Sequence | Purpose | Strengths | Weaknesses |
---|---|---|---|
Breath hold balanced SSFP cine | Global regional myocardial function and wall thickness | High SNR (T2/T1) image contrast gives reliable blood: myocardium endocardial border definition based on long T2 of blood | Sensitive to field inhomogeneity (off- resonance banding artefact). Unreliable appearance. ECG-mistriggering/Poor breath hold |
T2W-TSE with dark blood preparation and fat-suppression by STIR(short tau inversion recovery) | Oedema, Infiltration | Detection of myocardial fluid content by longer T2 relaxation time | Low SNR |
Incomplete blood suppression at endocardial boundary layer | |||
Unreliability due to diastolic cardiac motion ECG mistriggering | |||
Poor breathhold | |||
Stress first-pass myocardial perfusion | Cardiomyopathy related perfusion defects/exclusion of concurrent epicardial coronary artery disease | Higher resolution than SPECT | Incomplete myocardial coverage |
“Dark-rim” artefact Cardiac motion during image | |||
Early Gd enhancement (inversion-recovery spoiled gradient-echo | Microvascular obstruction Detection of intracardiac thrombus | High spatial resolution (compared to CMR perfusion) | Dependent on image timing after injection. ECG mistriggering |
Poor breath hold | |||
Late Gd enhancement (inversion recovery spoiled gradient-echo) | Myocardial fibrosis | High T1 contrast of diseased myocardium | Image contrast depends on inversion time adjustment and Gad washout. Ghosting from long T1 fluids (can be suppressed). |
ECGmistriggering | |||
Poor breath-hold | |||
Real-time or single-shot versions of many sequences above | As above | No breath-holding Tolerates ECG mistriggering | Coarser image resolution. |
Cardiac motion during image. |