Karen Ordovas, MD MAS FSCMR

Hear from experts in the field, learn the latest in CMR, and network with colleagues around the world at this premier virtual event for CMR professionals. The 25th Annual Scientific Sessions will feature scientific sessions and hands-on case sessions on various topics like coronary artery disease, cardiac masses, CMR in cardio-oncology, vascular imaging, and multi-modality imaging in valvular heart disease. Register now!

Members, don't forget to renew here! Do you live in any of these World Bank Category countries? If so, you can save on your renewal and should click now before the end of the year! We are excited to continue to provide you with workshops, Scientific Sessions discounts, and FSCMR recognition!

Don't forget to click on the Facebook and Twitter icons to stay updated between newsletters. Thank you all for your continued enthusiasm and advocacy for CMR!

SCMR is pleased to announce that Spanish translations of the first and second Guidelines for the Evaluation and Diagnosis of Chest Pain Webinars are available now on the SCMR HQ YouTube page! Special thanks to ANCAM for providing translation services. Learn more about the Guidelines and watch for further translations on the SCMR website.

I am pleased to announce that a session for the 2020 Best Case of the Week competition will be held at the 2022 annual SCMR Scientific Sessions (postponed from last year's meeting due to COVID interruptions to schedule). The top 5 cases from 2020 will be presented, and the winner will be announced at the Awards Ceremony at the conclusion of the meeting. We have some unusual and exciting cases to present. I am very much looking forward to it, and I hope you will be able to join me and the Case of the Week team in enjoying the competition.

Cardiac MR Eyes (👀)

Twitter-based #WhyCMR journal watch 📚⌚—join the online discussion!

1.    Tracking myocardial ECV during AL amyloid therapy 💚🍏🕵️‍♀️

2.    4D-flow secrets in Fontan Circulation: veno-venous shunting 🧊🌬️

3.    The future of cardiac magnetic resonance clinical trials 🧲🧪📚

4.    Low SCD risk in non-CAD patients with LGE if normal LV volumes & LVEF ❗❓📈🤯😲

5.    High variability in MWT measurement in HCM impacts clinical decisions 📏📐🎯

6.    CMR in suspected vaccine-related myocarditis 🙄💉🤷‍♀️💔

On 21 July 2021, experts Chiara Bucciarelli-Ducci, MD, and Colin Berry, MD, presented the Siemens Healthineers webinar Novel Insights into MINOCA and INOCA: Resolving Diagnostic Dilemmas and discussed the potential of diagnostic imaging for risk assessment and prognosis in MINOCA and INOCA patients. This webinar highlighted the added value of CMR, CT, and Angio imaging in both acute and chronic ischemia without obstructive coronary arteries. The recording of this innovative session is now available on the SCMR Online Learning Portal.

It is the last SCMR Newsletter of 2021! In the spirit of the holidays, let us talk about the candy cane of the heart—the aortic arch. A common indication for CMR in aortic arch assessment for congenital heart disease includes coarctation of the aorta, which accounts for 5–7% of all CHD. CMR allows us to obtain cross sectional measurements (via post contrast or non-contrast MRA) pre and post-intervention and assess the caliber of different parts of the aortic arch.

Figure 1 from Kawel-Boehm et al (JCMR 2015, right) is a nice guide for arch landmarks. Cross sectional measurements of the aorta are important for long-term follow-up to assess quality of repair and potential need for reintervention. Although rare in infants, collateral circulation can develop in childhood to augment perfusion to the lower body. CMR is a great tool for estimation of collateral artery flow using phase contrast images proximal and distal to the coarctation.

Figure 1. Sites of measurement. AS = aortic sinus; STJ = sinotubular junction; AA = ascending aorta; BCA = proximal to the origin of the brachiocephalic artery; T1 = first transverse segment; T2 = second transverse segment; IR = isthmic region; DA = descending aorta; D = thoracoabdominal aorta at the level of the diaphragm.

Figure 2A and 2B from Juan et al (JCMR 2012, left) include an example of a juxtaductal coarctation of the aorta in a 42 yo pregnant female demonstrated on post-contrast MRA. Note the inferior displacement of the left subclavian artery, which is often seen with this anomaly.

Wishing you all Happy Holidays and a Happy New Year! Looking forward to #SCMR2022!

Kanwal Farooqi, MD

Department of Pediatrics

Columbia University, New York, United States

As we enter the holiday season, we have been thinking of a wintery theme for the last Technologist Tip of the year. So, with a little imagination—and Yuletide magic—we bring you the “Snowman.” The Snowman will sometimes show itself at the base of the short axis (SA) localiser series, which we use to position the Long Axis (LA) cines (see figure below). The Snowman, which can intermittently take on the appearance of a mushroom, helps us to plan the 3-chamber long axis cine. To begin, simply perpendicular the slice through the Snowman’s body and head, and then on the 2-chamber view, rotate the slice so it transects the ventricular apex. You will now have a textbook 3-chamber view with a little help from the Snowman.

Last month's CMR Picture Puzzle answer:

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The 9 December 2021 webinar Multimodality Imaging in Hypertrophic Cardiomyopathy, featuring Drs. Christopher M. Kramer, Iacopo Olivotto, Steve R. Ommen, and Lynette Teo and moderated by Dr. Upasana Tayal, is now available to stream on-demand.

In this session, our panel of expert speakers cover:

Watch this webinar and other recorded sessions on SCMR's Online Learning Portal.

In rare cases, mRNA based COVID vaccines are associated with myocarditis. We know that many cases of myocarditis, including those associated with COVID-19, can be missed without the use of CMR. In our recent large multi-center study that involved many SCMR members, a high prevalence of LGE (88%) was noted in these patients.

While the initial clinical course and short-term outcomes are reassuring, the mid-term and long-term prognosis and clinical significance of LGE in these patients are uncertain. We are currently recruiting patients for a larger longitudinal study and invite you to join us for this retrospective study. We aim to study the clinical characteristics and long-term outcomes in adolescents and young adults with COVID vaccine–associated myocarditis. We also aim to compare their CMR findings with COVID-19 and multisystem inflammatory syndrome (MIS-C) patients. This information is of public interest especially as vaccination efforts are ongoing for adolescents and adults and as the Pfizer vaccine has recently been approved for use in 5- to 11-year-olds. 

Patients up to 30 years of age are included, and you can enroll your patients even if they were not in the original study. This study is supported by the SCMR COVID Taskforce. Contact Supriya Jain at sjain7@nymc.edu for details.

Supriya S. Jain, MD

New York Medical College/

Maria Fareri Children's Hospital at

Westchester Medical Center

New York, NY

Lars Grosse-Wortmann, MD

Oregon Health and Science University

Portland, OR

Color Doppler echocardiography of (A) apical 2 chamber and (B) apical 3 chamber views showing severe mitral regurgitation and turbulence flow at the aortic valve. From Case 21-04: Newly Developed Heart Failure: What Is the Etiology? Kana Fujikura, MD PhD, Charles W. Benton, RT(R)(CT)(MR), Calin V. Maniu, MD

The SCMR web site hosts “Case of the Week”—a case series designed to present case reports demonstrating the unique attributes of CMR in the diagnosis or management of cardiovascular disease. Each clinical presentation is followed by a brief discussion of the disease and unique role of CMR in disease diagnosis or management guidance. By nature, some of these are somewhat esoteric, but all are instructive. Recently we have published the case archive from 2020 in JCMR as a means of further enhancing the education of those interested in CMR and as a means of archiving this incredible resource from our members on PubMed. 

Please use this link for a filtered PubMed list of all CMR-related manuscripts for December 2021—more than 300 in total!