RadteraCardiac MRI - Function and Viability With Contrast
MR+ ContrastCardiac
Indications
- Ventricular function/volume quantification
- Myocardial viability / infarct scar (LGE)
- Cardiomyopathy characterization (ischemic vs non-ischemic, infiltrative)
- Myocarditis
- Suspected ARVC
- Cardiac mass
Patient prep
- MRI safety screening (devices/pacemakers - confirm MR-conditional)
- ECG/vector gating leads placed; breath-hold coaching
- IV access for gadolinium; eGFR per policy
- Supine, cardiac phased-array (torso) coil
Contrast
Agentgadolinium-based (extracellular, e.g., gadobutrol)
RouteIV
Dose0.1-0.2 mmol/kg
TimingLate gadolinium enhancement (LGE) ~10-20 min post-injection; optional first-pass perfusion at injection
Technique
- ECG-gated, breath-held acquisitions; localizers to define cardiac axes
- Cine bSSFP (SSFP) in standard cardiac planes for function/volumes
- Short-axis cine stack base-to-apex for volumetric LV/RV quantification
- LGE: segmented inversion-recovery GRE (PSIR), TI set to null normal myocardium (~200-300 ms); T1/T2 mapping per indication
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Localizers / scouts | multiple | bSSFP | varies | Define 2/3/4-chamber and short axis |
| 2 | Cine SSFP 2-/3-/4-chamber | long axis | bSSFP cine | 6-8 mm | Wall motion, valves |
| 3 | Cine SSFP short-axis stack | short axis | bSSFP cine | 6-8 mm (gap 2-4) | EF, volumes, mass |
| 4 | T2 / STIR or T2 mapping | short axis | T2 | 8 mm | Edema (myocarditis, acute MI) |
| 5 | First-pass perfusion (optional) | short axis | T1 GRE +C | 8-10 mm | Rest/stress ischemia |
| 6 | Early gadolinium (optional) | short axis/long axis | T1 +C | 8 mm | Thrombus, microvascular obstruction |
| 7 | LGE (PSIR IR-GRE) | short axis + long axis | T1 IR +C | 8 mm | Scar/viability; TI to null myocardium |
| 8 | T1 mapping (native + post) | short axis | T1 map | 8 mm | ECV, infiltration (amyloid, fibrosis) |
Key points
- Cine SSFP short-axis stack is the reference standard for ventricular volumes/EF.
- LGE is the gold standard for scar/viability; subendocardial-to-transmural in a coronary territory = ischemic; mid-wall/epicardial = non-ischemic.
- Set inversion time to null normal myocardium on LGE (PSIR is TI-insensitive and robust).
- Viability: transmural extent of LGE predicts recovery (<50% likely to recover).
- Add T2/T1/ECV mapping for myocarditis, amyloid, iron; confirm device MR-conditional status.
References
• SCMR Standardized Protocols for CMR (J Cardiovasc Magn Reson)
• ACR-NASCI-SPR Practice Parameter for Cardiac MRI
• Radiopaedia: Cardiac MRI protocol link
• RadioGraphics: Late Gadolinium Enhancement
• ACR-NASCI-SPR Practice Parameter for Cardiac MRI
• Radiopaedia: Cardiac MRI protocol link
• RadioGraphics: Late Gadolinium Enhancement
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.