Situacion actual: lo nuevo en tecnicas de imagen cardiaca / State of the art: new developments in cardiac imaging

La imagen cardiaca sigue desentrañando aspectos anatómicos y funcionales relacionados con la enfermedad de la víscera. La ecocardiografía desarrolla y optimiza la visualización tridimensional tanto transesofagica como transtoracica, consolida el valor de técnicas que permiten entender mejor la mecánica cardiaca y la función ventricular, y al tiempo la industria saca al mercado nuevos equipos más manejables aunque limitados e incompletos para un estudio estándar. La tomografía mantiene e incrementa su valor diagnostico y predictivo en el campo de la enfermedad coronaria a coste radiactivo cada vez menor. La cardiorresonancia permite valorar exquisitamente el daño y la recuperación miocárdica en cardiopatía isquémica y tras el síndrome coronario agudo. La aparición de nuevas tomogamma cámaras exclusivas para cardiología nuclear mejora la calidad del estudio y reduce la radiación. Las imágenes hibridas o de fusión entre diferentes tecnologías, como las nucleares y la tomografía, son prometedoras e ilusionantes (AU)

Cardiac imaging continues to reveal new anatomical and functional insights into heart disease. In echocardiography, both transesophageal and transthoracic three-dimensional imaging have been fully developed and optimized, and the value of the techniques that have increased our understanding of cardiacmechanics and ventricular function is well established. At the same time, the healthcare industry has released new devices onto the market which, although they are easier to use, have limitations that restricttheir use for routine assessment. Tomography’s diagnostic and prognostic value in coronary artery disease continues to increase while radiation exposure becomes progressively lower. With cardiac magnetic resonance imaging, myocardial injury and recovery in ischemic heart disease and following acute coronary syndrome can be monitored in exquisite detail. The emergence of new combined tomographic and gamma camera techniques, exclusively developed for nuclear cardiology, have improved the quality of investigations and reduced radiation exposure. The hybrid or fusion images produced by combining different techniques, such as nuclear cardiology techniques and tomography, promise an exciting future (AU)

[Progress on cardiac imaging techniques]. / Novedades en técnicas de imagen cardiaca.

The development of a noninvasive diagnostic test follows a typical timeline: description, enthusiasm, clinical assessment and application, and epidemiological study. However, for techniques such as echocardiography that are widely available, have no harmful effects and are inexpensive, clinical applications may become widespread before they have been evaluated. Real progress is being made with the use of new methodologies, such as myocardial deformation echocardiography and three-dimensional echocardiography. Three-dimensional transesophageal echocardiography has returned echocardiography to its place at the center of modern cardiac diagnosis after it had been displaced in recent years by cardiac multislice CT and cardiac magnetic resonance. However, the new radiological techniques that have helped to reduce radiation exposure to patients and that have improved image acquisition could restore CT to the heart of general cardiac diagnosis. At the moment, it is not possible to displace the echocardiography from its central role in cardiac imaging. This article contains a review of the most important publications on echocardiography, magnetic resonance imaging and cardiac CT that have appeared recently in cardiology journals, mainly during 2010.

Novedades en técnicas de imagen cardiaca / Progress on cardiac imaging techniques

Las pruebas diagnósticas no invasivas siguen una cronología típica: descripción, entusiasmo, evaluación y aplicabilidad clínica y epidemiológica. La ecocardiografía es una técnica sin efectos lesivos, altamente disponible y barata, por lo que su aplicabilidad clínica se difunde antes que su asentamiento y su evaluación. Los avances se están desarrollando con nuevas herramientas para el estudio de la deformación miocárdica y las aplicaciones clínicas del ecocardiograma tridimensional. La ecocardiografía transesofágica tridimensional ha vuelto a situar al ecocardiograma en el centro del diagnóstico cardiaco moderno que durante los últimos años había sido desplazado por la tomografía computarizada y la resonancia magnética. No obstante, nuevas tecnologías radiológicas que contribuyan a disminuir la irradiación de los pacientes y mejorar la adquisición de imágenes pueden llevar a la tomografía al eje capital del diagnóstico cardiológico global. Actualmente no podemos desplazar a la ecocardiografía como principal área de interés en imagen cardiaca. En este artículo revisamos las publicaciones más relevantes en las revistas de cardiología aparecidas principalmente durante 2010 en ecocardiografía, resonancia magnética y tomografía computarizada cardiaca (AU)

The development of a noninvasive diagnostic test follows a typical timeline: description, enthusiasm, clinical assessment and application, and epidemiological study. However, for techniques such as echocardiography that are widely available, have no harmful effects and are inexpensive, clinical applications may become widespread before they have been evaluated. Real progress is being made with the use of new methodologies, such as myocardial deformation echocardiography and three-dimensional echocardiography. Three-dimensional transesophageal echocardiography has returned echocardiography to its place at the center of modern cardiac diagnosis after it had been displaced in recent years by (..) (AU)