Circulation. 2001;103:e15-e17
(Circulation. 2001;103:e15.)
© 2001 American Heart Association, Inc.
Images in Cardiovascular Medicine |
Left Ventricular Hypertrophy Demonstrated by Four-Dimensional Myocardiography by Helical Computed Tomography
Yasushi Koyama, MD;
Hiroshi Matsuoka, MD;
Hiroshi Higashino, MD;
Teruhito Mochizuki, MD;
Hideo Kawakami, MD;
Katsuji Inoue, MD;
Ichirou Sogabe, MD;
Kazuhisa Nishimura, MD;
Shigeru Nakata, RT;
Masaya Doi, RT;
Masato Imai, RT;
Hisashi Shinohara, RT;
Taketoshi Ito, MD
From the Departments of Cardiology (Y.K., H.M., H.K., K.I., K.N),
Radiology (H.H., I.S.), and Radiological Technology (M.D., M.I., H.S., T.I.),
Ehime Prefectural Imabari Hospital, Imabari, and the Departments of
Radiological Technology (S.N.) and Radiology (T.M.), Ehime University School
of Medicine, Onsen-gun, Ehime, Japan.
Correspondence and reprint requests to Yasushi Koyama, MD, Dept of Cardiology, Ehime Prefectural Imabari Hospital, 794-0006, Imabari, Ehime, Japan. E-mail dyasusi{at}dokidoki.ne.jp
We present
4D images of hypertrophied myocardium in patients with essential
hypertension, hypertrophic cardiomyopathy with asymmetrical septal
hypertrophy, and apical hypertrophic cardiomyopathy using helical
computed tomography (CT)
(
Figures 1 through 4
).
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Figure 1. Two-dimensional images from cardiac axes of hypertrophied myocardium in patients with essential hypertension (HT; left), hypertrophic cardiomyopathy (HCM; middle) with asymmetrical septal hypertrophy (*), and apical hypertrophy (**; right).
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Figure 2. Images from a patient with essential hypertension at end-diastole (ED) and end-systole (ES). Left, 4D myocardiography (4D-MG); middle, 4D ventriculography (4D-VG); and right, watermarked display of 4D myocardiography and 4D ventriculography. The 4D ventriculography shows both right and left ventricular cavities and wall motion. The 4D myocardiography provides detailed myocardial images and whole dynamics of wall motion and systolic thickening of both ventricles. Myocardial hypertrophy is concentric and uniform. RV indicates right ventricle; LV, left ventricle; and IVS, intraventricular septum. Animated version of figure can be found at http://www.circulationaha.org
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Figure 3. Views from a patient with hypertrophic cardiomyopathy with asymmetrical septal hypertrophy (*) at end-diastole (ED) and end-systole (ES). Left, 4D myocardiography (4D-MG); middle, 4D ventriculography (4D-VG); and right, watermarked display of 4D myocardiography and 4D ventriculography. The 4D myocardiography and watermarked images clearly demonstrate asymmetrical septal hypertrophy. The mid-interventricular septum (IVS) bulges into left ventricular cavity (LV). The 4D ventriculography demonstrates the bending ("banana"-shaped) left ventricle (**). Left ventricle is usually more involved in hypertrophic process than right ventricle (RV); however, hypertrophy in both ventricles was observed in this patient. Animated version of this figure can be found at http://www.circulationaha.org
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Figure 4. Views from a patient with apical hypertrophy at end-diastole (ED) and end-systole (ES). Left, 4D myocardiography (4D-MG); middle, 4D ventriculography (4D-VG); and right, watermarked display of 4D myocardiography and 4D ventriculography. The 4D myocardiography and the watermarked display clearly demonstrate the apical hypertrophy (*). The 4D myocardiography discloses severe hypertrophy confined to apex and interventricular septum (IVS) at the apex. LV indicates left ventricle; RV, right ventricle. Animated version of this figure can be found at http://www.circulationaha.org
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Previously, we reported on 4D
CT-ventriculography, which can assess right and left ventricular
morphology and motion.1 In 4D
ventriculography, we used only information about the inner cavities of
the heart, and we discarded information regarding the myocardium.
However, it is important to estimate the extent and function of the
hypertrophied myocardium. Therefore, we retrieved and dealt with
informa-tion about the myocardium as demonstrated in a 4D manner (4D
myocardiography).
Methods of data acquisition were the same for 4D
CT-ventriculography as was reported
previously.1 Four-dimensional
myocardiography can analyze the detailed characteristics of
hypertrophic myocardium in both ventricles noninvasively. It provides
an assessment of myo-cardial volume, shape, and size and the extent
of myocardial hypertrophy in any cardiac phase and in any
perspective.
Footnotes
Animated versions of Figures 2 through 4
can be found at http://www.circulationaha.org
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
(Circulation. 2001;103:e15-e17.)
References
-
Koyama Y,
Matsuoka H, Higashino H, et al. Four dimensional cardiac image by
helical computed tomography.
Circulation. 1999;100:e61–e62.[Free Full Text]
