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Table 12 Aortopathy and connective tissue disease standard imaging

From: SCMR expert consensus statement for cardiovascular magnetic resonance of acquired and non-structural pediatric heart disease

Sequence

Imaging plane

Indication

Standard imaging

 Cine bSSFP

Parallel to the LVOT in orthogonal planes, short axis of the aortic root, Short-axis of the largest diameter of the ascending aorta, sagittal oblique in long axis of the aortic arch (“candy cane”)

Aortic valve morphology, measurement of aortic root and ascending aorta, and assessment of aortic arch anatomy

 Contrast-enhanced magnetic resonance angiography

3D volume, extend field of view superiorly to angle of the jaw

Extracardiac vascular anatomy for aneurysm formation and vertebral tortuosity

 3D bSSFP, GRE or mDIXON FSE respiratory navigator-gated and ECG-triggered whole heart sequencea

3D volume

Extracardiac vascular assessment for aneurysm formation, measurement of aortic root

Phase contrast flow

Ascending aorta

Descending aorta

Flow velocity and pattern

Additional case-specific or comprehensive imaging

 Cine bSSFP

Ventricular short-axis or axial (transverse) stack

LV volumes, mass, and EF

RV volumes, mass, and EF

 Cine bSSFP

Extend field of view to include head, neck, abdomen, and pelvis

Loeys-Dietz syndrome

 Proton-density-weighted FSE black blood imaging

Sagittal oblique in long axis of the aortic arch (“candy cane”)

Vascular anatomy

 Cine bSSFP

Short and long axis of the region of interest

Concern for dissection or interarterial thrombus

  1. 3D 3-dimensional, ECG electrocardiogram, EF ejection fraction, GRE gradient echo, LV left ventricular, RV right ventricular, LVOT left ventricular outflow tract, bSSFP balanced steady state free precession, FSE fast spin echo
  2. aImaging can be performed during systole or diastole; newer sequences may provide both