How to perform cardiac MR imaging.

The complex motion of the beating heart provides a challenge to the clinical MR imager. Use of ECG gating, however, "stops" the heart, allowing for acquisition of diagnostic quality images of the cardiac chambers, valves, pericardium, and great arteries and veins and their branches. Attention to placement of chest wall ECG electrodes and the course of ECG-leads from the patient maximizes the quality of the gating signal and results in better quality imagery; however, ECG gating increases image acquisition time of the cardiac examination. Therefore, care must be taken to perform the most efficient possible examination. Prior to commencing the examination, the imager must have a clear understanding of the clinical question of the referring physician so that a clinical protocol can be applied to acquire relevant morphologic and physiologic data. The intracardiac anatomy may not always be best demonstrated using standard axial, coronal, and sagittal image sections. Therefore, with an understanding of basic intracardiac anatomy, standard imaging planes parallel or orthogonal to the intrinsic cardiac axes may be constructed and observation of abnormalities better appreciated. If care is taken in the planning and execution of the cardiac MR examination, the radiologist will be able to exploit this exciting new technology to its full potential as a noninvasive cardiac imaging modality.