How to plan and perform a cardiac MR imaging examination

MR imaging of thoracic veins

The thoracic venous system can be visualized and characterized well with MR imaging. In this article, MR sequences that are suited for this purpose (including the more advanced techniques) are reviewed. The normal thoracic venous anatomy and a brief summary of its embryogenesis is provided. The appearances of congenital and acquired abnormalities of the systemic and pulmonary thoracic veins are described. This article also discusses recent applications of MR imaging in the evaluation of the pulmonary veins and the left atrium in patients who have atrial fibrillation.

ACR clinical statement on noninvasive cardiac imaging

Coronary artery disease and other acquired and congenital cardiac diseases are major medical and socio-economic problems. Historically, imaging has had a critical role in the diagnosis and evaluation of acquired and congenital cardiac disease. Advances in computed tomography (CT), with multidetector CT and electron beam CT technology, and magnetic resonance (MR) imaging, now make it possible to noninvasively image the coronary arteries, cardiac chambers, valves, myocardium, and pericardium and assess cardiac function, and CT and MR imaging are becoming increasingly important in the evaluation of cardiac disease. Radiologists, because of their extensive experience in CT and MR imaging, have an important role in imaging cardiac patients using these modalities. This clinical statement of the ACR discusses various technical and patient safety issues related to cardiac CT and MR imaging, and it suggests appropriate qualifications for radiologists until such time as ACR practice guidelines for the performance of cardiac CT and cardiac MR imaging are written and approved through the usual ACR process. It stresses that the interpreting physician is responsible for examining not only the cardiac structures of interest but also all the visualized noncardiac structures and must report any clinically relevant abnormalities of these adjacent structures.

Non-Coronary Cardiac CT Imaging

Cardiac multidetector CT (MDCT) has moved from purely anatomic imaging, to assessment of cardiac function. Significant advances since the advent of multidetector CT now make it feasible to assess not only the coronary arteries, but also ejection fraction, ventricular volumes, myocardial mass and the presence of wall-motion abnormalities. Advances include improvements in EKG-gating, including improvements in temporal resolution, as well as the addition of delayed contrast-enhanced methods. Anatomic imaging has improved as well, with thinner collimation and better reconstruction methods. Three-dimensional software programs now permit excellent surface rendered displays and multiplanar reconstructions suitable as surgical and procedural "road maps."