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IMAGING DEL VENTRICOLO DESTRO CON RISONANZA MAGNETICA

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IMAGING DEL VENTRICOLO DESTRO CON RISONANZA MAGNETICA

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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
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IMAGING DEL VENTRICOLO DESTRO CON RISONANZA MAGNETICA

  1. 1. Imaging del ventricolo destro con Imaging del ventricolo destro con Risonanza Magnetica Risonanza Magnetica Claudia Raineri Dipartimento di Cardiologia, Fondazione IRCCS Policlinico S. Matteo, Pavia
  2. 2. Funzione del ventricolo destro Funzione del ventricolo destroNei pz con ipertensione polmonare la capacità funzionale del VD è il principale determinate prognostico
  3. 3. Funzione del ventricolo destro Funzione del ventricolo destroDifficoltà di analizzare in modo completo la morfologia e la funzione del VD con le metodiche tradizionali per la complessa geometria !!!
  4. 4. Imaging con RM Imaging con RM• Non invasiva• Multiplanare• Alta risoluzione spaziale: studio anatomico• Studio funzionale quantitativo• Perfusione• Caratterizzazione tissutale• Angiografia
  5. 5. Applicazioni RM cardiaca Applicazioni RM cardiaca• Valutazione morfologica e funzionale• Analisi dei flussi• Contrast-enhanced imaging• Angiografia polmonare
  6. 6. Piani anatomiciPiani anatomici ASSE LUNGODUE CAMERE ASSE CORTO 2 CAMERE ASSE LUNGO 4 CAMERE
  7. 7. Valutazione morfo-funzionaleValutazione morfo-funzionale
  8. 8. Valutazione morfo-funzionaleValutazione morfo-funzionale
  9. 9. Valutazione morfo-funzionaleValutazione morfo-funzionale
  10. 10. Valutazione morfo-funzionale Valutazione morfo-funzionale• Volumi telediastolico, telesistolico , FE, stroke volume e portata cardiaca• Massa miocardica• Configurazione del setto interventricolare• Stiffness arteria polmonare
  11. 11. Valutazione morfo-funzionale Valutazione morfo-funzionale• VTD VD è aumentato del 30-50%• VTS VD è aumentato 2,5-3• La massa del VD ( calcolata come il volume del miocardio x peso specifico del tessuto) è aumentata di 2-3 volte• Indice di massa ventricolare aumentato dell’80%
  12. 12. Valutazione morfo-funzionale: VMIValutazione morfo-funzionale: VMI VMI = Massa VD/ massa VS Hagger et al, Rheumatology 2009
  13. 13. Valutazione morfo-funzionale: VMIValutazione morfo-funzionale: VMI Hagger et al, Rheumatology 2009
  14. 14. Valutazione morfo-funzionale:Valutazione morfo-funzionale: Configurazione del SIV Configurazione del SIV
  15. 15. Valutazione morfo-funzionale: dimensioniValutazione morfo-funzionale: dimensioni rami polmonari rami polmonari
  16. 16. Valutazione morfo-funzionale: pulsatilità APValutazione morfo-funzionale: pulsatilità AP
  17. 17. Valutazione morfo-funzionale: Valutazione morfo-funzionale: pulsatilità AP pulsatilità APPulsatilità = Max A - Min A /Min A x100Distensibilità= pulsatilità/ PP Gan et al . Chest 2007
  18. 18. Valutazione morfo-funzionale: Valutazione morfo-funzionale: pulsatilità AP pulsatilità AP81 pts: 70 con IP 16 controlliFollow-up 48 mesi Gan et al Chest 2007
  19. 19. Valutazione morfo-funzionale: pulsatilità APValutazione morfo-funzionale: pulsatilità AP Gan et al Chest 2007
  20. 20. Valutazione morfo-funzionale: pulsatilità APValutazione morfo-funzionale: pulsatilità AP Gan et al Chest 2007
  21. 21. Valutazione morfo-funzionale: pulsatilità APValutazione morfo-funzionale: pulsatilità AP70 con IP a riposo6 con IP da sforzo13 no IP Sanz et al .JACC Imaging 2009
  22. 22. Contrast-Enhanced ImagingContrast-Enhanced Imaging • Tipicamente alla giunzione fra VS e VD • Non correlato all’eziologia dell’IP • Non espressione di lesione ischemica ma fibrosi • Significato clinico-prognostico non univoco
  23. 23. FlussimetriaFlussimetria
  24. 24. Correlazione RM-Cateterismo cardiacoCorrelazione RM-Cateterismo cardiaco Nogami, J Magnetic Resonance Imaging, 2009
  25. 25. Correlazione RM-Cateterismo cardiacoCorrelazione RM-Cateterismo cardiaco Nogami, J Magnetic Resonance Imaging, 2009
  26. 26. Misurazione delle pressioni e delleMisurazione delle pressioni e delle resistenze vascolari polmonari resistenze vascolari polmonari Cateterismo RM guidato ( diossido di carbonio) Kuehne et al, Heart 2006
  27. 27. Angiografia polmonareAngiografia polmonare
  28. 28. Angiografia polmonareAngiografia polmonare
  29. 29. Angiografia polmonareAngiografia polmonare
  30. 30. Perfusione parenchima polmonarePerfusione parenchima polmonare
  31. 31. Benza et al.,JACC 2008
  32. 32. Valutazione pre e post TEAPValutazione pre e post TEAP
  33. 33. Reverse remodeling del VD post-TEAPReverse remodeling del VD post-TEAP Reesink et al., J Thoracic Cardiovasc Surgery 2007
  34. 34. Reverse remodeling del VD post-TEAPReverse remodeling del VD post-TEAP Abstract Leonardi, Darmini et al, Heart Faillure 2008
  35. 35. Conclusioni Conclusioni• Metodica non invasiva in rapido sviluppo checonsente valutazione multiparametrica siamorfologia che funzionale• Impiego sia nella diagnosi che nel follow up deipazienti con ipertensione polmonare• Valutazione prognostica
  36. 36. Limitazioni Limitazioni• Assenza di validazione dei dati su numero elevato di pazienti• Assenza di protocollo standardizzato di acquisizione delle immagini e di analisi dei diversi e numerosi parametriComplessità dell’analisi → Centri specializzati

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