Clinical advances in cardiovascular magnetic resonace imaging and angiography

Bosch, H.C.M. van den (2018)

Doctoral Thesis

Cardiovascular magnetic resonance imaging is an important noninvasive imaging modality for the diagnosis, clinical work‐up and treatment planning in patients suspected for a wide range of cardiovascular pathology. CMR imaging is accurate and reliable, and provides invaluable information to evaluate the cardiovascular system without the need of ionizing radiation. The studies described in this thesis evaluate new CMR imaging techniques in clinical practice and explore the prognostic value of new CMR imaging biomarkers in patients with symptomatic peripheral arterial occlusive disease. New advances and innovations in MR imaging technology improve and further expand the clinical applications of cardiovascular imaging in daily clinical practice. In this thesis, a new, fast free‐breathing 2D delayed‐enhancement MRI sequence is validated and demonstrated to be a reliable tool for detecting myocardial infarction. Furthermore, new technical developments allow single‐injection, three‐station, moving‐table MRA protocol at 3Tesla with similar diagnostic performance when compared to 1.5Tesla. Additionally, submillimeter isotropic voxel acquisition in the lower legs at 1.5Tesla improves the diagnostic accuracy and depicts more open infragenual arterial segments.

Additionally, it is demonstrated that new MRI biomarkers as distal aortic pulse wave velocity statistically significantly correlate with stenosis severity in symptomatic patients with peripheral arterial occlusive disease. Finally, we showed that CMR derived biomarkers relating to stenosis severity, aortic stiffness and left ventricular function play a role in prognosis of outcome in patients with symptomatic PAOD. In the future, incorporation of the described new MRI biomarkers in the clinical workup of peripheral arterial occlusive disease may play an important role for full vascular risk assessment and ultimately, patients may benefit in clinical practice.

• Magnetic resonance imaging
• Cardiac
• Vascular perpheral arterial occlusive disease
• Biomarkers

• All authors: Bosch, H.C.M. van den
• Supervisor: Roos, A. de
• Co-supervisor: Westenberg, J.J.M.
• Committee: Lamb, H.J.; Leiner, T.; Velthuis, B.K.; Huisman, M.V.; Tielbeek, A.V.
• Qualification: Doctor (dr.)
• Awarding Institution: Radiologie, Medicine / Leiden University Medical Center (LUMC), Leiden University
• Date: 2018-05-17
• ISBN (print): 9789463323390