Applications

Appropriate Applications for CMR and cvi42®

  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Heart Failure LV and RV size and morphology          
Systolic and diastolic function
Transmitral flow pattern
End-diastolic pulmonary vein forward flow
Tissue velocity and strain rates
Identification of myocardial viability and scar
Regional distribution of scarring
Detection of iron overload
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Coronary Artery Disease Anomalous coronary artery (CMR considered as first line diagnostic test)                    
Identification and characterization of coronary aneurysms (diameter/length)                    
Coronary artery and coronary bypass patency Identification of patients with multi vessel disease without exposure to ionizing radiation or iodinated contrast                
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Ischemic Heart Disease LV performance (stable angina guidelines) LV wall motion after low dose dobutamin                  
Combination of perfusion and LGE is useful as a primary form of stress testing)                    
Risk assessment in patients with prior coronary angiography or stenosis of unclear significance
Class I indication for differentiating acute infarction from aortic dissection (STEMI guidelines)
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Myocardial Infarction/Scar Identification of myocardial viability in scar tissue (post MI, pre-revascularization)                    
LV remodeling after MI                
Transmural extent as a predictor for recovery
MVO, greyzone analysis as prognostic marker of post-MI complication
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Cardiomyopathies HCM:
Jet assessment
                   
Quantification of the obstructed LVOT area                  
Perfusion deficits                      
Tissue composition (RV/LV scar, edema, fatty replacement)                  
Focal fibrosis (mid wall sign)                    
Sensitivity for detecting hereditary HCM                    
ARVC:
Dilatation and dysfunction of RV
Fatty or fibrous replacement
Sarkoidosis:
Inflammation (T2, early enhancement)
Irreversible injury
Amyoloidosis
Hypertrophy
Irreversible injury
Shortened T1 and T2 relaxation times
Hemochromatosis:
T2* quantification
                     
Non compaction:
Diastolic thickness ratio
Detection of thrombi
CM following cardiotoxic chemotherapy
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Myocarditis LV and RV stroke volume and index                      
Edema                    
Hyperemia                      
Fibrosis                    
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Valvular Heart Disease LV function                  
Jet detection                    
Planimetrie of stenotic valves                  
Regurgitation quantification                      
Peak and mean velocity of a stenotic jet                      
Pressure gradient                      
Forward and reverse volumes                      
Valvular masses                    
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Cardiac Masses Heart function                    
Mass structure and location                    
Tissue characterization
Distinguish tumor from thrombus


Degree of malignancy (myocardial or vascular infiltration)

  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Pericardial Disease Thickened pericardium > 4mm                      
Flattening or paradox movement of the septum                    
Conical deformation of the ventricle                      
Enlargement of the atria and hepatic veins                    
Impaired diastolic filling                    
Effusion restriction: distortion of tagged images in systole                      
3D anatomy                      
Physiology including blood flow and quantification of shunt lesions (Qp/Qs)                      
Cardiac function of all four chambers                    
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Pulmonary Angiography CE-MRA in patients with a suspicion of embolism, optionally with addition of lower extremity venous imaging                  
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Atrial Fibrillation Pre-ablation, assessment of shape and size of the atria and 3D orientation of the pulmonary vein                
Guidance of ablation procedures                      
Post ablation: identification of scar pulmonary infarction                  
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Carotid Disease Location and extend of stenoses                        
  cvi/cmr42 Modules
Indication Feature Short 3D Bi-Triplanar Multiple radial long axis 3D/4D Viewer MPR Strain analysis Tissue C. T2* Map T1 Map T2 Map Flow Perfusion
Thoracic Aortic Disease Location and extent of aneurysms, erosions, ulcers, and dissection evaluation of post surgical processes                    
Identification of congenital abnormalities                    
Aortic size and blood flow                    
Assessment of aortic plaque and atherosclerosis                        

ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents W. Gregory Hundley, David A. Bluemke, J. Paul Finn, Scott D. Flamm, Mark A. Fogel, Matthias G. Friedrich, Vincent B. Ho, Michael JeroschHerold, Christopher M. Kramer, Warren J. Manning, Manesh Patel, Gerald M. Pohost, Arthur E. Stillman, Richard D. White, and Pamela K. Woodard J. Am. Coll. Cardiol. 2010;55;26142662; originally published online May 17, 2010;

Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, Gerstad NA, Gillam LD, Hodgson JM, Kim RJ, Kramer CM, Lesser JR, Martin ET, Messer JV, Redberg RF, Rubin GD, Rumsfeld JS, Taylor AJ, Weigold WG, Woodard PK, Brindis RG, Hendel RC, Douglas PS, Peterson ED, Wolk MJ, Allen JM, Patel MR. ACCF/ACR/SCCT/SCMR/ ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48: 1475–1497.