Introduction. Magnetic resonance imaging is a non-invasive and non-irradiating imaging method, complementary to cardiac ultrasound in the assessment of cardiovascular disease and implicitly of cardiomyopathies. Although it is not a first intention imaging method, it is superior in the assessment of cardiac volumes, left ventricular ejection fraction, in the analysis of cardiac wall dyskinesia and myocardial tissue characteristics with and without using a contrast agent. The purpose of this paper is to review the current knowledge regarding cardiovascular magnetic resonance imaging (CMR) and its applications in cardiomyopathy analysis.   Methods. In order to create this review, relevant articles were searched and analyzed by using MeSH terms such as: "cardiac magnetic resonance imaging", "cardiomyopathy", "myocardial fibrosis". Three main international databases PubMed, Web of Science and Medscape were searched. We carried out a narrative review focused on the current indications of cardiovascular magnetic resonance imaging in cardiomyopathies, both common and raret, of ischemic and nonischemic types.   Results. Cardiac magnetic resonance imaging has a very important role in the diagnosis, assessment and prognosis of common cardiomyopathies (the dilated, hypertrophic and inflammatory types) or other more rare ones such as (amyloidosis, arrhythmogenic right ventricular, non-compaction or Takotsubo cardiomyopathy), as it represents the gold standard for evaluating the ejection fraction, ventricular volumes and mass. CMR techniques, such as late gadolinium enhancement, T1 and T2 mapping have proven their usefulness, helping differentiate between ischemic (subendocardial enhancement) and nonischemic cardiomyopathy (varied pattern) or also establish the etiology. Another important feature of this imaging technique is that it can establish the myocardial viability, thus the chance of contractile recovery after revascularization. This feature is based on the transmural extent of LGE, left ventricle wall thickness and the assessment of the contractile reserve after administration of low dose dobutamine. Conclusions. Cardiovascular magnetic resonance imaging is an indispensable tool, with proven efficiency, capable of providing the differential diagnosis between ischemic and nonischemic cardiomyopathy or establishing the etiology in the nonischemic type. In addition, these findings have a prognostic value, they may guide the patient management plan and, if necessary, can evaluate treatment response. Therefore, this technique should be part of any routine investigation of various cardiomyopathies.

ObjectivesThis study aimed to evaluate the association between cardiovascular risk factors and Coronary Artery Disease—Reporting and Data System (CAD-RADS) score in the Romanian population. CAD-RADS is a new, standardised method to assess coronary artery disease (CAD) using coronary CT angiography (CCTA).DesignA cross-sectional observational, patient-based study.SettingReferred imaging centre for CAD in Transylvania, Romania.ParticipantsWe retrospectively reviewed 674 patients who underwent CCTA between January 2017 and August 2018. The exclusion criteria included: previously known CAD, defined as prior myocardial infarction, percutaneous coronary intervention or coronary artery bypass graft surgery (n=91), cardiac CT for other than evaluation of possible CAD (n=85), significant arrhythmias compromising imaging quality (n=23). Finally, 475 patients fulfilled the inclusion criteria.MethodsDemographical, clinical and CCTA characteristics of the patients were obtained. CAD was evaluated using CAD-RADS score. Obstructive CAD was defined as ≥50% stenosis of ≥1 coronary segment on CCTA.ResultsWe evaluated the association between risk factors and CAD-RADS score in univariate and multivariable analysis. We divided the patients into two groups according to the CAD-RADS system: group 1: CAD-RADS score between 0 and 2 (stenosis <50%) and group 2: CAD-RADS score ≥3 (stenosis ≥50%). On univariate analysis, male gender, age, hypertension, dyslipidaemia, smoking and diabetes mellitus were positively associated with a CAD-RADS score ≥3. The multivariate analysis showed that male sex, age, dyslipidaemia, hypertension and smoking were independently associated with obstructive CAD.ConclusionThis study demonstrated a significant association between multiple cardiovascular risk factors and a higher coronary atherosclerotic burden assessed using CAD-RADS system in the Romanian population.

Intraosseous lipomas are rare bone lesions that can affect any part of the skeleton. In the calcaneum, they are, generally, asymptomatic, but in some cases, patients may complain of pain, swelling or tenderness. Well-conducted radiography and MRI examinations can lead to an accurate diagnosis. In most cases, patients could benefit from conservative means of treatment, but in long-lasting symptomatic cases, surgical treatment may be a good option. The purpose of this article is to increase clinicians’ awareness of this lesion as a possible cause of heel pain and to describe a case of a symptomatic intraosseous lipoma of the calcaneum who underwent curettage and bone cement filling after failure of conservative treatment.

Background/Aim: The aim of the study was to assess the relationship between myocardial fibrosis characteristics (percentage, localization, heterogeneity), evaluated by a non-invasive method such as cardiac magnetic resonance (CMR), with the extrasystolic ventricular arrhythmia in patients with non-ischemic cardiomyopathy. Patients and Methods: The study prospectively included 173 consecutive patients who underwent electrocardiogram Holter monitoring, transthoracic echocardiography and CMR with late gadolinium enhancement (LGE). Results: In univariate analysis, both the presence (OR=1.05, 95% CI=1.01-1.09; p=0.015), the percentage of fibrosis >15% (p=0.018), the septum size, the fibrosis in either lateral or septal walls (p=0.004), as well as fibrosis in the midwall (p=0.019) were statistically significant higher in the group with extrasystolic arrhythmia. After adjustment, the percentage of fibrosis >15%, had higher odds of extra systolic arrhythmia [OR=3.78 (95% CI=1.52-10.62, p=0.007)]. Conclusion: The presence, percentage, and localisation of left ventricle myocardial fibrosis characterized by LGE-CMR was associated with ventricular arrhythmias.Non-ischemic cardiomyopathy is a common heart muscle disease, without significant coronary artery impairment. The condition is associated with significant morbidity and mortality due to progressive heart failure (HF) and sudden cardiac death (SCD) (1, 2).

Giant-cell tumours are benign aggressive bone lesions that can affect any part of the skeleton. In early stages, curettage is preferred, but in case of local recurrence or voluminous lesions in the periacetabular region, wide resection and reconstruction are recommended. The purpose of this article is to increase clinicians’ awareness of the importance of the follow-up of these patients and to describe a case of a voluminous recurrence of a giant-cell tumour in the pelvis. We present a 25-year-old female who underwent internal hemipelvectomy assisted by 3D cutting-guides and reconstruction with a custom-made 3D-printed pelvic prosthesis, hip arthroplasty and ilio-sacral arthrodesis. No postoperative complications occurred and, at long-term follow-up, the patient had a stable and painless hip joint, good bone-implant osteointegration, with an excellent functional outcome. In spite of all available reconstructive techniques, in well-selected patients with voluminous pelvic resections, custom-made 3D-printed implants allow patients to have a good mechanical outcome.