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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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A Review of Multimodality Imaging in Hypertrophic Cardiomyopathy: Diagnosis, Risk Stratification, and Therapeutic

Rahul Gandhi1,2, Eng Lee Ooi3,4, Augustine Mugwagwa5,6

  • 1Department of Cardiology, North Shore Hospital, Auckland, New Zealand.

Radiology. Cardiothoracic Imaging
|November 13, 2025
PubMed

Insights

Multimodality imaging, including echocardiography, MRI, nuclear imaging, and CT, is essential for diagnosing and managing hypertrophic cardiomyopathy (HCM). This integrated approach ensures precise diagnosis, risk stratification, and personalized treatment for better patient outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) necessitates comprehensive imaging for diagnosis, risk assessment, and management.
  • Echocardiography is the primary tool for assessing left ventricular wall thickness and outflow tract gradients.

Purpose of the Study:

  • To highlight the importance of a multimodality imaging approach in evaluating hypertrophic cardiomyopathy.
  • To detail the specific contributions of echocardiography, cardiovascular MRI, nuclear imaging, and cardiac CT.

Main Methods:

  • Echocardiography for evaluating ventricular wall thickness, gradients, and mitral valve morphology.
  • Cardiovascular MRI for myocardial mass, flow dynamics, and tissue characterization (late gadolinium enhancement, extracellular volume).
  • Nuclear imaging for identifying HCM phenocopies (e.g., amyloidosis, sarcoidosis) and cardiac CT for coronary anatomy assessment.

Main Results:

  • Multimodality imaging provides a comprehensive evaluation of HCM, distinguishing it from phenocopies.
  • Each imaging modality offers unique strengths, contributing to precise diagnosis and risk stratification.
  • Stress echocardiography aids in detecting dynamic gradients and planning interventions.

Conclusions:

  • An integrated multimodal imaging approach is crucial for precise diagnosis, robust risk stratification, and individualized treatment planning in HCM.
  • This comprehensive evaluation optimizes clinical decision-making and patient outcomes in hypertrophic cardiomyopathy.
  • Combining echocardiography, MRI, nuclear imaging, and CT enhances the management of this complex myocardial disease.

Keywords:
Applications-MultimodalCTCardiacCardiomyopathiesEchocardiographyMR ImagingSPECTSPECT/CT

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