How we scan cardiac anatomy and function using cardiovascular magnetic resonance: a practical video guide

TL;DR

This paper provides a practical video guide for using cardiovascular magnetic resonance to assess heart anatomy and function, including strain analysis.

Contribution

A multilingual video guide and reproducibility data for implementing fast strain-encoded MRI in routine cardiac imaging.

Findings

Scan-rescan reproducibility of segmental longitudinal strain was excellent.

The video guide demonstrates SSFP and fSENC sequence acquisition for cardiac MRI.

Strain values showed good to excellent reproducibility even after scan interruptions.

Abstract

Fast Strain-encoding (fSENC) is a pulse sequence that enables the acquisition of cardiovascular magnetic resonance images within a few heartbeats and at free breathing to quantify myocardial strain, a deformation parameter of the heart muscle. Strain is gaining importance in heart failure diagnostics, but implementing fast strain-encoding into a routine magnetic resonance protocol has not been thoroughly explored from a practical viewpoint. This video manuscript aims to provide a simple guide for the acquisition of cardiovascular magnetic resonance exams in cardiac patients and to determine the scan-rescan reproducibility of segmental strain analyses.

A volunteer was scanned for demonstration purposes on a 1.5T MRI Scanner (‘Ingenia, Philips Healthcare, Best, The Netherlands’). The acquisition of cine steady-state free precession (SSFP) and fSENC sequences is demonstrated in a step-by-step fashion, accompanied by a multilingual video tutorial and an image guide. Scan-rescan reproducibility of acquisition-based strain values was excellent between subsequent scans for segmental longitudinal (SLS) [0.93 (0.91–0.95) and circumferential strain (SCS) [0.78 (0.73–0.82) to 0.84 (0.80–0.87)], and good to excellent between scans that were interrupted by a break for SLS [0.80 (0.74–0.85) to 0.84 (0.79–0.87)] and SCS [0.57 (0.46–0.66) to 0.65 (0.56–0.77)].

This multilingual video manuscript provides a practical guide to conducting cardiovascular magnetic resonance exams including SSFP and fSENC, useful for further quantitative analysis to grasp heart function on a global and regional basis.

This manuscript has the aim to guide through a cardiac magnetic resonance imaging protocol to assess cardiac anatomy and function, including the acquisition of cine-balanced steady-state free precession images for evaluation of conventional functional and volumetric parameters, and fast strain-encoded images for myocardial strain (deformation) analysis.

Graphical AbstractVideo manuscript to provide a simple guide for a cardiac magnetic resonance (CMR) imaging protocol to assess cardiac anatomy and function, including the acquisition of cine-balanced steady-state free precession (SSFP) images for evaluation of conventional functional and volumetric parameters, and fast strain-encoded (fSENC) images for myocardial strain (deformation) analysis.

Video manuscript to provide a simple guide for a cardiac magnetic resonance (CMR) imaging protocol to assess cardiac anatomy and function, including the acquisition of cine-balanced steady-state free precession (SSFP) images for evaluation of conventional functional and volumetric parameters, and fast strain-encoded (fSENC) images for myocardial strain (deformation) analysis.

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