Korean J Radiol.  2019 Nov;20(11):1477-1490. 10.3348/kjr.2019.0407.

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

• Lee JW
• Hur JH
• Yang DH
• Lee BY
• Im DJ
• Hong SJ
• Kim EY
• Park EA
• Jo Y
• Kim J
• Park CH
• Yong HS

• KMID: 2459416
• DOI: http://doi.org/10.3348/kjr.2019.0407

Abstract

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technological advances and the expanded national insurance coverage of CMR assessments. For improved patient care, proper acquisition of CMR images as well as their accurate interpretation by well-trained personnel are equally important. 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. KOSCI has also created a formal Committee on CMR guidelines to create 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

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

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  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.

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

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  Fig. 4 RV quantitative assessment with transaxial cine images. Endocardial contour in both diastole (A) and systole (B) phases is drawn in same way as for short-axis evaluation. Transaxial cine image offers best plane to identify tricuspid valve plane with good reproducibility.

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  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 = end-systolic, RA = right atrium

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  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 (Supplementary Movie 1). 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

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  Fig. 7 Images for postoperative tetralogy of Fallot sample report.

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