By Monvadi B. Srichai MD, Visit Amazon's David P. Naidich Page, search results, Learn about Author Central, David P. Naidich, , W. Richard Webb MD, Nestor L. Muller, Ioannis Vlahos MB BS BSc, Glenn A. Krinsky MD
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Additional info for Computed Tomography and Magnetic Resonance of the Thorax
Overall, dobutamine MR demonstrates high specificity with slightly lower sensitivity for assessment of contractile reserve, with a mean sensitivity of 73% (50% to 89%) and a mean specificity of 83% (70% to 95%) (83). Hypoperfused regions on resting first pass perfusion studies have also been used to assess myocardial viability. As previously mentioned, areas with inadequate blood supply will often not enhance as normal myocardium. Dysfunctional regions that display hypoenhancement on resting first pass perfusion imaging showed high specificity (89%) but low sensitivity (19%) for predicting functional recovery after revascularization (91–93).
The largest cusp is interposed between the AV orifice and the infundibulum and is termed the anterior (or infundibular) cusp. A second, posterior (or marginal) cusp is in relation to the right margin of the ventricle, and the third, medial (or septal) cusp is adjacent to the ventricular septum. The cusps are fibrous structures attached to a fibrous ring surrounding the AV orifice at the base to form a continuous annular membrane with their apices projecting into the ventricular cavity. The atrial surfaces are generally smooth, and their ventricular surfaces are often rough and irregular and, together with the apices and margins of the cusps, give attachment to several 5636_Naidich_ch01_pp001-086 22 12/6/06 5:14 PM Page 22 Computed Tomography and Magnetic Resonance of the Thorax anterior anterolateral anterolateral 1 2 17 Apex 6 Left Ventricular Segmentation Basal 3 1 5 4 inferolateral inferoseptal 7 inferior 2 13 8 14 anterior anteroseptal anterolateral 7 8 12 11 9 Mid-Cavity Horizontal Long Axis (HLA) (4 Chamber) 17 10 Apex 17 16 15 11 5 10 4 inferolateral inferoseptal 1.
The left AV opening is inferior and to the left of the aortic orifice and a little smaller than the corresponding aperture on the right side. This aperture is surrounded by a dense fibrous ring, covered by the lining membrane of the heart and guarded by the bicuspid AV valve known as the mitral valve. The aortic opening is circular and located anterior and to the right of the mitral valve. Its orifice is guarded by the aortic semilunar valve. The LV walls are about three times as thick as those of the right ventricle, and on short axis section its shape presents an oval or nearly circular outline.