, Alan A.; Schaub, Christof; Bonanno, Gabriele; Schmitter, Sebastian; Guensch, Dominik P.; Gräni, Christoph; Fischer, Kady
doi: 10.1007/s10554-026-03741-6pmid: N/A
Due to spatial heterogeneities of transmit B1 magnitude, cardiac MRI at 7 Tesla is still far from being clinically established. Different strategies were proposed to mitigate signal variations that may lead to a significant increase of the examination time. The aim of this study was to establish an efficient workflow for B1 shimming for cine imaging at 7T with a single B1 shim set and the investigation of the impact of field strength on volumetric and strain parameters Long- and short-axis images were acquired in ten volunteers at 3T and 7T. At 7T, B1 maps were acquired to calculate a single B1 phases him vector that was applied for the entire exam. Image quality reading was performed by two radiologists. Biventricular volumetric parameters were assessed by two readers. Biventricular function was further assessed for peak strain using feature tracking Image quality and contrast of long-axis images acquired at 7T was inferior compared to 3T, although all images were deemed to bediagnostically usable. In comparison to 3T, 7T slightly underestimated left ventricular volumes, with differences remaining under 10%of absolute values and thus of minimal clinical relevance. Strain parameters were not impacted by field strength A single B1 shim set provides excitation patterns without substantial signal dropouts in the heart. Moderate residual B1 variations and the reduced myocardium–blood contrast at 7T hindered neither quantification nor diagnostic quality. In conclusion, an efficient workflow could be realized at 7T for cardiac cine imaging for function and strain analysis
Multimodality cardiac imaging in anomalous aortic origin of a coronary artery: a case report highlighting the role of myocardial perfusion imaging in the presence of high-risk featuresBello, Juan; Berisha, Lorik; Suero-Abreu, Giselle A.; Radfar, Azar; Bloom, Jordan P.; Osborne, Michael T.; Tawakol, Ahmed
doi: 10.1007/s10554-026-03747-0pmid: 42268491
Anomalous aortic origin of a coronary artery is a congenital malformation that can induce myocardial ischemia impacting the quality of life and even leading to sudden cardiac death. Identifying ischemia and high-risk features is of paramount importance to guide therapy; however, the former represents a clinical challenge. The use of multimodality cardiac imaging with coronary computed tomography and myocardial perfusion imaging represents a non-invasive strategy to identify ischemia, quantify ischemic burden, and aid in risk stratification.
Comparative evaluation of PET quantitative methods for myocardial viability assessment in CAD patients and its prognostic valueLv, Yuhu; Zheng, Danzha; Zhou, Zhangyongxue; Dai, Zhibo; Wei, Siqi; Hu, Shu; Lan, Xiaoli; Gao, Zairong; Qin, Chunxia
doi: 10.1007/s10554-026-03744-3pmid: N/A
To compare different methods for myocardium quantification and exploratively evaluate the prognostic relationship between PET-measured viable myocardium and clinical outcomes in coronary artery disease (CAD) patients with ischemic cardiomyopathy (ICM). 183 CAD patients who underwent one-day 13NH3 and 18F-FDG PET/CT myocardial viability assessment were retrospectively enrolled. Using Corridor4DM software, different types of myocardium (viable, normal, scar) were quantified via visual analysis, semi-quantitative scoring, and software automatic quantification. As an exploratory secondary analysis, patients were grouped and method-dependent grouping differences were analyzed. The correlation between viable myocardium, treatment decisions, and prognosis was retrospectively evaluated. Software identified the most normal myocardium and the least viable myocardium, while semi-quantitative scoring was the opposite. High inter-method consistency (all ICC>0.75) was observed, in which visual and software analyses showed optimal agreement, contrasting with scoring analysis. No significant differences were found among when viable myocardium<20%, but scoring analysis underestimated viable myocardium as its extent increased (P<0.001). Notably, all three methods exhibited concordant and comparable prognostic predictive value (AUC: 0.595–0.669 for OS and 0.529–0.533 for MACE). And exploratory prognostic analysis (n = 113) revealed no statistically significant interaction between treatment strategy and viability for either OS or MACE. However, a potential trend was observed where revascularization was associated with improved outcomes specifically in patients with a higher extent of viable myocardium (≥ 37%). Three analyses demonstrated high consistency in myocardium quantification, with visual and software analysis showing optimal agreement. Software analysis enhances clinical efficiency, offering improved sensitivity and objectivity. Furthermore, the three methods showed concordant prognostic predictive value; While exploratory analyses suggested potential prognostic trends, no statistically significant interaction was found between treatment strategy and viability. Accurately assessing viable myocardium via software automatic quantification offers an objective tool for assessment, though its role in guiding treatment decisions requires further validation.
Myocardial tuberculosis: a diagnostic challenge illustrated by two cases and review of contemporary managementTremouilhac, Eve-Marie; Richaud, Clémence; Tresorier, Romain; Vivet, Clémentine; Cassagnes, Lucie; Clerfond, Guillaume; Zaghdoudi, Aida
doi: 10.1007/s10554-026-03745-2pmid: N/A
Myocardial tuberculosis is a rare form of extrapulmonary tuberculosis, characterized by variable clinical presentations and a potentially misleading diagnosis. We report two cases of myocardial tuberculosis: one case of disseminated disease involving the brain, lungs, lymph nodes, gastrointestinal tract, skin, and myocardium, and another case of isolated myocardial involvement. Both patients were treated with first-line anti-tuberculosis treatment. In addition, one patient received corticosteroids and therapeutic anticoagulation therapy. Clinical and radiological outcomes were favorable in both patients. Although extremely rare, myocardial tuberculosis should be considered, particularly in endemic settings. Cardiac magnetic resonance imaging is an essential diagnosis tool and should be integrated into a multimodal diagnostic approach combining clinical assessment, radiological features and bacteriologic or histological findings when available. Early initiation of antituberculosis therapy can lead to favorable clinical outcomes.
Prevalence of impaired flow-mediated epicardial vasodilation among different types of coronary flow regulationValenta, Ines; Alavi, Mohammad; Parihar, Ashwin S.; Jain, Sudhir; Schindler, Thomas Hellmut
doi: 10.1007/s10554-026-03736-3pmid: 42251217
To assess the prevalence of impairment of flow-mediated epicardial vasodilation (IEV) in the presence of normal and abnormal coronary microvascular function. In 332 consecutive symptomatic patients, global and longitudinal myocardial blood flow (MBF) at rest and during pharmacologically stimulated hyperemia was evaluated with 13N-ammonia positron emission tomography/computed tomography (PET/CT). Normal coronary microvascular function (nCMF) was defined by a myocardial flow reserve (MFR = MBFstress/MBFrest) of ≥ 2.0 (group 1; n = 210 (G1)), while an abnormal MFR of < 2.0 (predominantly due to decreases in hyperemic MBF) denoted classical CMD (group 2; n = 83 (G2)) or (predominantly related to increases in resting MBF ≥ 1.0mL/g/min) signified endogen CMD (group 3; n = 39 (G3)), respectively. Furthermore, normal flow-mediated epicardial vasodilation (NEV) was defined as longitudinal hyperemic MBF gradient < -0.10 mL/g/min, whereas a value ≥ -0.10 mL/g/min signified IEV.In the entire study population, IEV was present in 34.6.% (115/332). IEV was highest in group 1 (46.2%), while there was a comparable low prevalence between group 2 and group 3 (13.3% vs. 17.9%; p = 559). The hyperemic longitudinal MBF gradient was significantly higher in G1 compared to G2 (-0.28 ± 0.10 vs. -0.19 ± 0.08 mL/g/min; p ≤ 0.008), but comparable between group 1 and group 3 (-0.28 ± 0.10 and − 0.27 ± 0.10 mL/g/min; p = 0.795). The hyperemic longitudinal MBF gradient and ΔMBF Gradient correlated inversely with the global hyperemic MBF, respectively (r = 0.41, SEE = 0.09 and r = 0.34, SEE = 0.09, both p ≤ 0.001). Nearly half of symptomatic patients with normal global MFR may have IEV. As IEV carries important diagnostic and prognostic information, it may further optimize prognostication on cardiovascular individuals deserving further clinical testing.Graphical abstract[graphic not available: see fulltext]