Purpose/ Objective

Volumetric imaging of the whole heart and the great vessels is very important for surgical planning and clinical decision making, particularly in complex congenital heart diseases. However, volumetric imaging is challenging due to presence of respiratory and cardiac motion. Gadolinium contrast injection is still a concern for patients with severe renal impairment and contrast allergy, as well as the need for intravenous cannulation. With use of a navigator 3D SSFP sequence, volumetric bright blood imaging can be achieved without the need for contrast injection. However, this sequence is still limited by the intrinsic limitations of SSFP sequences (e.g. presence of dephasing artifacts in regions with turbulence) and the need for additional scanning time due to dual gating. Volumetric imaging of the whole heart and the great vessels is very important for surgical planning and clinical decision making, particularly in complex congenital heart diseases. However, as the heart is beating and the diaphragms are moving, respiratory and ECG navigation must be performed to minimize motion artifacts. With use of a balanced SSFP sequence, bright blood imaging can be achieved without the need for contrast injection.

Following this activity, learns will understand the following about the sequence:

1. Understand the underlying technical principles of the sequence
2. Understand the usual technical parameters used and the background principles.
3. Understand the limitations of the sequence.
4. Understand the common applications.

Planners

Kenneth Cheung and Christopher Lam

Accreditation Statement

The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Society for Cardiovascular Magnetic Resonance (SCMR) designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Claiming CME

• Attend the sessions in full for which credit is sought
• Complete the post-activity evaluation
• A certificate of completion will be available once the evaluation is submitted

Financial Disclosures

The planners and faculty for this activity did not have any relevant relationships to disclose, unless listed below:

Nothing to Disclose

Any resulting conflicts of interest were resolved prior to the start of the activity according to ACCME Criteria & Standards.

Disclosure of Commercial Support

SCMR received no funding to support this activity.

Bibliography

Uribe S, Tangchaoren T, Parish V, Wolf I, Razavi R, Greil G, Schaeffter T. Volumetric cardiac quantification by using 3D dual-phase whole-heart MR imaging. Radiology. 2008 Aug;248(2):606-14. SCMR Standardized Imaging Protocols 2020 Update Kramer CM, Barkhausen J, Bucciarelli-Ducci C, Flamm SD, Kim RJ, Nagel E. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update. J Cardiovasc Magn Reson. 2020 Feb 24;22(1):17.