This is a 22-years old man who was detected to have a large heart on a routine chest radiography and subsequently was found to have severe pulmonary hypertension. The short axis cines show the dilatation of the RV with thinning and hypokinesia with a fixed leftward deviation of the septum. An echo suggested a sub-valvular pulmonary stenosis (sub-PS), but the windows were not very good.
The MRI cines for the RVOT and pulmonary valve clearly show the sub-valvular stenosis caused by a membrane. The peak velocity was around 4.5m/sec and the jet (red arrows) caused by the stenosis was clearly seen (Fig. 1).
We also performed a cardiac CT to understand how this would look like on the CT. The anatomy of the membrane (Figs. 2, 3 - blue arrows) causing the sub-valvular pulmonary stenosis was much better appreciated, because of the better spatial resolution, seen separate from the valve itself (red arrows), as against on the MRI.
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Very well done. Good cases and excellent review of the literature. Keep up the good work. I am a cardiologist and I perform cardiac MRI and CT in the Baltimore area and at the NIH in Bethesda. I check this website at least once a month to view the cases and see if I have missed any recent articles.
Kudos
Posted by: Sriram Padmanabhan | April 26, 2006 at 03:10 PM