Cardiac MRI technique guide written in a way that’s useful for MRI technologists, Patient Preparation, Coils & Positioning, Sequences & Protocol (Typical)

 Cardiac MRI technique guide written in a way that’s useful for MRI technologists (techs).

🫀 Cardiac MRI Technique – For Technologists

1. Patient Preparation

• Screening: Check MRI safety (pacemaker, ICD, prosthetics, etc.).

• Fasting: 4–6 hrs fasting (to reduce stomach motion and improve image quality).

• IV Access: 18–20G cannula for contrast (if required).

• Monitoring: ECG leads (ensure good gating), pulse oximetry, BP monitoring.

• Breathing practice: Coach patient on breath-holds (8–12 sec).

2. Coils & Positioning

• Use Cardiac or Body phased-array coil.

• Patient supine, head-first.

• ECG leads placed carefully away from imaging area.

• Center at mid-heart (approx. nipple line / 4th intercostal space).

3. Sequences & Protocol (Typical)

(Scanner: 1.5T preferred, 3T requires careful shimming)

A. Localizers

• 3-plane (axial, sagittal, coronal).

• Quick survey of thorax to plan cardiac planes.

B. Cine Imaging (Function)

• Sequence: Balanced SSFP (bSSFP / TrueFISP / Fiesta).

• Planes:

  • 2-chamber (vertical long axis).

  • 4-chamber (horizontal long axis).

  • LVOT (3-chamber).

  • Short-axis stack (base → apex).

• Purpose: LV/RV function, wall motion, EF calculation.

C. Black Blood (Morphology)

• Double IR T1 & T2 weighted (optional).

• Useful for anatomy & edema evaluation.

D. Flow Imaging (if needed)

• Phase contrast (PC) sequence → across Ao, PA, valves.

• Measures velocity, regurgitation, shunt (Qp:Qs).

E. Contrast (if indicated)

• First-pass Perfusion (during gadolinium injection, stress/rest).

• LGE (Late Gadolinium Enhancement) – inversion recovery sequence 10–15 min post contrast.

  • Adjust TI to null normal myocardium.

  • Acquired in short-axis, 2-chamber, 4-chamber.

F. Optional Advanced Sequences

• T1/T2 mapping (tissue characterization).

• Stress perfusion (adenosine/dobutamine).

• 3D angiography (coronary or great vessels).

4. Breath-Hold & ECG Tips

• Most cine sequences = breath-hold (8–12 sec).

• If patient cannot breath-hold → use free-breathing with respiratory navigator.

• ECG gating: Ensure clear R-wave detection, avoid T-wave mis-triggering.

5. Reporting Outputs

Tech should ensure:

• Stack completeness (no missing slices apex–base).

• Good ECG gating (no mistriggers).

• Contrast bolus timing correct for perfusion.

• LGE TI scout performed and optimized.

✅ Summary for Techs:

1. Screen & prepare patient (IV, ECG, breathing).

2. Localizers → Cine stack → Flow → Contrast perfusion → LGE.

3. Always check image quality before moving forward.