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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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Coronary MR angiography. Patient with anomalous origin of the right coronary artery from the left aortic sinus of Valsalva. Coronary angiography was performed using an ECG and respiratory navigator-gated 3D SSFP sequence with data acquisition timed to the diastolic rest period of the cardiac cycle. Multiplanar reformatting oriented in short-axis to the aortic root yielded this image.
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Figure 5: Coronary MR angiography. Patient with anomalous origin of the right coronary artery from the left aortic sinus of Valsalva. Coronary angiography was performed using an ECG and respiratory navigator-gated 3D SSFP sequence with data acquisition timed to the diastolic rest period of the cardiac cycle. Multiplanar reformatting oriented in short-axis to the aortic root yielded this image.

Mentions: A version of 3D SSFP is generally the technique of choice for coronary artery imaging in patients with CHD (Figure 5) [43-46]. For this purpose in particular, data acquisition must be confined to the rest period of the cardiac cycle (i.e., that with the least motion) to minimize blurring of these small, fast moving structures. The rest period of the heart is chosen by reviewing a high temporal resolution cine image of the heart (≥50 images per cardiac cycle), usually a 4-chamber view, and identifying the appropriate trigger delay and acquisition (shot) duration. Younger patients will typically have faster heart rates and thus require a shorter acquisition duration. Moreover, at higher heart rates (> 90-100 bpm) the optimal rest period may be in end-systole. If a patient has difficulty being still during the scan and the primary diagnostic goal is to visualize the proximal coronary arteries (e.g., suspect anomalous origin of a coronary artery), it may be helpful to shorten the scan duration by prescribing a smaller, more targeted imaging volume around the aortic root rather than the entire heart.


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)

Coronary MR angiography. Patient with anomalous origin of the right coronary artery from the left aortic sinus of Valsalva. Coronary angiography was performed using an ECG and respiratory navigator-gated 3D SSFP sequence with data acquisition timed to the diastolic rest period of the cardiac cycle. Multiplanar reformatting oriented in short-axis to the aortic root yielded this image.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Coronary MR angiography. Patient with anomalous origin of the right coronary artery from the left aortic sinus of Valsalva. Coronary angiography was performed using an ECG and respiratory navigator-gated 3D SSFP sequence with data acquisition timed to the diastolic rest period of the cardiac cycle. Multiplanar reformatting oriented in short-axis to the aortic root yielded this image.
Mentions: A version of 3D SSFP is generally the technique of choice for coronary artery imaging in patients with CHD (Figure 5) [43-46]. For this purpose in particular, data acquisition must be confined to the rest period of the cardiac cycle (i.e., that with the least motion) to minimize blurring of these small, fast moving structures. The rest period of the heart is chosen by reviewing a high temporal resolution cine image of the heart (≥50 images per cardiac cycle), usually a 4-chamber view, and identifying the appropriate trigger delay and acquisition (shot) duration. Younger patients will typically have faster heart rates and thus require a shorter acquisition duration. Moreover, at higher heart rates (> 90-100 bpm) the optimal rest period may be in end-systole. If a patient has difficulty being still during the scan and the primary diagnostic goal is to visualize the proximal coronary arteries (e.g., suspect anomalous origin of a coronary artery), it may be helpful to shorten the scan duration by prescribing a smaller, more targeted imaging volume around the aortic root rather than the entire heart.

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