ARRYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

Notes

· Use Anterior Surface Coil only & turn off the posterior coil to avoid wraparound artifact

· Consider prone positioning for obese patients

· Make sure the entire right ventricle is included on all scans.

· Use SENSE to improve imaging time.

· Slice thickness 6 - 8 mm, with 2 - 4 mm interslice gaps to equal 10 mm (unless otherwise indicated)

Pulse Sequences

1. 3 Plane Survey

1. B-TFE (Axial) (8 - 10 mm slice thickness)

2. INTERACTIVE

3. T1_TSE-BB (4 Chamber) *Include RVOT

4. T1_TSE-BB FS(4 Chamber) *Include RVOT

5. T1_TSE-BB (Short Axis)

6. T2W-BB (4 Chamber)

7. DYNAMIC FIRST-PASS PERFUSION

8. B-TFE_BH (4 Chamber)

9. B-TFE_BH (RVOT)

10. B-TFE_BH (Short Axis) *This series is used for ejection fraction calculation and should be relatively motion free.

11. IR_TFE_LOOKLOCKER *(make sure right ventricle myocardium is nulled; RV inversion time may be up to 50 ms less than LV)

12. IR_TFE_3D_BH (4 Chamber)

13. IR_TFE_3D_BH (Short Axis)

14. IR_TFE_3D_BH (2 Chamber)

15. IR_TFE_3D_BH (RV 2 Chamber)

References & Illustrations

Ø Cardiovascular MRI Articles

Ø Arrhythmogenic Right Ventricular Dysplasia http://www.aafp.org/afp/2006/0415/p1391.html

o The most common location for this tissue transformation is between the anterior infundibulum, right ventricular apex, and inferior or diaphragmatic aspect of the right ventricle, the so-called “triangle of dysplasia” as indicated below…

Ø Standardized cardiovascular magnetic resonance imaging (CMR) protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocols http://scmr.org/assets/files/1532-429X-10-35.pdf

Phase Contrast Articles

Ø Cardiovascular Applications of Phase-Contrast MRI http://www.ajronline.org/cgi/content/full/192/3/662

Ø Cardiovascular Flow Measurement with Phase-Contrast MR Imaging: Basic Facts and Implementation http://radiographics.rsna.org/content/22/3/651.full

SVC and Inferior Vena Cava:

The encoding velocity for the first measurement or for flow measurement is 110 cm/sec. The usual velocity for peak velocity measurement is 50–80 cm/sec.

Ascending Aorta:

The encoding velocity for the first measurement or for flow measurement is 200 cm/sec. The usual velocity for peak velocity measurement is 100–160 cm/sec.

Main Pulmonary Artery:

The encoding velocity for the first measurement or for flow measurement is 180 cm/sec. The usual velocity for peak velocity measurement is 60–120 cm/sec.

Right and Left Pulmonary Arteries:

The encoding velocity for the first measurement or for flow measurement is 200 cm/sec. The usual velocity for peak velocity measurement is 60–120 cm/sec.

Ø Quantification of Flow Dynamics in Congenital Heart Disease: Applications of Velocity-encoded Cine MR Imaging http://radiographics.rsna.org/content/22/4/895.full

Rev: 5/13/10