Multimodality Imaging of Bands in the Heart

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after January 27, 2023:

Cardiac-Interventional Radiography: 3.25
Procedures: 3.25
Diagnostic and Electrophysiology Procedures: 3.25

Computed Tomography: 3.25
Procedures: 3.25
Neck and Chest: 3.25

Registered Radiologist Assistant: 3.25
Procedures: 3.25
Thoracic Section: 3.25

Outline

1. Introduction
2. Imaging Modalities
3. Normal Structures and Variants
   1. Crista Terminalis
   2. Taenia Sagittalis
   3. Chiari Network
   4. Coumadin Ridge
   5. Moderator Band
   6. Papillary Muscles and Chordae Tendineae
4. Aberrant Structures
   1. Aberrant Papillary Muscles
   2. Accessory Chordae Tendineae
   3. Accessory Mitral Valve Tissue
   4. Aberrant Ventricular Bands
   5. Aberrant Atrial Bands
5. Pathologic Entities
   1. Double-chambered RV
   2. Double-chambered RA
   3. Cor Triatriatum
   4. Subaortic Stenosis
   5. Shone Complex
6. Conclusion

Objectives

Upon completion of this course, students will:

1. know which cardiac bands and bandlike structures are usually asymptomatic
2. be familiar with the various types of bands in the heart
3. know the most frequent result of cardiac pathologic entities
4. identify the common clinical scenarios in which imaging is involved in cardiac band diagnosis
5. know the first-line imaging modality used in the evaluation of the heart
6. understand the reasons why a patient might be referred for further imaging after the completion of the first-line imaging of the heart
7. be familiar with the advantages, disadvantages, and indications for utilizing the various imaging modalities in the evaluation of cardiac bands
8. be familiar with how cardiac band normal variants and other structures are typically depicted on MR imaging
9. know what is essential for dynamic and functional information in cardiac CT imaging
10. understand how a thrombus can be characterized and distinguished from a neoplasm in CT imaging
11. recognize some basic facts about the crista terminalis
12. distinguish thrombus from crista terminalis at MR imaging
13. be familiar with the pattern types of the taenia sagittalis muscle
14. understand how taenia sagittalis is visualized at medical imaging
15. be familiar with the broad spectrum of possible Chiari network manifestations
16. recognize both the possible protective role that a Chiari network might have, as well as the potential clinically significant conditions to which it could lead
17. know how a Chiari network presents at imaging
18. know the more familiar nomenclature for the left lateral ridge of the left atrial wall between the left superior vein and left atrial appendage
19. know how to distinguish the left lateral ridge from a pathologic entity on CT and MR imaging
20. identify the reason behind the nomenclature of the moderator band
21. recognize the functions of the moderator band
22. be familiar with how the moderator band is depicted at imaging
23. know the location at which a prominent or hypertrophied moderator band can be confused with a thrombus on echocardiography
24. be familiar with the basic anatomic structure and location of papillary muscles
25. understand the conditions resulting from papillary muscle variances
26. be familiar with how the Berdajs system classifies papillary muscles at imaging
27. identify the various types of aberrant papillary muscle anomalies
28. be familiar with the conditions caused by the various types of aberrant papillary muscle anomalies
29. know how MR imaging benefits the assessment of aberrant papillary muscles
30. indicate how the various aberrant papillary muscle anomalies are depicted at imaging
31. understand the potential clinical symptoms of accessory chordae tendineae
32. be familiar with how accessory chordae tendineae appear at imaging
33. identify the insertion locations for the chordae tendineae of AMVT
34. know the potential clinical symptoms of AMVT
35. be familiar with some of the basic anatomy and morphology of aberrant ventricular bands
36. specify the clinical conditions which can arise from a false tendon
37. be familiar with the various types of false tendons
38. understand how an aberrant atrial band demonstrates at imaging
39. be familiar with how double-chambered RV demonstrates at imaging
40. know how a double-chambered LV differs from a double-chambered RV
41. know the cardiac chambers in which cor triatriatum sinister and cor triatriatum dexter would be located
42. specify the morphologic types of cor triatriatum dexter
43. be familiar with the morphologic and prevalence information about subaortic stenosis
44. understand what imaging information is important for subaortic stenosis surgical decision making
45. know which imaging techniques can demonstrate the various left-sided obstructive cardiovascular lesions associated with shone complex