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Cardiac Axes
 
The cardiac anatomy is complex, and cardiac structures have different appearances depending on the imaging plane. The most useful imaging planes are those parallel and perpendicular to the cardiac axes. The short axis (SA), vertical long cardiac axis (VLA - 2 chamber view - 2C) and horizontal long axis (HLA - 4 chamber view - 4C) are the standard views in cardiovascular imaging. The orientation of a heart is described relative to an imaginary line drawn from the base of the heart (valve plane) to the apex.
Obtaining cine images in these double-oblique planes requires the use of multiple localizing MRI sequences and knowledge of the cardiac anatomy. The long axis image plane is determined by the line that runs from the apex of the heart to a midpoint at the base of the heart, often taken to be midway between the mitral valve leaflets. The short axis is planned perpendicular to the long axis view.

 
Images, Movies, Sliders:
 Angulation of Cardiac Planes Cine Images of Septal Infarct  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 Cardiac Infarct 4 Chamber Cine 1  Open this link in a new window
 Cardiac Infarct Short Axis Cine bFFE 1  Open this link in a new window
 
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• Related Searches:
    • Breath Hold Imaging
    • Cardiovascular Imaging
    • Cardiac Gating
    • Orthogonal
    • Myocardial Late Enhancement
 
Further Reading:
  Basics:
A Guide To Cardiac Imaging
   by www.simplyphysics.com    
  News & More:
Healthy Heart Anatomy
   by www.columbiasurgery.org    
MRI Resources 
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Breath Hold ImagingMRI Resource Directory:
 - Abdominal Imaging -
 
Breath hold imaging in MRI is a technique with one ore more stoppage of breathing during the sequence and require therefore a short scan time. Breath hold techniques are used with fast gradient echo sequences in thoracic or abdominal regions with much respiratory movement.
Breath hold cine MRI techniques are used in cardiovascular imaging and provide detailed views of the beating heart in different cardiac axes.
Breath hold imaging requires the full cooperation of the patient, caused by usual MRI scan times from 15 to 20 sec.. In some cases breath holding can be practiced outside the MRI scanner to improve patient cooperation with the examination. Shorter scan times e.g. by parallel imaging techniques, or the administration of oxygen can help the patient to hold the breath during the scan.
See also Abdominal Imaging.
 
Images, Movies, Sliders:
 MRI Upper Abdomen T1 with Contrast  Open this link in a new window
 Normal Dual Inversion Fast Spin-echo  Open this link in a new window
 Anatomic Imaging of the Lungs  Open this link in a new window
 
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• View the DATABASE results for 'Breath Hold Imaging' (7).Open this link in a new window

 
Further Reading:
  News & More:
The Effects of Breathing Motion on DCE-MRI Images: Phantom Studies Simulating Respiratory Motion to Compare CAIPIRINHA-VIBE, Radial-VIBE, and Conventional VIBE
Tuesday, 7 February 2017   by www.kjronline.org    
Controlling patient's breathing makes cardiac MRI more accurate
Friday, 13 May 2016   by www.upi.com    
Accurate T1 Quantification Using a Breath-hold Inversion Recovery TrueFISP Sequence
2003   by rsna2003.rsna.org    
MRI Resources 
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Cardiac MRIForum -
related threads
 
In the last years, cardiac MRI techniques have progressively improved. No other noninvasive imaging modality provides the same degree of contrast and temporal resolution for the assessment of cardiovascular anatomy and pathology. Contraindications MRI are the same as for other magnetic resonance techniques.
The primary advantage of MRI is extremely high contrast resolution between different tissue types, including blood. Moreover, MRI is a true 3 dimensional imaging modality and images can be obtained in any oblique plane along the true cardiac axes while preserving high temporal and spatial resolution with precise demonstration of cardiac anatomy without the administration of contrast media.
Due to these properties, MRI can precisely characterize cardiac function and quantify cavity volumes, ejection fraction, and left ventricular mass. In addition, cardiac MRI has the ability to quantify flow (see flow quantification), including bulk flow in vessels, pressure gradients across stenosis, regurgitant fractions and shunt fractions. Valve morphology and area can be determined and the severity of stenosis quantified. In certain disease states, such as myocardial infarction, the contrast resolution of MRI is further improved by the addition of extrinsic contrast agents (see myocardial late enhancement).
A dedicated cardiac coil, and a field strength higher than 1 Tesla is recommended to have sufficient signal. Cardiac MRI acquires ECG gating. Cardiac gating (ECGs) obtained within the MRI scanner, can be degraded by the superimposed electrical potential of flowing blood in the magnetic field. Therefore, excellent contact between the skin and ECG leads is necessary. For male patients, the skin at the lead sites can be shaved. A good cooperation of the patient is necessary because breath holding at the end of expiration is practiced during the most sequences.
See also Displacement Encoding with Stimulated Echoes.
For Ultrasound Imaging (USI) see Cardiac Ultrasound at US-TIP.com.

See also the related poll results: 'In 2010 your scanner will probably work with a field strength of' and 'MRI will have replaced 50% of x-ray exams by'
 
Images, Movies, Sliders:
 Infarct 4 Chamber Cine  Open this link in a new window
    

Courtesy of  Robert R. Edelman
 MVP Parasternal  Open this link in a new window
    

Courtesy of  Robert R. Edelman
 Delayed Myocardial Contrast Enhancement from Infarct  Open this link in a new window
      

Courtesy of  Robert R. Edelman
 
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• View the DATABASE results for 'Cardiac MRI' (15).Open this link in a new window


• View the NEWS results for 'Cardiac MRI' (15).Open this link in a new window.
 
Further Reading:
  Basics:
Cardiac MRI - Technical Aspects Primer
Wednesday, 7 August 2002
Prediction of Myocardial Viability by MRI
1999   by circ.ahajournals.org    
  News & More:
Validation of Thermometric Cardiac Imaging by MRI
Thursday, 26 January 2017   by www.satprnews.com    
Controlling patient's breathing makes cardiac MRI more accurate
Friday, 13 May 2016   by www.upi.com    
New technique could allow for safer, more accurate heart scans
Thursday, 10 December 2015   by www.gizmag.com    
Precise visualization of myocardial injury: World's first patient-based cardiac MRI study using 7T MRI
Wednesday, 10 February 2016   by medicalxpress.com    
Susceptibility-weighted cardiovascular magnetic resonance in comparison to T2 and T2 star imaging for detection of intramyocardial hemorrhage following acute myocardial infarction at 3 Tesla
Tuesday, 28 October 2014   by 7thspace.com    
MRI Resources 
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Cardiovascular ImagingMRI Resource Directory:
 - Cardiovascular Imaging -
 
Cardiovascular MR imaging includes the complete anatomical display of the heart with CINE imaging of all phases of the heartbeat. Ultrafast techniques make breath hold three-dimensional coverage of the heart in different cardiac axes feasible. Cardiac MRI provides reliable anatomical and functional assessment of the heart and evaluation of myocardial viability and coronary artery disease by a noninvasive diagnostic imaging technique.
Cardiovascular MRI offers potential advantages over radioisotopic techniques because it provides superior spatial resolution, does not use ionizing radiation, has no imaging orientations constraints and contrast resolution better than echocardiography. It also offers direct visualization and characterization of atherosclerotic plaques and diseased vessel walls and surrounding tissues in cardiovascular research.
MRI perfusion approaches measure the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents and assess the extent of injury after a myocardial infarction and the presence of myocardial viability with a technique based on late enhancement. Extracellular MRI contrast agents, like Gd-DTPA, accumulate only in irreversibly damaged myocardium after a time period of at least 10 minutes.
This type of patients may also have an implanted cardiac stent, bypass or a cardiac pacemaker and special caution should be observed on the MRI safety and the contraindications. While a number of coronary stents have been tested and reported to be MRI compatible, coronary stents must be assessed on an individual basis, with the medical team weighing the risks and benefits of the MRI procedure.
Cardiac MRI overview:
Coronary angiography,
Coronary Angiography with D-Tagging
Myocardial perfusion imaging and viability
Calculation of ventricular volume, myocardial mass and wall thickness
Functional parameters
Description of a stenosis or aneurysma
Anatomical display of the heart, vessels and the surrounding tissue
Cardiovascular MRI has become one of the most effective noninvasive imaging techniques for almost all groups of heart and vascular disease.

 
Images, Movies, Sliders:
 Angulation of Cardiac Planes Cine Images of Septal Infarct  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 Left Circumflex Ischemia First-pass Contrast Enhancement  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 Delayed Myocardial Contrast Enhancement from Infarct  Open this link in a new window
 
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• View the DATABASE results for 'Cardiovascular Imaging' (18).Open this link in a new window


• View the NEWS results for 'Cardiovascular Imaging' (6).Open this link in a new window.
 
Further Reading:
  Basics:
Cardiac MRI - Technical Aspects Primer
Wednesday, 7 August 2002
Coronary Artery Disease: Combined Stress MR Imaging Protocol-One-Stop Evaluation of Myocardial Perfusion and Function1
   by radiology.rsnajnls.org    
A Guide To Cardiac Imaging
   by www.simplyphysics.com    
  News & More:
New Imaging Technique Reveals Different Heart Motions by Age, Gender
Thursday, 10 December 2009   by www.sciencedaily.com    
Rockland Technimed: Tissue Viability Imaging
Saturday, 15 December 2007   by www.onemedplace.com    
MRI Resources 
Pacemaker - Online Books - Contrast Agents - MRI Training Courses - Stimulator pool - Mobile MRI Rental
 
Cine SequenceInfoSheet: - Sequences - 
Intro, 
Overview, 
Types of, 
etc.
 
Cine sequences used in cardiovascular MRI are collection of images (usually at the same spatial location) covering of one full period of cardiac cycle or over several periods in order to obtain complete coverage.
The pulse sequence used, is either a standard gradient echo pulse sequence, a segmented data acquisition, a gradient echo EPI sequence or a gradient echo with balanced gradient waveform. In cardiac gating studies it is possible to assign consecutive lines either to different images, yielding a multiphase sequence with as many images as lines, or the lines are grouped together into segments and assigned to the same image. The overall time to acquire such a segment has to be small compared to the RR-interval of the cardiac cycle, i. e. 50 ms, and hence contains typically 8 to 16 image lines.
This strategy is called segmented data acquisition, and has the advantage of reducing overall imaging time for cardiac images so that they can be acquired within a breath hold, but obviously decreasing the temporal resolution of each individual image. This method shows dynamic processes, such as the ejection of blood out of the heart into the aorta, by means of fast imaging and displaying the resulting images in a sequential-loop, the impression of a real-time movie is generated. Ejection fractions and stroke volumes calculated from these cine MRI images in different cardiac axes have been shown to be more accurate than any other imaging modality.
See also Cardiac Gating.

 
Images, Movies, Sliders:
 Angulation of Cardiac Planes Cine Images of Septal Infarct  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 Cardiac Infarct Short Axis Cine Overview  Open this link in a new window
    

Courtesy of  Robert R. Edelman
 Infarct 4 Chamber Cine  Open this link in a new window
    

Courtesy of  Robert R. Edelman
 
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• View the DATABASE results for 'Cine Sequence' (2).Open this link in a new window

 
Further Reading:
  News & More:
Study Shows Cardiac MRI Use Reduces Adverse Events for Patients with Acute Chest Pain
Monday, 10 June 2013   by www.healthcanal.com    
Study identifies new way to predict prognosis for heart failure patients
Tuesday, 10 December 2013   by medicalxpress.com    
MRI Resources 
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