Cardiac Magnetic Resonance Imaging: Techniques and Principles
Section snippets
Patient Considerations in Cardiac MRI
The first consideration is to determine if cardiac MRI is the appropriate study. Cardiac MRI is typically not a first-line study; rather, it is often obtained after echocardiography, radionuclide imaging, coronary angiography or cardiothoracic CT. Unanswered questions that persist after these studies may lead to consideration of further testing. Thus, it is important to match the clinical question with the strengths and weakness of cardiac MRI.
In uncooperative or disoriented patients, it may be
Cardiac MRI Setup
Electrocardiographic (ECG)-gating is necessary to avoid image blurring to ensure a diagnostic cardiac MRI study.4 MRI-compatible leads are attached to the anterior chest with an adhesive using three or four electrodes. It is important to assure that the leads are not twisted or looped and that there is adequate contact with the skin. In patients with substantial chest or abdominal body hair, shaving of the region where the lead is to be placed will improve contact. In general, areas of the skin
Cardiac MRI Physics
As in other parts of the body, acquisition of cardiac MRI relies on protons, mainly attached to water molecules that spin when placed in a magnetic field. This gyration produces a magnetic field that can align with a superconducting magnet of large magnetic field. In addition, a spatially applied field generates slightly different spins along a gradient. A radiofrequency (RF) pulse can be applied such that only protons spinning at the same frequency as the RF pulse capture the RF energy.
The
Dark-Blood Imaging
Cardiac MRI sequences are typically categorized as dark- or black-blood and bright-blood (often gradient-echo) sequences. Dark-blood imaging was traditionally done with multislice T1-weighted spin-echo sequences (Fig. 1). This sequence often provides excellent anatomic image quality of cardiac chambers, great vessels, and pericardium and is relatively unaffected by metallic artifact.9 It remains valuable when precise anatomic detail is necessary such as in assessment for fat in the right
Imaging Planes of the Heart
Imaging of the heart is often challenging because of its double oblique angulation and the convention of other cardiac imaging modalities to obtain images in planes orthogonal to the heart. Thus, in addition to the conventional axial, sagittal, and coronal axes of the thorax, these cardiac axes are typically acquired. Because of the various imaging options available to evaluate cardiac morphology and function, it is important that a standard approach and nomenclature is be used.32
The cardiac
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