27th ISMRM Annual Meeting • 11-16 May 2019 • Montréal, QC, Canada

Educational Course
CMR in Kidney Failure: Non-Contrast Imaging

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CMR in Kidney Failure: Non-Contrast Imaging
Weekday Course

ORGANIZERS: Reza Nezafat

Wednesday, 15 May 2019
Room 512A-H  08:15 - 10:15 Moderators:  Chong Duan, Moriel Vandsburger

Skill Level: Intermediate to Advanced

Session Number: W-04

In this course, we will cover imaging protocols for cardiac MR without contrast administration.

Target Audience
Clinicians and scientists interested in cardiovascular MRI.

Educational Objectives
As a result of attending this course, participants should be able to:
- Describe alternative non-contrast MR sequences for assessing vascular and anatomy, myocardial perfusion, and myocardial viability; and
- Apply these alternative non-contrast MR sequences for assessing vascular and anatomy, myocardial perfusion, and myocardial viability.


  Viability Assessment
Walter Witschey
The purpose of this educational talk is to discuss imaging techniques for cardiac MRI assessment of myocardial viability using endogenous contrast. We will first define viability in the context of non-advanced imaging methods and understand the fundamental pathophysiologic changes that occur in the cardiomyocyte and heart. We will then review the basic physical principles of endogenous contrast techniques, show their application to viability assessment, recommend best practices and briefly show a vision for their application 5 and 10 years from now. Some endogenous contrast techniques we will look at include cardiac T1 and T2 MRI, magnetization transfer, T1rho, chemical exchange saturation transfer, spectroscopy, and multiparametric approaches.

  Vascular & Anatomical Imaging
Ruth Lim
Cardiac MRI in kidney failure can be challenging, however anatomic assessment of the heart and vessels can be readily performed without requirement for intravenous contrast. The information obtained may have value in prognosis and for therapeutic monitoring. Applicable techniques will be reviewed and changes that may be observed in chronic kidney disease (e.g. left ventricular remodelling) will be discussed.

  Myocardial Perfusion
Frank Kober
This overview will discuss expectations, solutions, advantages and limitations related to measuring perfusion in the human heart without contrast agents. The major existing approaches to Arterial Spin Labeling (ASL) in the heart will be outlined. The reasons why myocardial ASL is challenging compared with other organs will be outlined. It should also become clear why cardiac ASL is a well-working and validated method in the rodent heart whereas human applications are still scarce.

  Panel Discussion
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