Cardiovascular disease in women: insights from magnetic resonance imaging

Figures

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  Fig. 1. Acute Myocarditis. Four chamber long-axis view T2-weighted image (a) and corresponding late gadolinium enhancement (LGE) image (b). The white arrows indicate patchy epicardial and mid-wall areas of myocardial edema a with corresponding epicardial and mid-wall late enhancement (b)

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  Fig. 2. Takotsubo cardiomyopathy. Three-chamber view of a patient with Takotsubo cardiomyopathy. a shows the T2 weighted image with increased signal intensity of the mid-cavity and apical segments (white arrows) without late gadolinium enhancement (b)

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  Fig. 3. Peripartum cardiomyopathy. Cine long-axis four chamber view, end-diastolic frame (a), late gadolinium enhancement short-axis (b), and three chamber view (c) in a woman with postpartum cardiomyopathy. The images show only a mildly dilated LV cavity (a) and mid-wall late gadolinium enhancement of the basal inferolateral wall (white arrows)

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  Fig. 4. Rheumatoid arthritis and cardiac injury. Short-axis LGE image in 2 patients with rheumatoid arthritis: the left panel shows epicardial LGE of the basal inferolateral wall (a white arrows), due to myocarditis; the right panel shows near transmural anteroseptal myocardial infarction (b white arrows) with areas of microvascular obstruction (MVO, black arrow), due to left anterior descending coronary artery occlusion

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  Fig. 5. Duchenne muscular dystrophy. A woman with dystrophin mutation carrier status was screened for myocardial disease with CMR. Late gadolinium enhancement images demonstrated epicardial enhancement of the basal lateral wall in both the short-axis (a) and long-axis views (white arrows), a typical subtle pattern of myocardial injury seen in Duchenne muscular dystrophy

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  Fig. 6. Sex differences in transplantation-free survival in pulmonary arterial hypertension. Transplant-free survival in male (solid line) and female (dashed line) patients with pulmonary arterial hypertension starting first-line pulmonary arterial hypertension-specific therapies (P = 0.002) [150]. Reprinted from CHEST, 145 [5], Jacobs W et al., The Right Ventricle Explains Sex Differences in Survival in Idiopathic Pulmonary Arterial Hypertension, 1230–1236. Copyright (2014), with permission from Elsevier

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  Fig. 7. Pulmonary arterial hypertension. Short axis balanced steady state free precession cine image in patient with precapillary pulmonary hypertension in diastole demonstrating right ventricular dilatation and hypertrophy as well as bulging of the interventricular septum into the small left ventricle as a sign of high pulmonary arterial pressure. The septal flattening can easily be demonstrated by echocardiography, but the biventricular mass, volumetric, and functional quantification using CMR is superior to echocardiographic estimates

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  Fig. 8. Bicuspid valve. Balanced steady-state, free precession cine CMR in the short-axis plane demonstrating a bicuspid aortic valve in a young woman with Turner syndrome. Echocardiography is first-line modality for assessment of cardiac valves. However, CMR can corroborate the valve morphology in case of suboptimal image quality with echocardiography. RA, right atrium; LA, left atrium; RV, right ventricle

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  Fig. 9. Dilated ascending aorta in pregnant patient. 3D volume rendering reformation of a non-contrast CMR angiogram in a patient with bicuspid aortic valve and Marfan Syndrome shows dilatation of the ascending aorta (arrow). In this patient with a maximum ascending aortic dimension of 45 mm, close clinical monitoring was recommended during pregnancy and delivery