Investig Magn Reson Imaging.  2019 Dec;23(4):316-327. 10.13104/imri.2019.23.4.316.

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging (KOSCI) - Part 2: Interpretation of Cine, Flow, and Angiography Data

Affiliations
  • 1Department of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon, Korea.
  • 2Department of Radiology, Hanil General Hospital, Seoul, Korea.
  • 3Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea. donghyun.yang@gmail.com
  • 4Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. leebae@catholic.ac.kr
  • 5Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 7Department of Radiology, Seoul National University Hospital, Seoul, Korea.
  • 8Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
  • 9Department of Radiology, Jeju National University Hospital, Jeju, Korea.
  • 10Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 11Department of Radiology, Korea University Guro Hospital, Seoul, Korea.

Abstract

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

Keyword

Guideline; Heart; Magnetic resonance imaging; Image interpretation; Image analysis

MeSH Terms

Angiography*
Heart
Insurance Coverage
Korea
Magnetic Resonance Imaging*
Patient Care

Figure

  • Fig. 1 American Heart Association 17-segment model of the LV myocardium. LV = left ventricle

  • Fig. 2 LV quantitative assessment. For LV quantitative assessment, stack of short-axis slices containing entire LV is required, and endocardial (red) and epicardial (green) contours should be drawn in both diastole (a) and systole (b) phases. Inclusion or exclusion of papillary muscles should be mentioned. Note that papillary muscles are excluded in this example.

  • Fig. 3 RV quantitative assessment with short axis cine. For RV quantitative assessment, a stack of short axis slices containing the entire RV is required and an endocardial contour should be drawn in both the diastole (a) and systole (b) phases. Generally, the epicardial border is not drawn. RV = right ventricle

  • Fig. 4 RV quantitative assessment with transaxial cine. Draw the endocardial contour in both the diastole (a) and systole (b) phases in the same way as for short axis evaluation. The transaxial cine is the best plane to identify the tricuspid valve plane and is good for reproducibility.

  • Fig. 5 Pitfall of RV short-axis evaluation: use different planes together. Short-axis evaluation of RV requires extra care in basal slice contouring, and it is helpful to use different planes together. Most basal slice (red line) is selected using 4-chamber cine images (a, b), and endocardial contour is drawn in ED and ES phases. In ES phase, since valvular plane moves to apex (basal descent), endocardial contour that can be drawn in ED phase (c) may not be drawn in ES phase (e) at most basal slice. In addition, there may be different endocardial contour along valvular plane between ED (d) and ES phases (f). ED = end-diastolic; ES = endsystolic; RA = right atrium

  • Fig. 6 Case of 31-year-old man with coarctation of aorta. (a) Contrast-enhanced MR angiography showing coarctation of aorta at isthmic portion of aorta. (b) Velocity map crossing stenotic lesion showing flow acceleration (arrow) at coarctation site. (c) Velocity map at level of AA. Because of low VENC value of 150 cm/s, aliasing artifact (arrowheads) occurred along wall of DA, just at distal portion of coarctation site. (d, e) Time-flow volume curve maps showing change in flow volume along cardiac cycle. AA = ascending aorta; DA = descending aorta; VENC = velocity encoding

  • Fig. 7 Images for the post-operative tetralogy of Fallot sample report.


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