SlideShare ist ein Scribd-Unternehmen logo
1 von 61
Downloaden Sie, um offline zu lesen
Cardiac MRI-Basics
By
Dr.Shaik Asma
Post graduate student
 Cardiac MRI consists of using MRI to
study heart anatomy, physiology, and
pathology.
Advantages
Cardiac MRI offers:
 improved soft tissue definition
 protocol can be tailored to likely
differential diagnoses
◦ a large number of sequences are available
◦ dynamic imaging provides functional
assessment
 no ionizing radiation
◦ MRI safety still requires consideration
Technique
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac gating
Cardiac MRI basics
MR imaging techniques
 Blood techniques
Dark blood
Bright blood
 Imaging sequences
 Imaging planes
Pulse sequences-Overview
 Black blood-anatomy
Spin echo(SE)
 Bright blood-dynamic and angiography
Gradient echo(GE)
 Phase contrast(PC)-quantify flow
 Delayed enhancement-
infarct/inflammation/infiltration
 2D SSFP with IR prep
 Gadolinium assisted MRA
3D fast spoiled GE
 Basic cardiovascular MR imaging
sequences include black blood imaging
and bright blood imaging.
 Black blood imaging is used to depict
anatomy, pericardial and mediastinal
abnormalities, and extra luminal aortic
disease.
 Black blood imaging includes ECG-gated
true spin-echo or fast spin-echo imaging
or inversion-recovery (IR) half-Fourier
single-shot turbo fast-spin-echo
sequences.
 Bright blood imaging is used to
demonstrate flow and motion and to
image valvular disease.
 Bright blood cine sequences include
segmented-k-space small-flip-angle
gradient-echo sequences or fast
imaging with steady-state precession
or refocused steady-state free
precession (SSFP)
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Advantages
 Since it uses the residual transverse
magnetization instead of wasting
it,there is increased signal to noise
ratio.
 Since transverse magnetization is
added back to longitudinal
magnetization,the steady state is
reached quicker,in as little as single
TR.
 The TRs are extremely
 The images have both T1and T2
weighted.(The molecules with long T2
and short T1 will have bright
signal(both fat and water)
 Thus bright signal in steady state
white blood images is attributable to
T1 and T2 signal from the blood,not
flow related.
 Gating of white blood images allows
evaluation of dynamic cardiac function
and physiology throughout cardiac
cycle.Examples include motion of
myocardium and valve leaflets.
 Gating in white blood images serve to
time image acquisition during diastolic
phase of cardiac cycle,thereby limiting
cardiac motion artifact.
Cardiac MRI basics
Black Blood Imaging Protocol
Bright Blood Imaging Protocol
Cine imaging
Cine imaging or cine MRI, are a type of MRI
sequence acquired to capture motion
 For the heart, this is achieved by acquisition at
multiple time points throughout the cardiac
cycle, after synchronisation with the ECG has
been achieved.
 Separate k-spaces are assigned to different
phases or segments of the cardiac cycle.
 Images are reconstructed from each k-
space and shown in a movie.
 This type of imaging technique requires fast
imaging techniques using very short repetition
and echo times such as balanced steady-state
free precession or spoiled gradient
Cardiac MRI basics
Cardiac MRI basics
Cardiac MRI basics
Contrast-enhanced techniques
Perfusion imaging (also known as first-pass images)
 These are T1 weighted, gradient-echo
sequences. Image acquisition is performed 3 minutes
after gadolinium contrast administration. If there is a
hypoenhanced area, this implies a zone of
myocardial infarction that is non-viable.
Viability study delayed (also known as myocardial
enhancement study)
 These are T1 weighted, gradient-echo
sequences. Image acquisition is performed 10 minutes
after gadolinium contrast administration.
 Focal myocardial fibrosis has a delayed gadolinium
contrast wash out. So hyperenhancement indicates a
myocardial scar, thus an evolved myocardial
infarction.
Cardiac MRI basics
Cardiac MRI basics
MR planes of imaging
 The two main planes used for cardiac
MRI include the body (scanner) planes
and the cardiac planes.
 Body Planes
Body planes are oriented orthogonal to
the long axis of the body and consist
of axial, sagittal, and coronal planes .
 The axial plane can depict the four
chambers of the heart and the
pericardium simultaneously.
 The sagittal plane can show the great
vessels arising in continuity from the
ventricles.
 The coronal plane can be used to
assess the left ventricular outflow
tract, the left atrium, and the
pulmonary veins.
Cardiac MRI basics
Cardiac planes
 The standard cardiac planes are
established using the scout images
and include
short axis view
horizontal long axis (four-chamber view)
vertical long axis (two-chamber view)
 These planes are prescribed along a line
extending from the cardiac apex to the
center of the mitral valve (long axis of the
heart) using the axial body plane images.
 The short-axis plane extends perpendicular
to this true long axis of the heart at the level
of the mid left ventricle.
 The horizontal long(4 chamber) axis is
generated by selecting the horizontal plane
that is perpendicular to the short axis
 The vertical long (2 chamber)axis is
prescribed along a vertical plane orthogonal
to the short-axis plane
Cardiac MRI basics
Short axis view
 The short-axis plane extends
perpendicular to this true long axis of
the heart at the level of the mid left
ventricle
Cardiac MRI basics
Two chamber view
 To achieve a two-chamber scout view,
a true axial view through the left
ventricle should be obtained, and then
an oblique coronal scout view should
be positioned parallel to the
interventricular septum
Cardiac MRI basics
4 chamber view
 The horizontal long axis(4 chamber
view) is generated by selecting the
horizontal plane that is perpendicular
to the short axis
Cardiac MRI basics
Left ventricular outflow view
 To obtain a long-axis left ventricular
view, an imaging plane should be
positioned from the left ventricular
apex through the mitral valve by using
a two-chamber view depicting the
mitral valve
Cardiac MRI basics
Cardiac MRI basics
Planning and acquisition of
standard cardiac views
Short-axis view
Horizontal long axis view
Two chamber view
right ventricular outflow tract view
left ventricular outflow tract view
Cardiac MRI basics
Indications of cardiac MRI
Cardiac MRI basics
Conclusion
THANK YOU

Weitere ähnliche Inhalte

Was ist angesagt? (20)

Cardiac MRI
Cardiac MRICardiac MRI
Cardiac MRI
 
Coronary CT
Coronary CTCoronary CT
Coronary CT
 
Cardiac mri
Cardiac mriCardiac mri
Cardiac mri
 
CT Coronary Angiography (CTCA)
CT Coronary Angiography (CTCA)CT Coronary Angiography (CTCA)
CT Coronary Angiography (CTCA)
 
Coronary ct angiography
Coronary ct angiographyCoronary ct angiography
Coronary ct angiography
 
Ct coronary angiography edited 1st
Ct   coronary  angiography edited 1stCt   coronary  angiography edited 1st
Ct coronary angiography edited 1st
 
Cardiovascular Imaging
Cardiovascular ImagingCardiovascular Imaging
Cardiovascular Imaging
 
CT Angiography presentation
CT Angiography presentation CT Angiography presentation
CT Angiography presentation
 
Mri cardic imaging
Mri cardic imaging Mri cardic imaging
Mri cardic imaging
 
Cardiac ct ccta2
Cardiac ct ccta2Cardiac ct ccta2
Cardiac ct ccta2
 
Magnetic Resonance Perfusion
Magnetic Resonance PerfusionMagnetic Resonance Perfusion
Magnetic Resonance Perfusion
 
Cardiac MRI
Cardiac MRICardiac MRI
Cardiac MRI
 
CT Coronary angiography
CT Coronary angiography CT Coronary angiography
CT Coronary angiography
 
Magnetic Resonance Angiography and techniques
Magnetic Resonance Angiography and techniquesMagnetic Resonance Angiography and techniques
Magnetic Resonance Angiography and techniques
 
Tissue harmonic imaging
Tissue harmonic imaging Tissue harmonic imaging
Tissue harmonic imaging
 
Basics of CCTA
Basics of CCTABasics of CCTA
Basics of CCTA
 
Ct angio ppt
Ct angio pptCt angio ppt
Ct angio ppt
 
MRI artifacts
MRI artifactsMRI artifacts
MRI artifacts
 
Cardiac CT
Cardiac CTCardiac CT
Cardiac CT
 
Coronary CT Angiography
Coronary CT Angiography Coronary CT Angiography
Coronary CT Angiography
 

Ähnlich wie Cardiac MRI basics

CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...
CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...
CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...RukamaneeYadav
 
Nuclear medicine for cardiothoracic surgeons
Nuclear medicine for cardiothoracic surgeonsNuclear medicine for cardiothoracic surgeons
Nuclear medicine for cardiothoracic surgeonsSrikanthK120
 
ECHO WINDOWS AND VIEWS.pptx
ECHO WINDOWS AND VIEWS.pptxECHO WINDOWS AND VIEWS.pptx
ECHO WINDOWS AND VIEWS.pptxRutviThaker
 
Angiography of Head and Neck
Angiography of Head and NeckAngiography of Head and Neck
Angiography of Head and NeckSharmaRajan4
 
Diagnostic Procedures for Cardiovascular system
Diagnostic Procedures for Cardiovascular systemDiagnostic Procedures for Cardiovascular system
Diagnostic Procedures for Cardiovascular systemrangeles5
 
ECHO in Cardiac Failure
ECHO in Cardiac Failure ECHO in Cardiac Failure
ECHO in Cardiac Failure MANULALVS
 
Echo parameters in crt patients selection
Echo parameters in crt patients selectionEcho parameters in crt patients selection
Echo parameters in crt patients selectionJai Babu
 
intto to echo.pdf
intto to echo.pdfintto to echo.pdf
intto to echo.pdfMariyaQazi
 
1804.06812
1804.068121804.06812
1804.06812maicu1
 
radiology.CVS 1st lecture.(dr.abeer)
radiology.CVS 1st lecture.(dr.abeer)radiology.CVS 1st lecture.(dr.abeer)
radiology.CVS 1st lecture.(dr.abeer)student
 
Cardiac diagnostics and laboratory tests
Cardiac diagnostics and laboratory tests Cardiac diagnostics and laboratory tests
Cardiac diagnostics and laboratory tests Dr. Rima Das
 
CSF Flow Study In MRI
CSF Flow Study In MRICSF Flow Study In MRI
CSF Flow Study In MRIMohitdeswal13
 
invasive non invasive procedures.pdf for bsc nursing students
invasive non invasive procedures.pdf for bsc nursing studentsinvasive non invasive procedures.pdf for bsc nursing students
invasive non invasive procedures.pdf for bsc nursing studentsshanmukhadevi
 
basicechocardiography-170913182344 (2).pdf
basicechocardiography-170913182344 (2).pdfbasicechocardiography-170913182344 (2).pdf
basicechocardiography-170913182344 (2).pdflittlealphonsa
 

Ähnlich wie Cardiac MRI basics (20)

Cardiac MRI
Cardiac MRICardiac MRI
Cardiac MRI
 
introduction
introductionintroduction
introduction
 
4D Flow MRI
4D Flow MRI4D Flow MRI
4D Flow MRI
 
CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...
CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...
CT Coronary Angiography.pptx, eart muscle) Acute angina (type of chest pain) ...
 
Nuclear medicine for cardiothoracic surgeons
Nuclear medicine for cardiothoracic surgeonsNuclear medicine for cardiothoracic surgeons
Nuclear medicine for cardiothoracic surgeons
 
ECHO WINDOWS AND VIEWS.pptx
ECHO WINDOWS AND VIEWS.pptxECHO WINDOWS AND VIEWS.pptx
ECHO WINDOWS AND VIEWS.pptx
 
Angiography of Head and Neck
Angiography of Head and NeckAngiography of Head and Neck
Angiography of Head and Neck
 
Diagnostic Procedures for Cardiovascular system
Diagnostic Procedures for Cardiovascular systemDiagnostic Procedures for Cardiovascular system
Diagnostic Procedures for Cardiovascular system
 
ECHO in Cardiac Failure
ECHO in Cardiac Failure ECHO in Cardiac Failure
ECHO in Cardiac Failure
 
Echo parameters in crt patients selection
Echo parameters in crt patients selectionEcho parameters in crt patients selection
Echo parameters in crt patients selection
 
intto to echo.pdf
intto to echo.pdfintto to echo.pdf
intto to echo.pdf
 
Echocardiography an introduction
Echocardiography an introductionEchocardiography an introduction
Echocardiography an introduction
 
1804.06812
1804.068121804.06812
1804.06812
 
Radiology 5th year, 12th lecture (Dr. Abeer)
Radiology 5th year, 12th lecture (Dr. Abeer)Radiology 5th year, 12th lecture (Dr. Abeer)
Radiology 5th year, 12th lecture (Dr. Abeer)
 
radiology.CVS 1st lecture.(dr.abeer)
radiology.CVS 1st lecture.(dr.abeer)radiology.CVS 1st lecture.(dr.abeer)
radiology.CVS 1st lecture.(dr.abeer)
 
Cardiac diagnostics and laboratory tests
Cardiac diagnostics and laboratory tests Cardiac diagnostics and laboratory tests
Cardiac diagnostics and laboratory tests
 
CSF Flow Study In MRI
CSF Flow Study In MRICSF Flow Study In MRI
CSF Flow Study In MRI
 
7-190517175000.pdf
7-190517175000.pdf7-190517175000.pdf
7-190517175000.pdf
 
invasive non invasive procedures.pdf for bsc nursing students
invasive non invasive procedures.pdf for bsc nursing studentsinvasive non invasive procedures.pdf for bsc nursing students
invasive non invasive procedures.pdf for bsc nursing students
 
basicechocardiography-170913182344 (2).pdf
basicechocardiography-170913182344 (2).pdfbasicechocardiography-170913182344 (2).pdf
basicechocardiography-170913182344 (2).pdf
 

Kürzlich hochgeladen

Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 

Kürzlich hochgeladen (20)

Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 

Cardiac MRI basics

  • 2.  Cardiac MRI consists of using MRI to study heart anatomy, physiology, and pathology.
  • 3. Advantages Cardiac MRI offers:  improved soft tissue definition  protocol can be tailored to likely differential diagnoses ◦ a large number of sequences are available ◦ dynamic imaging provides functional assessment  no ionizing radiation ◦ MRI safety still requires consideration
  • 13. MR imaging techniques  Blood techniques Dark blood Bright blood  Imaging sequences  Imaging planes
  • 14. Pulse sequences-Overview  Black blood-anatomy Spin echo(SE)  Bright blood-dynamic and angiography Gradient echo(GE)  Phase contrast(PC)-quantify flow  Delayed enhancement- infarct/inflammation/infiltration  2D SSFP with IR prep  Gadolinium assisted MRA 3D fast spoiled GE
  • 15.  Basic cardiovascular MR imaging sequences include black blood imaging and bright blood imaging.  Black blood imaging is used to depict anatomy, pericardial and mediastinal abnormalities, and extra luminal aortic disease.  Black blood imaging includes ECG-gated true spin-echo or fast spin-echo imaging or inversion-recovery (IR) half-Fourier single-shot turbo fast-spin-echo sequences.
  • 16.  Bright blood imaging is used to demonstrate flow and motion and to image valvular disease.  Bright blood cine sequences include segmented-k-space small-flip-angle gradient-echo sequences or fast imaging with steady-state precession or refocused steady-state free precession (SSFP)
  • 22. Advantages  Since it uses the residual transverse magnetization instead of wasting it,there is increased signal to noise ratio.  Since transverse magnetization is added back to longitudinal magnetization,the steady state is reached quicker,in as little as single TR.  The TRs are extremely
  • 23.  The images have both T1and T2 weighted.(The molecules with long T2 and short T1 will have bright signal(both fat and water)  Thus bright signal in steady state white blood images is attributable to T1 and T2 signal from the blood,not flow related.
  • 24.  Gating of white blood images allows evaluation of dynamic cardiac function and physiology throughout cardiac cycle.Examples include motion of myocardium and valve leaflets.  Gating in white blood images serve to time image acquisition during diastolic phase of cardiac cycle,thereby limiting cardiac motion artifact.
  • 28. Cine imaging Cine imaging or cine MRI, are a type of MRI sequence acquired to capture motion  For the heart, this is achieved by acquisition at multiple time points throughout the cardiac cycle, after synchronisation with the ECG has been achieved.  Separate k-spaces are assigned to different phases or segments of the cardiac cycle.  Images are reconstructed from each k- space and shown in a movie.  This type of imaging technique requires fast imaging techniques using very short repetition and echo times such as balanced steady-state free precession or spoiled gradient
  • 32. Contrast-enhanced techniques Perfusion imaging (also known as first-pass images)  These are T1 weighted, gradient-echo sequences. Image acquisition is performed 3 minutes after gadolinium contrast administration. If there is a hypoenhanced area, this implies a zone of myocardial infarction that is non-viable. Viability study delayed (also known as myocardial enhancement study)  These are T1 weighted, gradient-echo sequences. Image acquisition is performed 10 minutes after gadolinium contrast administration.  Focal myocardial fibrosis has a delayed gadolinium contrast wash out. So hyperenhancement indicates a myocardial scar, thus an evolved myocardial infarction.
  • 35. MR planes of imaging
  • 36.  The two main planes used for cardiac MRI include the body (scanner) planes and the cardiac planes.  Body Planes Body planes are oriented orthogonal to the long axis of the body and consist of axial, sagittal, and coronal planes .
  • 37.  The axial plane can depict the four chambers of the heart and the pericardium simultaneously.  The sagittal plane can show the great vessels arising in continuity from the ventricles.  The coronal plane can be used to assess the left ventricular outflow tract, the left atrium, and the pulmonary veins.
  • 39. Cardiac planes  The standard cardiac planes are established using the scout images and include short axis view horizontal long axis (four-chamber view) vertical long axis (two-chamber view)
  • 40.  These planes are prescribed along a line extending from the cardiac apex to the center of the mitral valve (long axis of the heart) using the axial body plane images.  The short-axis plane extends perpendicular to this true long axis of the heart at the level of the mid left ventricle.  The horizontal long(4 chamber) axis is generated by selecting the horizontal plane that is perpendicular to the short axis  The vertical long (2 chamber)axis is prescribed along a vertical plane orthogonal to the short-axis plane
  • 42. Short axis view  The short-axis plane extends perpendicular to this true long axis of the heart at the level of the mid left ventricle
  • 44. Two chamber view  To achieve a two-chamber scout view, a true axial view through the left ventricle should be obtained, and then an oblique coronal scout view should be positioned parallel to the interventricular septum
  • 46. 4 chamber view  The horizontal long axis(4 chamber view) is generated by selecting the horizontal plane that is perpendicular to the short axis
  • 48. Left ventricular outflow view  To obtain a long-axis left ventricular view, an imaging plane should be positioned from the left ventricular apex through the mitral valve by using a two-chamber view depicting the mitral valve
  • 51. Planning and acquisition of standard cardiac views