? Routine sequences, acquire in all studies (after scout(s) and sense reference scans). For all bSSFP cine imaging, please ensure that the entire cardiac cycle is captured (especially all of diastole)
- T1-BB axial (aortic arch to inferior aspect of heart below diaphragm) (TSE)
- Horizontal long axis (HLA) (bSSFP cine)
- Vertical long axis (VLA) (bSSFP cine)
- Short axis (SHAX) stack (cover from apex to mitral valve plane) (bSSFP cine)
- 4-chamber stack (bSSFP cine)
- Aortic valve flow (Velocity encoded)
- Pulmonic valve flow (Velocity encoded)
? Delayed (late gadolinium) enhancement (LGE) protocol:
- Inject 0.15 mmol/kg ProHance (gadoteridol). Reduce to 0.1 mmol/kg if CrCl < 60 ml/min/1.73m2). Inject IMMEDIATELY AFTER T1-BB sequence.
- Look-locker at 10 mins in mid-ventricular short axis plane
- PSIR (phase sensitive IR) in short axis stack, same geometry (slice location) as bSSFP cine and obtain LGE images in diastole
- PSIR in 4-chamber stack, same geometry as SSFP cine and obtain LGE images in diastole
- PSIR in 2-chamber view (single image) and obtain LGE images in diastole
? T1 Mapping Protocol (for amyloid, HCM, sarcoid, myocarditis, diffuse fibrosis)
- Run normal cine sequences
- PRE-CONTRAST ? Run MOLLI 3_5 sequence for non-contrast (native) T1 map. Acquire images in short axis plane in 3 slices: basal, mid-ventricular, and apical
- Run standard LGE sequence as above
- POST-CONTRAST (> 15 mins after injection) ? Run MOLLI 3_T again in same slices as above. Please ensure that pre and post contrast images are acquired in the exact same way/parameters (i.e. FOV, matrix, slice location). Any deviation will not allow us to process the post-contrast images appropriately
? Dobutamine viability assessment
- After 3 mins. infusion of 5 mcg/kg/min dobutamine, repeat of VLA, 4 chamber, and 3 short axis slices in base, mid-, and apical LV
- Increase to 10 mcg/k/min, wait 3 mins., and repeat images as above
? Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C)
- T1-BB with fat suppression (SPIR) in axial and short axis planes identical to T1-BB w/o SPIR
- Reduce 4 chamber cine slice thickness to 5 mm
? Myocarditis
- Run normal cine sequences
- T2 ? BB in short axis plane, with STIR.
- Ensure same slice location and geometry as LGE and bSSFP SAX
- T1 mapping protocol
- T1 BB immediately post contrast for early gadolinium enhancement (EGE)
[Field] Sarcoidosis
- Run normal cine sequences
- T2 ? BB in short axis plane, with STIR.
- Ensure same slice location and geometry as LGE and bSSFP SAX
- T1 mapping protocol
[Field] Hypertrophic Cardiomyopathy
- LVOT plane (bSSFP cine)
- Aortic valve short axis (bSSFP cine)
- Aortic flow below valve in plane perpendicular to LVOT (Velocity encoded)
- 2-3 slices below the valve
- Single slice at the level of the valve
- 1-2 slices above the valve
- T1 mapping protocol
? Constrictive Pericarditis
- Real time (non-breath hold, non-ECG gated) in SHAX slices at base, mid-, and apex
- Real time in 4-chamber plane
? Cardiac Mass
- T1-BB in axial plane immediately after contrast injection
- Resting perfusion (dynamic images during contrast injection of 5 ml) during breath hold
? Iron overload
- T2-star sequence in mid-ventricular short axis single slice (single breath hold)
? Aortic stenosis
- LVOT plane (bSSFP cine)
- Aortic valve short axis (bSSFP cine)
- Aortic flow below valve in plane perpendicular to LVOT (Velocity encoded)
- T1 mapping protocol
? Aorta
- MRA of thoracic aorta
- Oblique sagittal view (?candy cane?) view of the thoracic aorta (usually requires 3-4 slices) with cine SSFP sequence
? ASD
- Short axis cine CMR stack (bSSFP) of the atria (from annular plane to the top of the aortic arch)
- Contiguous slices (i.e. no skipping)
- Thinner slices (5mm)
- 4CH stack (bSSFP), rather than the usual protocol please do contiguous, thinner slices. We want to get views parallel to the septum
- Contiguous slices
- Thinner slices (5mm)
- Velocity Encoding-1?3 contiguous slices positioned parallel to the atrial septal plane to obtain an?en face?view of the defect and with through-plane velocity encoding.
- Velocity Encoding-Stack of contiguous thin slices in a 4-chamber plane and/or in an oblique sagittal plane perpendicular to the atrial septum to completely encompass the atrial septum, and with in-plane velocity encoding in the direction of atrial septal defect flow
? Additional sequences or planes
Please obtain a T2 map in the short axis mid ventricular slice (same as T1 map) prior to the administration of gadolinium.