ISMRM 25th Annual Meeting & Exhibition • 22-27 April 2017 • Honolulu, HI, USA

Weekend Educational Course: Cardiac MRI: Function, Perfusion & Viability
Weekend Course

ORGANIZERS: Reza Nezafat, Ph.D., Sonia Nielles-Vallespin, Ph.D. & Winfred A. Willinek, M.D.

Saturday, 22 April 2017
Room 316A  13:15 - 17:25 Moderators: Andrew Scott, Behzad Sharif

Skill Level: Basic

Slack Channel: #e_cv
Session Number: WE10

This course will review the essentials for any cardiac exam, then provide an overview of the clinical needs, technical foundations, and research promises focused on evaluating cardiac function, perfusion, and viability.

Target Audience
Attendees who have an emerging interest and want to develop a working knowledge of cardiac MRI, gain an in-depth perspective on the technical foundations, in order to improve clinical diagnostics or advance research in cardiac function, perfusion, and viability imaging.

Educational Objectives
Upon completion of this course, participants should be able to:
-Select the appropriate solutions to meet the clinical needs of cardiac imaging in: i) heart failure, ii) ischemic heart disease, iii) non-ischemic heart disease;
-Recognize the clinical indications and assess emerging techniques for cardiac perfusion imaging in ischemic heart disease; and
-Appraise novel methods for cardiac viability imaging for non-ischemic heart disease.

Clinical Needs & Applications: Evaluation of Cardiac Function
Yuchi Han
State of the Art: Acquisition & Processing
Alistair Young
Cardiovascular MRI provides detailed information about the health status of the heart and the progression of disease. This talk will give course participants an overview of current methods used to evaluate cardiac performance on a global and regional level. Particular focus will be on strengths and weakness of methods to quantify myocardial strain, and atlas based methods for quantifying cardiac remodelling as z-scores.

Future Perspectives: Acquisition & Processing
Mehdi Hedjazi Moghari
Clinical Needs: Ischemic Heart Disease
Alexander Gotschy
Cardiovascular magnetic resonance (CMR) has become an established non-invasive imaging modality for the diagnosis of ischemic heart disease (IHD) and contributes important information for therapeutic decisions regarding revascularization. For the identification of ischemia, CMR provides two methods, which are routinely used in clinical practice. Ischemia can be visualized either as regional hypoperfusion when using CMR-perfusion imaging during vasodilator induced hyperaemia, or as impaired regional wall motion under dobutamine stress CMR. CMR has proven its robustness, diagnostic performance and prognostic value in patients with IHD in several multicenter trials.

Quantitative Myocardial Perfusion
Hui Xue, Michael Hansen, Peter Kellman
Quantification of myocardial blood flow (MBF, in the unit of ml/min/g) is more objective to assess myocardial micro-circulation under rest and pharmaceutical or exercise stress condition and capture global flow reduction. Although perfusion quantification has been studies for the past 20 years, it is still not clear how to build a practical quantitative myocardial perfusion workflow. This syllabus reviews key components of such system and emphasizes on motion correction, intensity to Gd concentration conversion and Gd kinetics modelling. With recent developments more focusing on the automation and completeness of entire workflow, including fully automated processing and motion correction, the quantitative perfusion is becoming clinically practical.

Dobutamine Stress MRI
Connie Tsao
Break & Meet the Teachers
Clinical Needs & Applications: Myocardial Tissue Relaxometry
Michael Salerno
This lecture will discuss the clinical needs and applications of myocardial relaxometry.  We will discuss the need to develop relaxometry imaging biomarkers which are sensitive, specific, predictive and robust. These criteria will need to be fulfilled to make clinical decisions in individual patients.  We will also discuss current and emerging clinical applications of myocardial relaxometry.

Myocardial T1 Imaging Techniques
Sebastien Roujol
Myocardial T2 & T2* & T1 Rho Mapping Techniques
Graham Wright, Nilesh Ghugre
MRI measures of signal decay without refocusing, with intermittent refocusing and with continuous refocusing reflected by time constants T2*, T2, and T1ρ can yield important clinical information in myocardial pathophysiology. T2* is used to characterize iron overload, although specificity is reduced by susceptibility effects. By incorporating refocusing of static inhomogeneity effects, T2 yields more specific characterization of signal changes associated with changes in blood oxygenation reflecting ischemia and changes in water mobility reflecting inflammation. Decreasing refocusing interval reduces dephasing due to diffusion through gradients and chemical exchange effects and has been used to increase T1ρ contrast between healthy and infarcted myocardium.

Clinical Needs & Applications
Raymond Chan
The following presentation will outline the clinical needs and applications for the use of CMR for cardiac function, perfusion and viability in clinical cardiology.

State of the Art: Viability Sequences
Taehoon Shin
This talk will be presenting recent advances in late gadolinium enhancement (LGE) cardiac imaging which can overcome limitations of the standard protocol based on inversion recovery segmented 2D acquisition. The advanced approaches to be discussed will include single-shot imaging with motion corrected averaging, single-breath-hold 3D imaging, free-breathing isotropic 3D imaging with respiratory, and techniques to improve scar-blood contrast and scar-fat contrast.  


The International Society for Magnetic Resonance in Medicine is accredited by the Accreditation Council for
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