Pädagogische Ziele

Learning objectives

After reading this chapter, you should be able:

  • To list the main difficulties in cardiac MRI
  • Present the methods to overcome these
  • Explain the principles of ECG gating
  • Describe the techniques and results of:
    • Morphological and functional cardiac exploration
    • Cine phase-contrast velocity mapping
    • Myocardial perfusion and late enhancement imaging
    • Coronary MR angiography

Schlüsselpunkte

Application Sequence Gating Breath. Prep Inj. Blood Contr.
Morphology Fast SE
 
 with Dark blood preparation 		P H DB – ● T1, T2
Morphology Ultrafast SE
 
 with Dark blood preparation 		P L/A DB – ● T1, T2
function Balanced steady state GE cine sequence
 
 ± tagging ± stress 		R/P H/F ± tagging ± stress
 
 (Dobu tamine) 		○ T2/T1
Flow Phase contrast R/P H PE – ● +
 
 ○ – 		Speed (phase)
Perfusion GE-EPI, ultrafast GE or GE with balanced gradients and preparation by saturation recuperation (SR) P H/C/F SR Gado
 
 1st p.
 
 ± stress 		○ T1
Delayed enhancement IR/PSIR – ultrafast GE
 
 with TI adapted to suppress the signal from the healthy myocardium (IR) or in PSIR technique 		P H IR
 
 PSIR 		delayed Gado ○ Healthy myo cardium,
 
 T1

 

Gating: P = prospective, R = retrospective

Breathing: H = Breath-hold, F = Free breathing, C = Respiratory compensation

Preparation: DB = Dark Blood, PE = Phase encoding, SR = Saturation Recuperation, IR = Inversion recuperation, PSIR = Phase Sensitive Inversion Recovery

Injection: Dobu = Dobutamine, Adenos. = Adenosine, Gado = Gadolinium chelates

Blood signal: ● = dark blood, ○ = bright blood, ● + = flow moving toward the observer, in black, ○ – = flow moving away from the observer, in white

Referenzen

  1. Finn, Nael. Cardiac MR imaging: state of the technology. Radiology. 2006 Nov;241(2):338-54.
  2. Bogaert, Dymarkowski. Clinical cardiac MRI : with interactive CD-ROM. 2005:549 p..
  3. Poustchi-Amin, Gutierrez. How to plan and perform a cardiac MR imaging examination. Radiologic clinics of North America. 2004 May;42(3):497-514, v.
  4. Pujadas, Reddy. MR imaging assessment of cardiac function. J Magn Reson Imaging. 2004 Jun;19(6):789-99.
  5. Strach, Meyer. Cardiac stress MR imaging with dobutamine. European radiology. 2006 Dec;16(12):2728-38.
  6. Markl, Reeder. Steady-state free precession MR imaging: improved myocardial tag persistence and signal-to-noise ratio for analysis of myocardial motion. Radiology. 2004 Mar;230(3):852-61..
  7. Garot, Bluemke. Fast determination of regional myocardial strain fields from tagged cardiac images using harmonic phase MRI. Circulation. 2000 Mar 7;101(9):981-8.
  8. Lotz, Meier. Cardiovascular flow measurement with phase-contrast MR imaging: basic facts and implementation. Radiographics. 2002 May-Jun;22(3):651-71.
  9. Gatehouse, Keegan. Applications of phase-contrast flow and velocity imaging in cardiovascular MRI. European radiology. 2005 Oct;15(10):2172-84.
  10. Edelman. Contrast-enhanced MR imaging of the heart: overview of the literature. Radiology. 2004 Sep;232(3):653-68.
  11. Reeder, Du. Advanced cardiac MR imaging of ischemic heart disease. Radiographics. 2001 Jul-Aug;21(4):1047-74.
  12. Dembo, Shifrin. MR imaging in ischemic heart disease. Radiologic clinics of North America. 2004 May;42(3):651-73, vii.
  13. Barkhausen, Hunold. Imaging of myocardial perfusion with magnetic resonance. J Magn Reson Imaging. 2004 Jun;19(6):750-7.
  14. Kellman and Arai. Imaging sequences for first pass perfusion - a review. J Cardiovasc Magn Reson. 2007;9(3):525-37.
  15. Croisille. [Ischemic heart disease (myocardial perfusion and viability): techniques and results]. Journal de radiologie. 2004 Oct;85(10 Pt 2):1819-20.
  16. Kellman, Arai. Phase-sensitive inversion recovery for detecting myocardial infarction using gadolinium-delayed hyperenhancement. Magn Reson Med. 2002 Feb;47(2):372-83.
  17. Dirksen, Lamb. Coronary magnetic resonance angiography: technical developments and clinical applications. J Cardiovasc Magn Reson. 2003;5(2):365-86.
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