Document Detail


Radiology of the right ventricle.
MedLine Citation:
PMID:  10198649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RV changes may be generalized into dilatation and hypertrophy. Increased preload results in ventricular dilatation. Increased afterload causes hypertrophy. Change in the shape of the RV resulting from increased afterload and myocardial hypertrophy induces tricuspid regurgitation, which superimposes changes of chamber dilatation onto those of hypertrophy. Sustained ventricular dilatation and hypertrophy frequently progresses to RV failure. In these cases, RV systolic function decreases in association with elevation of RV and right atrial diastolic pressure. Changes in the wall thickness and shape of the RV are variable, and depend upon the severity of the volume or pressure load presented, as well as its duration and rate of progression. Because the RV is an anterior cardiac structure, it occupies little of any heart border. Therefore, the sensitivity of plain film examination to RV disease is limited. Inferential diagnosis of RV disease can often be made based upon identification of other radiographic changes, notably the state of the pulmonary circulation, and the position of the heart in the chest. Conventional contrast right ventriculography may be used to assess the size and position of the RV, as well as associated acquired and congenital lesions that result in RV dysfunction. Due to the unusual shape of the RV cavity, however, and the unpredictable manner in which it dilates, accurate quantitative analysis by this technique is limited. Furthermore, the common association between RV disease and pulmonary hypertension limits the applicability of this imaging technique for evaluating patients with RV disease. Multiplanar MR imaging allows direct demonstration of changes in RV size and wall morphology. Furthermore, application of Simpson's rule to tomographic slices acquired at ventricular diastole and systole allows direct, accurate, and reproducible quantitative analysis of ventricular volume and myocardial mass, allowing radiographic assessment in patients for diagnosis, as well as longitudinally during medical management or after surgical treatment for congenital and acquired diseases that result in RV dysfunction.
Authors:
L M Boxt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Radiologic clinics of North America     Volume:  37     ISSN:  0033-8389     ISO Abbreviation:  Radiol. Clin. North Am.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-04-27     Completed Date:  1999-04-27     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0123703     Medline TA:  Radiol Clin North Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  379-400     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Beth Israel Medical Center, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output, Low / diagnosis
Cardiac Volume / physiology
Dilatation, Pathologic / diagnosis,  radiography
Humans
Hypertension, Pulmonary / diagnosis
Hypertrophy, Right Ventricular / diagnosis*,  radiography
Magnetic Resonance Imaging
Tomography, X-Ray Computed
Tricuspid Valve Insufficiency / diagnosis
Ventricular Dysfunction, Right / diagnosis*,  radiography
Ventricular Pressure / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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