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Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease.

Fratz S, Chung T, Greil GF, Samyn MM, Taylor AM, Valsangiacomo Buechel ER, Yoo SJ, Powell AJ - J Cardiovasc Magn Reson (2013)

Bottom Line: The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols.Variations in practice are highlighted and expert consensus recommendations are provided.Indications and appropriate use criteria for CMR examination are not specifically addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (German Heart Center Munich) of the Technical University Munich, Munich, Germany. fratz@dhm.mhn.de

ABSTRACT
Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.

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Spin echo and gradient echo cine. 63-year-old patient who has undergone surgical repair of coarctation of the aorta. The images are oriented parallel to the long-axis of the aortic arch and shown in diastole. A. ECG-triggered fast spin echo sequence acquired with a double inversion preparation pulse to suppress signal from flowing blood. Note that the resulting signal from blood is dark. B. ECG-gated steady-state free precession cine sequence. Note the signal from blood is bright.
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Figure 1: Spin echo and gradient echo cine. 63-year-old patient who has undergone surgical repair of coarctation of the aorta. The images are oriented parallel to the long-axis of the aortic arch and shown in diastole. A. ECG-triggered fast spin echo sequence acquired with a double inversion preparation pulse to suppress signal from flowing blood. Note that the resulting signal from blood is dark. B. ECG-gated steady-state free precession cine sequence. Note the signal from blood is bright.

Mentions: Spin echo pulse sequences are typically used in CMR to generate images in which flowing blood appears dark and more stationary tissues appear as varying shades of gray or white (Figure 1). The most common variants of this technique are fast (turbo) spin echo (commercial names: TSE, Siemens; FSE, General Electric; TSE, Philips) and single-shot fast (turbo) spin echo (commercial names: HASTE, Siemens; SSFSE, General Electric; SSTSE, Philips). Both versions usually employ ECG-triggering to compensate for cardiac motion and preparation pulses to suppress signal from blood and improve image contrast. Respiratory motion can be addressed by breath-holding, acquiring multiple signal averages, triggering from respiratory bellows, or respiratory-navigator gating. By utilizing half-Fourier k-space filling, the single-shot technique acquires all the data to make an image in one heartbeat and is thus very time efficient. The fast spin echo technique collects data for one image over multiple heartbeats and thus takes longer than the single-shot technique, but it produces higher resolution images.


Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease.

Fratz S, Chung T, Greil GF, Samyn MM, Taylor AM, Valsangiacomo Buechel ER, Yoo SJ, Powell AJ - J Cardiovasc Magn Reson (2013)

Spin echo and gradient echo cine. 63-year-old patient who has undergone surgical repair of coarctation of the aorta. The images are oriented parallel to the long-axis of the aortic arch and shown in diastole. A. ECG-triggered fast spin echo sequence acquired with a double inversion preparation pulse to suppress signal from flowing blood. Note that the resulting signal from blood is dark. B. ECG-gated steady-state free precession cine sequence. Note the signal from blood is bright.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3686659&req=5

Figure 1: Spin echo and gradient echo cine. 63-year-old patient who has undergone surgical repair of coarctation of the aorta. The images are oriented parallel to the long-axis of the aortic arch and shown in diastole. A. ECG-triggered fast spin echo sequence acquired with a double inversion preparation pulse to suppress signal from flowing blood. Note that the resulting signal from blood is dark. B. ECG-gated steady-state free precession cine sequence. Note the signal from blood is bright.
Mentions: Spin echo pulse sequences are typically used in CMR to generate images in which flowing blood appears dark and more stationary tissues appear as varying shades of gray or white (Figure 1). The most common variants of this technique are fast (turbo) spin echo (commercial names: TSE, Siemens; FSE, General Electric; TSE, Philips) and single-shot fast (turbo) spin echo (commercial names: HASTE, Siemens; SSFSE, General Electric; SSTSE, Philips). Both versions usually employ ECG-triggering to compensate for cardiac motion and preparation pulses to suppress signal from blood and improve image contrast. Respiratory motion can be addressed by breath-holding, acquiring multiple signal averages, triggering from respiratory bellows, or respiratory-navigator gating. By utilizing half-Fourier k-space filling, the single-shot technique acquires all the data to make an image in one heartbeat and is thus very time efficient. The fast spin echo technique collects data for one image over multiple heartbeats and thus takes longer than the single-shot technique, but it produces higher resolution images.

Bottom Line: The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols.Variations in practice are highlighted and expert consensus recommendations are provided.Indications and appropriate use criteria for CMR examination are not specifically addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (German Heart Center Munich) of the Technical University Munich, Munich, Germany. fratz@dhm.mhn.de

ABSTRACT
Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.

Show MeSH
Related in: MedlinePlus