From: Arrhythmogenic right ventricular cardiomyopathy (ARVC): cardiovascular magnetic resonance update
Sequence | Imaging plane | Parameters | Comments |
---|---|---|---|
Double inversion recovery TSE/FSE a) Axial: with and without fat suppression b) short axis: without fat suppression | a) Axial: obtain ~6-8 images centered on the left/right ventricle | TR = 2 R-R intervals, TE = 5 msec (minimum-full) (GE), TE = 30 msec (Siemens) slice thickness = 5 mm, interslice gap = 5 mm, and field of view (FOV) = 28–34 cm. ETL 16-24 | This sequence provides optimal tissue characterization of the RV free wall. Prescribe from the pulmonary artery to the diaphragm. Fat suppression improves reader confidence in diagnosis of RV fat infiltration. |
b) Short axis: obtain ~6-8 images centered on the left ventricle | |||
SSFP Bright Blood Cine Images | Axial, Four chamber and Short Axis. RV 3 chamber (optional) | TR/TE minimum, flip angle = 45-70°, slice thickness = 8 mm, interslice gap = 2 mm. FOV = 36–40 cm, 16–20 views per segment. Parallel imaging n = 2 is desirable | Axial images are best to assess RV wall motion. RV quantitative analysis is performed on the short axis cine images. |
GADOLINIUM IS ADMINISTERED ACCORDING TO INSTITUTIONAL PROTOCOL (usually 0.15 – 0.2 MMOL/KG) | |||
TI scout | Four chamber | TI scout sequences or trial TI times to suppress normal myocardium for the right inversion time. | |
Delayed Gadolinium Imaging (Phase Sensitive Inversion Recovery recommended) | Axial, Short Axis, Four Chamber and Vertical Long Axis | TR/TE per manufacturer recommendations flip angle = 20-25°, slice thickness = 8 mm, interslice gap = 2 mm. FOV = 36–40 cm, No parallel imaging. Use phase sensitive inversion recovery if available (PSIR) | PSIR is more robust and independent of TI time. Optimal for imaging fibrosis. LV epicardial enhancement in the infero-lateral wall has been reported in classic ARVC and in left dominant forms. |