Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update

Abstract

This document is an update to the 2013 publication of the Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Protocols. Concurrent with this publication, 3 additional task forces will publish documents that should be referred to in conjunction with the present document. The first is a document on the Clinical Indications for CMR, an update of the 2004 document. The second task force will be updating the document on Reporting published by that SCMR Task Force in 2010. The 3rd task force will be updating the 2013 document on Post-Processing. All protocols relative to congenital heart disease are covered in a separate document.The section on general principles and techniques has been expanded as more of the techniques common to CMR have been standardized. A section on imaging in patients with devices has been added as this is increasingly seen in day-to-day clinical practice. The authors hope that this document continues to standardize and simplify the patient-based approach to clinical CMR. It will be updated at regular intervals as the field of CMR advances.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Left – Black blood axial scout image through the base of the left ventricle (LV) and right ventricle (RV). Planning of the 2 chamber long-axis is shown by the white line. Center – White blood 2 chamber long axis scout image. Planning of the 4 chamber long-axis is shown by the white line. Right – White blood 4-chamber long axis scout image

Fig. 2

Top – Planning of the short axis image plane parallel to the mitral valve in the 4 chamber long axis plane (left) and 2 chamber long-axis plane (right). Bottom panel – 9 short axis cine slices shown from base (top left) to apex (bottom right)

Fig. 3

Left – Basal short axis cine image. Planning of the 3-chamber long axis is shown by the white line. Right – 3-chamber long axis cine image

Fig. 4

Top left – Axial black blood scout image through the pulmonary artery. Planning of the RV outflow tract (RVOT) view is shown by the yellow line. Top right – RVOT cine image. Planning of axial stack of images is shown by the yellow lines. Bottom panel – 6 sequential axial images are shown from the RVOT (top left) to the inferior pole of the RV (bottom right)

Fig. 5

Three short axis images (apex at top, mid in the middle, and base at the bottom) acquired during the first pass of gadolinium based contrast agent (GBCA) through the myocardium. Note the perfusion defect in the lateral wall in the mid and basal slices

Fig. 6

Four-chamber long axis inversion recovery gradient echo late gadolinium enhanced image from a patient with a 50–75% transmural apical septal and apical myocardial infarction

Fig. 7

Velocity-encoded flow quantitation sequence acquired at the sinotubular junction in a patient with aortic stenosis. The initial sequence (Magnitude [left] and velocity [center] images) was acquired with a VENC of 250 cm/sec, which was too low, as aliasing (red arrow) is evident. The sequence was reacquired (right) with a VENC upward adjusted to 350 cm/sec, and aliasing is no longer present