具体描述
Focusing on one of the most exciting imaging modalities available in modern clinical cardiology, Atlas of Multiplane Transesophageal Echocardiography provides a comprehensive analysis of this modality drawn from the authors' experience. Designed to cover the breadth and depth of the topic, the book covers the evaluation of prosthesis, interventional cardiology techniques, and intraoperative transesophageal echocardiology. Each chapter begins with normal cardiac structure and function followed by abnormalities and demonstrates how to measure and interpret cardiac chamber sizes and function. Transesophageal echocardiographic images are juxtaposed with top-quality anatomic specimens, nearly 3000 images in total, to give a clear understanding of normal and abnormal cardiac anatomy. The clinical emphasis provides an authoritative review of the available techniques and the images that can be obtained with them.
A Comprehensive Guide to Modern Cardiac Imaging: Beyond the Surface Title: A Comprehensive Guide to Modern Cardiac Imaging: Beyond the Surface Target Audience: Cardiologists, Cardiac Imaging Specialists, Cardiac Surgeons, Advanced Medical Students, and Cardiovascular Fellows. --- Book Overview This volume offers a rigorous and in-depth exploration of the evolving landscape of non-invasive and minimally invasive cardiac assessment, moving beyond foundational textbooks to focus on advanced diagnostic techniques, complex case management, and the integration of multi-modality data streams. A Comprehensive Guide to Modern Cardiac Imaging: Beyond the Surface serves as an essential reference for practitioners seeking to master the subtleties of contemporary cardiovascular diagnosis in the 21st century. The book is structured around the principle that accurate diagnosis relies on synthesizing information from multiple imaging modalities, emphasizing procedural planning, real-time guidance, and post-procedural surveillance. It meticulously details the technical nuances, interpretation algorithms, and clinical applications of the most critical advanced imaging modalities utilized in cardiology today. Section I: Advanced Echocardiographic Platforms and Fundamentals Reimagined This section lays the groundwork by revisiting core echocardiographic principles through the lens of modern high-resolution hardware and sophisticated post-processing software. It moves past standard two-dimensional imaging to focus on quantitative methods that drive contemporary clinical decision-making. Chapter 1: Fundamentals of Contemporary Ultrasound Physics and Instrumentation: A detailed examination of contemporary transducer technology, acoustic beam steering, contrast enhancement kinetics, and artifact reduction specific to high-frequency array systems. Emphasis is placed on optimizing image acquisition protocols for reproducible quantitative measurements across various patient cohorts (obese, critically ill, pediatric). Chapter 2: Advanced Strain Imaging and Myocardial Mechanics: This chapter delves deeply into speckle tracking echocardiography (STE). It covers the theory behind deformation analysis, validation studies comparing STE to tissue Doppler imaging (TDI), and standardized methods for segmental strain mapping. Clinical applications discussed include the early detection of subclinical cardiomyopathy, assessment of myocardial recovery post-infarction, and quantification of ventricular dyssynchrony in guiding pacing strategies. Chapter 3: Quantitative Assessment of Valve Function: A significant departure from visual estimation, this section focuses exclusively on non-Doppler methods for quantifying valvular regurgitation and stenosis severity. It provides step-by-step protocols for calculating EROA (Effective Regurgitant Orifice Area), RVol (Regurgitant Volume) via integration of volume measurements, and effective regurgitant orifice size (ERO). Detailed appendices address pitfall identification in pressure half-time analysis and the challenges of eccentric jets. Chapter 4: Contrast Echocardiography in Complex Physiology: Explores the use of intravenous microbubble contrast agents, not merely for opacification, but for advanced physiological assessments. Topics include assessment of microvascular obstruction (MVO) post-PCI, assessment of shunt fractions in complex congenital heart disease (CHD), and optimizing contrast enhancement for endocardial border delineation in patients with poor acoustic windows. Section II: Cross-Modality Integration: CT, MRI, and Hybrid Approaches This core section addresses the synergy between different imaging modalities, emphasizing when and how to transition between techniques to answer specific clinical questions that a single modality cannot resolve. Chapter 5: Cardiac Magnetic Resonance Imaging (CMR) for Tissue Characterization: A comprehensive review of CMR sequences vital for clinical cardiology. Detailed protocols for T1 mapping (native and post-gadolinium) for diffuse fibrosis and amyloidosis assessment, T2 mapping for edema detection, and late gadolinium enhancement (LGE) imaging for scar burden quantification are provided. Clinical algorithms for differentiating various cardiomyopathies (e.g., hypertrophic vs. infiltrative) using quantitative CMR metrics are central to this chapter. Chapter 6: Computed Tomography (CT) in Structural Heart Disease Planning: Focuses on the indispensable role of multi-detector CT (MDCT) in preparing for structural interventions. This includes precise measurement of aortic annulus dimensions, mitral valve geometry for MitraClip/Triclip planning, and complex coronary artery evaluation prior to transcatheter valve replacement (TAVR/TMVR). Advanced post-processing techniques using vendor-neutral software platforms are demonstrated. Chapter 7: Fusion Imaging and Real-Time Guidance: Explores the practical application of image fusion technology. This involves overlaying pre-procedural planning data (e.g., high-resolution CT/MRI) onto live fluoroscopic or ultrasound guidance during complex electrophysiology studies (EPS) or minimally invasive surgical repairs. Emphasis is placed on registration accuracy, latency management, and safety protocols in the hybrid suite environment. Section III: Imaging in Structural Interventions and Pathology This final section applies the advanced imaging concepts to specific, high-acuity clinical scenarios, focusing on periprocedural visualization and complication management. Chapter 8: Imaging Guidance for Transcatheter Aortic Valve Replacement (TAVR): A procedural deep dive covering pre-TAVR assessment (valve anatomy, annular sizing, risk assessment for complications like paravalvular leak or coronary obstruction). It details the real-time echocardiographic surveillance required during valve deployment, balloon inflation, and post-deployment echocardiographic assessment using quantitative measures of residual gradients and leakage. Chapter 9: Non-Invasive Assessment of Post-Structural Intervention Outcomes: This chapter addresses the imaging follow-up after complex structural repairs. Detailed protocols for assessing structural valve deterioration (SVD) post-TAVR, quantifying residual mitral regurgitation, and identifying prosthetic valve thrombosis using a combination of Doppler, TOE (where indicated), and CT techniques. Chapter 10: Imaging in Cardiac Oncology and Cardiotoxicity Monitoring: Addresses the unique challenges of imaging hearts exposed to cardiotoxic chemotherapy or immunotherapy agents. Focuses on establishing baseline global longitudinal strain (GLS) and developing individualized surveillance protocols based on LVEF changes and functional decline, ensuring timely intervention to mitigate irreversible cardiac injury. Chapter 11: Comprehensive Evaluation of Cardiac Masses and Thrombi: Detailed classification and characterization of intracardiac masses using contrast-enhanced ultrasound and CMR. Specific attention is paid to differentiating malignant tumors from common entities like vegetation, organizing thrombus, and false tendons, with clear guidance on when advanced tissue sampling or surgical consultation is mandated. --- Key Features of the Volume Emphasis on Quantification: Minimal reliance on subjective qualitative assessment; maximum focus on reproducible, software-driven measurements. Procedural Focus: Each section integrates imaging findings directly into actionable procedural planning and execution steps. Case-Based Learning: Numerous high-fidelity, annotated images and video clips (accessible via companion digital resources) illustrate complex findings. Critical Pitfalls Chapter: Dedicated analysis of common errors in acquisition, processing, and interpretation across all modalities, ensuring diagnostic rigor. Future Directions: Concluding thoughts on the integration of Artificial Intelligence (AI) in automated analysis and workflow optimization within cardiovascular imaging centers.
