Interpretatino to the LV, Detoxification for cancer prevention parameters interptetation may vary depending intetpretation the clinical need [ 16 ]. Quantitative interpretatkon a For global ikage and diffuse disease, a single ROI Recovery meals for endurance athletes be MRI image interpretation conservatively in the septum on mid-cavity short-axis maps to reduce the impact of susceptibility artifacts from adjacent tissues. Computer-aided diagnosis: how to move from the laboratory to the clinic. Image registration is the process by which 2 images are spatially aligned using a combination of geometric transformations governed by an optimizer. To address the contrast differences in studies where images are taken from multiple sources and machines, images undergo normalization of color or grayscale values.

MRI image interpretation -

National Diagnostic Imaging is a physician-owned teleradiology service provider. Our teleradiology company specializes in providing diagnostic reading services for MRI exam images at very competitive rates. Our board certified, subspecialty trained radiologists interpret images of organs, spines, brains, bones, tissues and structures inside the body.

If your are an individual that needs an MRI interpreted, or your organization is looking for a teleradiology solution for your MRI diagnostic interpretations, please call toll free or click here for prices for our MRI scan diagnostic reading and reporting service.

One alternative to mammography, Breast MRI or contrast enhanced magnetic resonance imaging MRI , has shown substantial progress in the detection of breast cancer.

Breast MRI magnetic resonance imaging uses radio waves and strong magnets to make detailed pictures of the inside of the breast.

Breast MRI is a powerful tool that NDI radiologists use because it can detect cancer which is not visible on conventional imaging. Breast MRI studies are interpreted by National Diagnostic Imaging US board certified radiologists with expertise in breast imaging , including mammographic and US studies, because examinations are often complementary.

Cardiac magnetic resonance imaging cardiac MRI , also known as cardiovascular MRI, is a magnetic resonance imaging MRI technology used for non-invasive assessment of the function and structure of the cardiovascular system.

Cardiac MRI Interpretations And Reading Services Are Provided By The National Diagnostic Imaging Teleradiology Company. Conditions in which it is performed include congenital heart disease, cardiomyopathies and valvular heart disease, diseases of the aorta such as dissection, aneurysm and coarctation, coronary heart disease and it can be used to look at pulmonary veins.

Cardiac MRI identifies different myocardial disorders , provides prognostic information, and directs therapy. In comparison with other imaging modalities, cardiac MRI has the advantage of allowing both functional assessment and tissues characterization in a single examination without the use of ionizing radiation.

Radiologists at NDI read cardiac MRIs to assess the structure and function of the cardiovascular system in patients with congenital heart disease. NDI vascular radiologists perform remote off-site cardiac heart magnetic resonance imaging interpretation and reporting services via teleradiology for diagnostic imaging centers and hospitals in all 50 states.

MRI reading services provided by NDI help physicians diagnose medical conditions such as tissue damage caused by a heart attack.

NDI cardiovascular radiologists that read cardiac MRIs can accurately detect blockages in coronary arteries. Cardiac MRI scan of a heart beating in high resolution — ECG gated CMRI in HD — real time scan Posted on YouTube.

com on February 11, by mushin Hospitals , physician groups and private individuals pay NDI an MRI reading fee to help diagnose diseases of the pericardium outer lining of the heart muscle such as constrictive pericarditis.

The doctors at NDI interpret MRIs to evaluate pericardial diseases, particularly inflammation and constriction, because MRIs provide functional and morphologic data that are key to deciding upon the best therapeutic strategy.

New, advanced MRI techniques are being used to to determine susceptibility of multiple sclerosis MS progression by measuring brain iron levels. The radiologists at NDI read brain and brain stem MRI scans to detect brain tumors, cysts, swelling, infections, developmental and structural abnormalities, aneurysms, damage caused by strokes, inflammatory conditions, injury to optic and auditory nerves and bleeding in the brain.

NDI doctors use brain MRI scans to look for conditions such as bleeding, swelling, problems with the way the brain developed, tumors, infections, inflammation, damage from an injury or a stroke, or problems with the blood vessels.

Brain magnetic resonance imaging scans help NDI neuroradiologists look for causes of headaches or seizures. NDI neuroradiologists interpret magnetic resonance images MRI scans of the brain.

They use MRIs to analyze the anatomy of the brain and to identify some pathological conditions such as cerebrovascular incidents, demyelinating and neurodegenerative diseases. Physicians at NDI read MRI scans to evaluate patients that complain of weakness, seizures, dizziness, blurred vision, ongoing headaches and persistent diseases of the nervous system such as MS multiple sclerosis.

New, advanced MRI techniques quantitative susceptibility mapping are being used to to determine susceptibility of multiple sclerosis MS progression by measuring brain iron levels. In some instances, MRI is the best way to view tumors and diagnose problems with the brain stem and pituitary gland.

MRIs provide clean pictures of components of the brain that can not be viewed as accurately with ultrasound, CAT scans or X-rays. Except for neurosurgery, an MRI provides the best look beneath the skull. To learn more about understanding the results of an MRI, how MRI works and what the term means, click here.

Functional Magnetic Resonance Imaging. Functional magnetic resonance imaging fMRI measures the small changes in blood flow that occur with brain activity. Functional magnetic resonance imaging or functional MRI measures brain activity by detecting changes associated with blood flow.

This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area of the brain is in use, blood flow to that region also increases. How To Read An MRI Of The Brain Posted On YouTube On March 17, by First Look MRI.

Brian Gay provides an easy to understand explanation of an MRI brain scan and how to read it. An MRI examination of the spine displays the anatomy of the vertebrae that compose the spine, ligaments that bind the vertebrae together, along with the disks, spinal cord and the openings between the vertebrae where nerves pass.

Patient symptoms that prompt physicians to recommend spinal MRIs include back pain coinciding with fever, signs of brain or spinal cancer, lower back injuries, chronic back pain, MS, bladder problems and weakness or numbness in legs and bladder problems.

An MRI is a very sensitive imaging test of the spine commonly used in typical clinical practice. Radiologists at NDI read and interpret spine, thoracic, cervical and lumbar lower spine and back MRIs to identify degenerative disc disease, herniated discs and spinal stenosis.

A lumbar MRI specifically examines the lumbar section of the spine. This is the area where back problems typically originate.

Berns and his staff read MRIs to find tumors affecting the nerves or bones of the spine. Types of cancer that are commonly detected by teleradiologists at NDI in the spine spread there from the prostate, lungs or breasts. Radiologists at NDI frequently detect compression fractures of the spine while reading MRIs.

Docs at NDI look for joint inflammation, bony overgrowth, spinal cord tumors, abscesses, arthritis and bone loss when reading MRIs.

Radiologists at NDI look for areas of the spine that have poor blood supply, an infection, nerve damage or congenital problems. Gillard Lectures On How to Read Your Lumbar MRI Posted On YouTube On August 22, By Douglas Gillard, DC, Professor of Clinical Science.

Why invest in an MRI interpretation online? Hear directly from a radiologist - the expert in MRI readings. Be able to see your findings for yourself. Most doctors lack the time or training to show you your imaging findings in detail. Understand it!

Get results faster! Maximize your time! Get your own report today! Request My MRI Video Report. Patients love them! Really amazing and valuable report. Knowledge is power.

Mediphany has equipped me with an in-depth understanding of my injury. I can now be prepared to ask informed questions at my orthopedic visit! Doctors like video reports too. Why Mediphany?

Our radiologists are experts at explaining findings. Your video report will be ready to watch online within 24 hours with our Express option.

Easily share your video report with your physician, friends or family. There is nobody else offering personalized video reports online. Everything is done online, no printing or scanning required. Options for sending us your images and report. Upload the files yourself.

Have your radiology center upload on your behalf. Share your online portal details. Want to learn on your own? Upload your own MRI or CT for FREE to view the images Use our normal comparison CT or MRI scans to contrast with your own Watch our explanation videos of normal anatomy Read our self-help articles on common problems.

Free Self-Help. Getting started is easy. Create Your Mediphany Account. Note that your password needs to contain at least one capital letter and one numeric character. Get Started with Mediphany. Customers Love Mediphany. I believe when dealing with my health, knowledge is power. I can now be prepared to ask informed questions at my orthopaedic visit!

The video report was such a relief!! Mediphany was very helpful in assisting me with transferring my images; but most importantly, they gave me the explanation I needed. I can't say how much I appreciate this personal service online as the video report was a specialist literally talking with me, by name, and explaining my images.

The video report was outstanding. It made my decision to have a knee replacement simple. Certainly worth the small cost to save time and give me confidence in making the decision to have surgery. It is PRICELESS.

I cannot get over how amazing and helpful this video is!! The hospital had given us a regular radiology report, but it had very little meaning for us. It is absolutely BRILLIANT!! THANK YOU!!! Frequently Asked Questions FAQs. How accurately can MRI detect abnormalities? How long does it take to get an MRI scan?

How to read and interpret MRI results? Comparison of right ventricular volume measurements between axial and short axis orientation using steady-state free precession magnetic resonance imaging. Clarke CJ, Gurka MJ, Norton PT, Kramer CM, Hoyer AW. Assessment of the accuracy and reproducibility of RV volume measurements by CMR in congenital heart disease.

Manisty C, Ripley DP, Herrey AS, Captur G, Wong TC, Petersen SE, et al. Splenic switch-off: a tool to assess stress adequacy in adenosine perfusion cardiac MR imaging. Shaw LJ, Berman DS, Picard MH, Friedrich MG, Kwong RY, Stone GW, et al.

Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging. Di Bella EV, Parker DL, Sinusas AJ. On the dark rim artifact in dynamic contrast-enhanced MRI myocardial perfusion studies.

Magn Reson Med. Thomson LE, Fieno DS, Abidov A, Slomka PJ, Hachamovitch R, Saouaf R, et al. Added value of rest to stress study for recognition of artifacts in perfusion cardiovascular magnetic resonance.

Chung SY, Lee KY, Chun EJ, Lee WW, Park EK, Chang HJ, et al. Comparison of stress perfusion MRI and SPECT for detection of myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease.

Stanton T, Marwick TH. Assessment of subendocardial structure and function. Panting JR, Gatehouse PD, Yang GZ, Grothues F, Firmin DN, Collins P, et al.

Abnormal subendocardial perfusion in cardiac syndrome X detected by cardiovascular magnetic resonance imaging. N Engl J Med. Pilz G, Klos M, Ali E, Hoefling B, Scheck R, Bernhardt P. Angiographic correlations of patients with small vessel disease diagnosed by adenosine-stress cardiac magnetic resonance imaging.

Kawecka-Jaszcz K, Czarnecka D, Olszanecka A, Klecha A, Kwiecien-Sobstel A, Stolarz-Skrzypek K, et al. Myocardial perfusion in hypertensive patients with normal coronary angiograms. J Hypertens. Karamitsos TD, Ntusi NA, Francis JM, Holloway CJ, Myerson SG, Neubauer S. Feasibility and safety of high-dose adenosine perfusion cardiovascular magnetic resonance.

Jerosch-Herold M. Quantification of myocardial perfusion by cardiovascular magnetic resonance. Schwitter J, DeMarco T, Kneifel S, von Schulthess GK, Jorg MC, Arheden H, et al.

Magnetic resonance-based assessment of global coronary flow and flow reserve and its relation to left ventricular functional parameters: a comparison with positron emission tomography. Kelle S, Graf K, Dreysse S, Schnackenburg B, Fleck E, Klein C. Evaluation of contrast wash-in and peak enhancement in adenosine first pass perfusion CMR in patients post bypass surgery.

Taylor AJ, Al-Saadi N, Abdel-Aty H, Schulz-Menger J, Messroghli DR, Friedrich MG. Detection of acutely impaired microvascular reperfusion after infarct angioplasty with magnetic resonance imaging. Rieber J, Huber A, Erhard I, Mueller S, Schweyer M, Koenig A, et al. Cardiac magnetic resonance perfusion imaging for the functional assessment of coronary artery disease: a comparison with coronary angiography and fractional flow reserve.

Eur Heart J. Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K, et al. Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Klocke FJ, Simonetti OP, Judd RM, Kim RJ, Harris KR, Hedjbeli S, et al. Limits of detection of regional differences in vasodilated flow in viable myocardium by first-pass magnetic resonance perfusion imaging.

Mordini FE, Haddad T, Hsu LY, Kellman P, Lowrey TB, Aletras AH, et al. Diagnostic accuracy of stress perfusion CMR in comparison with quantitative coronary angiography: fully quantitative, semiquantitative, and qualitative assessment.

Sammut EC, Villa ADM, Di Giovine G, Dancy L, Bosio F, Gibbs T, et al. Prognostic value of quantitative stress perfusion cardiac magnetic resonance. Ishida M, Schuster A, Morton G, Chiribiri A, Hussain S, Paul M, et al. Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance.

Kellman P, Hansen MS, Nielles-Vallespin S, Nickander J, Themudo R, Ugander M, et al. Myocardial perfusion cardiovascular magnetic resonance: optimized dual sequence and reconstruction for quantification. Jerosch-Herold M, Wilke N, Wang Y, Gong GR, Mansoor AM, Huang H, et al.

Direct comparison of an intravascular and an extracellular contrast agent for quantification of myocardial perfusion. Cardiac MRI group.

Int J Card Imaging. Brown LAE, Onciul SC, Broadbent DA, Johnson K, Fent GJ, Foley JRJ, et al. Fully automated, inline quantification of myocardial blood flow with cardiovascular magnetic resonance: repeatability of measurements in healthy subjects. Jerosch-Herold M, Swingen C, Seethamraju RT. Myocardial blood flow quantification with MRI by model-independent deconvolution.

Med Phys. Hsu LY, Jacobs M, Benovoy M, Ta AD, Conn HM, Winkler S, et al. Diagnostic performance of fully automated pixel-wise quantitative myocardial perfusion imaging by cardiovascular magnetic resonance. Kim RJ, Shah DJ, Judd RM. How we perform delayed enhancement imaging.

McCrohon JA, Moon JC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJ, et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance.

Klem I, Heitner JF, Shah DJ, Sketch MH Jr, Behar V, Weinsaft J, et al. Improved detection of coronary artery disease by stress perfusion cardiovascular magnetic resonance with the use of delayed enhancement infarction imaging.

Saremi F, Grizzard JD, Kim RJ. Optimizing cardiac MR imaging: practical remedies for artifacts. Kellman P, Arai AE, McVeigh ER, Aletras AH. Phase-sensitive inversion recovery for detecting myocardial infarction using gadolinium-delayed hyperenhancement. Weinsaft JW, Kim HW, Shah DJ, Klem I, Crowley AL, Brosnan R, et al.

Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction.

Bondarenko O, Beek AM, Hofman MB, Kuhl HP, Twisk JW, van Dockum WG, et al. Standardizing the definition of hyperenhancement in the quantitative assessment of infarct size and myocardial viability using delayed contrast-enhanced CMR.

Amado LC, Gerber BL, Gupta SN, Rettmann DW, Szarf G, Schock R, et al. Accurate and objective infarct sizing by contrast-enhanced magnetic resonance imaging in a canine myocardial infarction model. Hsu LY, Natanzon A, Kellman P, Hirsch GA, Aletras AH, Arai AE. Quantitative myocardial infarction on delayed enhancement MRI.

Part I: animal validation of an automated feature analysis and combined thresholding infarct sizing algorithm. Flett AS, Hasleton J, Cook C, Hausenloy D, Quarta G, Ariti C, et al. Evaluation of techniques for the quantification of myocardial scar of differing etiology using cardiac magnetic resonance.

Klem I, Heiberg E, Van Assche L, Parker MA, Kim HW, Grizzard JD, et al. Sources of variability in quantification of cardiovascular magnetic resonance infarct size - reproducibility among three core laboratories.

Vermes E, Childs H, Carbone I, Barckow P, Friedrich MG. Auto-threshold quantification of late gadolinium enhancement in patients with acute heart disease. Kim HW, Farzaneh-Far A, Kim RJ. Cardiovascular magnetic resonance in patients with myocardial infarction: current and emerging applications.

Schmidt A, Azevedo CF, Cheng A, Gupta SN, Bluemke DA, Foo TK, et al. Infarct tissue heterogeneity by magnetic resonance imaging identifies enhanced cardiac arrhythmia susceptibility in patients with left ventricular dysfunction.

Yan AT, Shayne AJ, Brown KA, Gupta SN, Chan CW, Luu TM, et al. Characterization of the peri-infarct zone by contrast-enhanced cardiac magnetic resonance imaging is a powerful predictor of post-myocardial infarction mortality. Kim HW, Rehwald WG, Jenista ER, Wendell DC, Filev P, van Assche L, et al.

Dark-blood delayed enhancement cardiac magnetic resonance of myocardial infarction. Kellman P, Xue H, Olivieri LJ, Cross RR, Grant EK, Fontana M, et al. Dark blood late enhancement imaging. Francis R, Kellman P, Kotecha T, Baggiano A, Norrington K, Martinez-Naharro A, et al. Prospective comparison of novel dark blood late gadolinium enhancement with conventional bright blood imaging for the detection of scar.

Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, et al. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance SCMR and CMR Working Group of the European Society of Cardiology consensus statement.

Messroghli DR, Moon JC, Ferreira VM, Grosse-Wortmann L, He T, Kellman P, et al. von Knobelsdorff-Brenkenhoff F, Schuler J, Doganguzel S, Dieringer MA, Rudolph A, Greiser A, et al. Detection and monitoring of acute myocarditis applying quantitative cardiovascular magnetic resonance.

Circ Cardiovasc Imaging. Treibel TA, Fontana M, Maestrini V, Castelletti S, Rosmini S, Simpson J, et al. Automatic measurement of the myocardial interstitium: synthetic extracellular volume quantification without hematocrit sampling. Carbone I, Childs H, Aljizeeri A, Merchant N, Friedrich MG.

Importance of reference muscle selection in quantitative signal intensity analysis of T2-weighted images of myocardial edema using a T2 ratio method. Biomed Res Int. Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, et al. Cardiovascular magnetic resonance in myocarditis: a JACC white paper.

He T, Gatehouse PD, Kirk P, Mohiaddin RH, Pennell DJ, Firmin DN. He T, Gatehouse PD, Smith GC, Mohiaddin RH, Pennell DJ, Firmin DN. He T, Gatehouse PD, Kirk P, Tanner MA, Smith GC, Keegan J, et al. Anderson LJ, Holden S, Davis B, Prescott E, Charrier CC, Bunce NH, et al.

Carpenter JP, He T, Kirk P, Roughton M, Anderson LJ, de Noronha SV, et al. Kirk P, Roughton M, Porter JB, Walker JM, Tanner MA, Patel J, et al. Article CAS PubMed PubMed Central Google Scholar. Dyverfeldt P, Bissell M, Barker AJ, Bolger AF, Carlhall CJ, Ebbers T, et al.

Mohiaddin RH, Kilner PJ, Rees S, Longmore DB. Magnetic resonance volume flow and jet velocity mapping in aortic coarctation. Mohiaddin RH, Pennell DJ. MR blood flow measurement. Clinical application in the heart and circulation.

Cardiol Clin. Rebergen SA, van der Wall EE, Doornbos J, de Roos A. Magnetic resonance measurement of velocity and flow: technique, validation, and cardiovascular applications. Am Heart J. Lotz J, Meier C, Leppert A, Galanski M.

Cardiovascular flow measurement with phase-contrast MR imaging: basic facts and implementation. Iwamoto Y, Inage A, Tomlinson G, Lee KJ, Grosse-Wortmann L, Seed M, et al. Direct measurement of aortic regurgitation with phase-contrast magnetic resonance is inaccurate: proposal of an alternative method of quantification.

Pediatr Radiol. Richau J, Dieringer MA, Traber J, von Knobelsdorff-Brenkenhoff F, Greiser A, Schwenke C, et al. Effects of heart valve prostheses on phase contrast flow measurements in cardiovascular magnetic resonance - a phantom study. Gatehouse PD, Rolf MP, Graves MJ, Hofman MB, Totman J, Werner B, et al.

Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements. Kawel-Boehm N, Maceira A, Valsangiacomo-Buechel ER, Vogel-Claussen J, Turkbey EB, Williams R, et al.

Normal values for cardiovascular magnetic resonance in adults and children. Holloway BJ, Rosewarne D, Jones RG. Imaging of thoracic aortic disease.

Br J Radiol. Burman ED, Keegan J, Kilner PJ. Pulmonary artery diameters, cross sectional areas and area changes measured by cine cardiovascular magnetic resonance in healthy volunteers.

Seller N, Yoo SJ, Grant B, Grosse-Wortmann L. How many versus how much: comprehensive haemodynamic evaluation of partial anomalous pulmonary venous connection by cardiac MRI.

Eur Radiol. Angelini P, Cheong BY, Lenge De Rosen VV, Lopez A, Uribe C, Masso AH, et al. High-risk cardiovascular conditions in sports-related sudden death: prevalence in 5, schoolchildren screened via cardiac magnetic resonance. Tex Heart Inst J.

Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, et al. Download references. Scott D. Flamm: Dr. Mark A. Matthias G. Friedrich: Dr. Friedrich is partially funded by the Canadian Foundation for Innovation and the Fonds de Recherche Santé Québec.

Dudley J. Eike Nagel: Dr. Nagel acknowledges financial support from the German Ministry of Education and Research and the Hesse Ministry of Arts and Science via the German Centre for Cardiovascular Research DZHK.

Grant support from Bayer Healthcare. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, and HELIOS Klinikum Berlin Buch, Schwanebecker Chaussee 50, , Berlin, Germany.

University of Wisconsin School of Medicine and Public Health, Madison, USA. Department of Radiology of the University Hospital Basel, Basel, Switzerland. Imaging, and Heart and Vascular Institutes, Cleveland Clinic, Cleveland, OH, USA.

Departments of Medicine and Diagnostic Radiology, McGill University, Montreal, QC, Canada. Duke Cardiovascular Magnetic Resonance Center, and Departments of Medicine and Radiology, Duke University Medical Center, Durham, NC, USA. Department of Cardiology, Academic Teaching Hospital Agatharied of the Ludwig-Maximilians-University Munich, Hausham, Germany.

Departments of Medicine and Radiology and the Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA, USA. Royal Brompton Hospital, and Imperial College, London, UK.

Institute for Experimental and Translational Cardiovascular Imaging, DZHK German Centre for Cardiovascular Research Centre for Cardiovascular Imaging, partner site RheinMain, University Hospital Frankfurt, Frankfurt am Main, Germany.

You can also search for this author in PubMed Google Scholar. JSM wrote paragraphs, edited manuscript, corresponding author. DAB, JB, SDF, MAF, MGF, RJK, FvKB, CMK, DJP, SP and EN wrote paragraphs, edited manuscript. All authors read and approved the final manuscript. Correspondence to Jeanette Schulz-Menger.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.

Reprints and permissions. Schulz-Menger, J. Standardized image interpretation and post-processing in cardiovascular magnetic resonance - update. J Cardiovasc Magn Reson 22 , 19 Download citation. Received : 28 January Accepted : 17 February Published : 12 March Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Position statement Open access Published: 12 March Standardized image interpretation and post-processing in cardiovascular magnetic resonance - update Society for Cardiovascular Magnetic Resonance SCMR : Board of Trustees Task Force on Standardized Post-Processing Jeanette Schulz-Menger 1 , David A.

Bluemke 2 , Jens Bremerich 3 , Scott D. Flamm 4 , Mark A. Fogel 5 , Matthias G. Friedrich 6 , Raymond J. Kim 7 , Florian von Knobelsdorff-Brenkenhoff ORCID: orcid.

Kramer 9 , Dudley J. Abstract With mounting data on its accuracy and prognostic value, cardiovascular magnetic resonance CMR is becoming an increasingly important diagnostic tool with growing utility in clinical routine.

Preamble Cardiovascular magnetic resonance CMR has evolved into a gold standard non-invasive imaging tool in cardiovascular medicine, especially for visualizing and quantifying cardiovascular anatomy, volumes, and function, as well as for myocardial tissue characterization.

General recommendations The recommendations listed in this section apply to the acquisition and post-processing of all CMR data. The general requirements include: 1. Workstation and screen of adequate specification and resolution as per the specifications of the post-processing software 2.

Left ventricular chamber assessment Visual analysis a Before analyzing the details, review all cines in cine mode, validate observations from one plane with the others, and check for artifacts, especially in patients with irregular heart rates.

b Dynamic evaluation of global LV function: Interpretation of both ventricular chambers, in concert with extracardiac structures including assessment for hemodynamic interaction between the two chambers e.

c Assessment of LV function from a global and segmental perspective. d In presence of segmental wall motion abnormalities, use of standard LV segmentation nomenclature corresponding to the supplying coronary artery territories is recommended [ 3 , 5 , 7 ].

Quantitative analysis a General recommendations i In patients with severe arrhythmias, the end-systolic volumes tend to be overestimated and ejection fraction underestimated.

ii Calculated parameters: LV end-diastolic volume, LV end-systolic volume, LV stroke volume, LV ejection fraction, cardiac output, LV mass, and body-surface area indexed values of all except ejection fraction. iii Evaluation of the stack of short axis images with computer-aided analysis packages.

iv Contours of endocardial and epicardial borders at end-diastole and end-systole Fig. v Epicardial borders should be drawn on the middle of the chemical shift artifact line when present.

vi The LV end-diastolic image should be chosen as the image with the largest LV blood volume. vii The LV end-systolic image should be chosen as the image with the smallest LV blood volume.

viii Deviations may occur and extra care should be taken in the setting of LV dyssynchrony. ix Automatic contour delineation algorithms must be checked for appropriateness by the reader.

b LV volumes i Papillary muscles and trabecular tissue are myocardial tissue and thus ideally should be included with the myocardium as part of LV mass. ii Outflow tract: The LV outflow tract is included as part of the LV blood volume. iii Basal descent: As a result of systolic motion of the mitral valve toward the apex basal descent , care must be taken with the one or two most basal slices by using a standardized consistent approach.

c LV mass i Calculation: difference between the total epicardial volume sum of epicardial cross-sectional areas multiplied by the sum of the slice thickness and interslice gap minus the total endocardial volume sum of endocardial cross-sectional areas multiplied by the sum of the slice thickness and interslice gap , which is then multiplied by the specific density of myocardium 1.

ii Papillary muscles: Papillary muscles and trabecular tissue are myocardial tissue and thus ideally should be included with the myocardium as part of LV mass, and this is particularly relevant in diseases with LV hypertrophy [ 6 ]. iii Basal descent and apex: When the most basal slice contains only a small crescent of basal lateral myocardium and no discernable ventricular blood pool, an epicardial contour for the visible myocardium is included for LV mass only.

d Rapid quantitative analysis i A rapid quantitative analysis, known as the area-length method, can be performed using biplanar e. e Cavity diameter and LV wall thickness can be obtained similar to echocardiography using two CMR approaches [ 12 , 15 ]: i Basal short-axis slice: immediately basal to the tips of the papillary muscles.

ii 3-chamber view: in the LV minor axis plane at the mitral chordae level basal to the tips of the papillary muscles.

iii Both approaches have good reproducibility. iv For maximal LV wall thickness, the measurement should be made perpendicular to the LV wall to ensure accurate measurements. f Research: i Real-time cine acquisitions become increasingly available and might be beneficial in patients with arrhythmia or limited breathholding capacity.

ii Quantitative evaluation of LV myocardial dynamics e. Full size image. Right ventricular RV chamber assessment Visual analysis a Review all cines in cine mode, validate observations from one plane with the others, and check for artifacts and coverage of the right ventricle RV.

b Assessment of global and regional RV function septal wall, free wall , where appropriate. c Assessment of LV and RV chambers for hemodynamic interaction i. constrictive physiology. Quantitative analysis a General recommendations i Calculated parameters: RV end-diastolic volume, RV end-systolic volume, RV ejection fraction, RV stroke volume, cardiac output, and body-surface area indexed values of all except ejection fraction.

ii The contiguous stack of short-axis images or axial cine images is evaluated with computer-aided analysis packages Fig. iii An axial stack of cines covering the RV provides the best identification of the tricuspid valve plane. iv Endocardial borders are contoured at end-diastole and end-systole Fig.

v The RV end-diastolic image should be chosen as the image with the largest RV blood volume. vi RV end-systolic image should be chosen as the image with the smallest RV blood volume.

vii As for the LV, it may be necessary to review all image slices in the stack to define end-systole. viii The pulmonary valve may be visualized, and contours are included just up to, but not superior to this level.

b RV volumes i Total volumes are taken as the sum of volumes from individual 2D slices, accounting for any interslice gap and slice thickness.

c RV mass is usually not quantified in routine assessment. d Confirmation of results i If no shunts or valvular regurgitation is present, the RV and LV stroke volumes should be nearly equal small differences are seen as a result of bronchial artery supply and papillary muscle inclusions in the measurements.

Post-processing of myocardial perfusion imaging Visual analysis a Workflow: i Display perfusion and corresponding LGE images side-by-side.

ii Adjust window, contrast and brightness level for an optimized contrast within the LV myocardium not the entire image. iii Apply the same contrast, brightness and window settings to all images of the dynamic series. v Check that there was an adequate haemodynamic response to stress by reviewing the heart rate and blood pressure change between stress and symptomatic response to stress.

vi The key diagnostic feature for identifying a perfusion defect is the arrival and first passage of the contrast bolus through the LV myocardium.

vii Visual analysis is based on a comparison between regions to identify relative hypoperfusion. b Stress images alone may permit the diagnosis of inducible perfusion defects. c Scar tissue may not necessarily cause a perfusion defect, especially if rest perfusion is acquired after stress.

d Criteria for an inducible perfusion defect Fig. ii Persists beyond peak myocardial enhancement and for several RR intervals. iii Is more than two pixels wide. iv Is usually most prominent in the subendocardial portion of the myocardium. v Often manifests as a transmural gradient across the wall thickness of the segment involved: most dense in the endocardium and gradually becoming less dense towards the epicardium.

vi Over time, defect regresses from the subepicardium towards the subendocardium. vii Is present at stress but not at rest. viii Conforms to the distribution territory of one or more coronary arteries.

e Interpret location and extent of inducible perfusion defect s using AHA segment model [ 5 ]. i Comment on transmurality of perfusion defect [ 20 ].

ii Indicate extent of perfusion defect relative to scar on LGE. f Criteria for dark banding artifacts Fig. These artifacts have the following characteristics: Are most prominent when contrast arrives in the LV blood pool. Persist only transiently before the peak myocardial contrast enhancement.

Appear predominantly in the phase-encoding direction. Are approximately one pixel wide. g Pitfalls of visual analysis i Multi-vessel disease: Visual analysis is based on relative signal differences within an imaged section of the heart. ii Microvascular disease: Diseases that affect the myocardial microvasculature e.

iii If vasodilation during stress data acquisition was inadequate, visual analysis may lead to false negative interpretation of the perfusion study [ 28 ]. iv The distance of the myocardium to the surface coil affects signal intensity and may lead to misinterpretation if not considered in the analysis.

Post-processing of late gadolinium enhancement LGE of the left ventricle Visual assessment a For most clinical indications, visual assessment of LGE images is sufficient. b Workflow: i Modify image window and level so that: Noise is still detectable nulled myocardium should not be a single image intensity.

LGE regions are not saturated LGE regions should not be a single image intensity. c Criteria for presence of LGE. d Assess pattern of LGE i Coronary artery disease CAD type: Should involve the subendocardium and be consistent with a coronary artery perfusion territory.

ii Non-CAD-type: Usually spares the subendocardium and is limited to the mid-wall or epicardium, although non-CAD-type should be considered if subendocardial involvement is global [ 45 ].

e Interpret location and extent using AHA segment model [ 5 ] [ 20 ]. i Comparison of LGE images should be made with cine and perfusion images if the latter are obtained to correctly categorize ischemia and viability [ 46 ].

iii In patients with acute myocardial infarction, include subendocardial and mid-myocardial hypoenhanced no-reflow zones as part of infarct size.

f Pitfalls i Bright ghosting artifacts can result from poor electrocardiogram ECG gating, poor breath-holding, and long T1 species in the imaging plane e.

iii Occasionally, it can be difficult to distinguish no reflow zones or mural thrombus from viable myocardium.

v In PSIR images manual windowing and quantification algorithms may behave differently when compared with magnitude images. Post-processing of T2-weighted imaging Visual analysis a The visual analysis of T2-weighted images aims for detecting or excluding regions with significant SI increase, as a marker for an increased free water content edema.

c Workflow: i Identify and display appropriate image s. iii Check for artifacts typically SI changes crossing anatomical structures. d Criteria for edema: i Clearly detectable high SI area respecting anatomical borders.

ii Follows an expected regional distribution pattern transmural, subendocardial, subepicardial, focal. iii Verifiable in two perpendicular views. e High SI areas suggestive of myocardial edema should be compared to i regional function.

Magnetic resonance imaging MRI is a medical imaging technique that imahe a magnetic field and computer-generated radio MRI image interpretation to create detailed interpretaiton of the unterpretation MRI image interpretation ikage in your body. Most MRI machines imagee large, tube-shaped magnets. When interprdtation lie inside an MRI machine, the magnetic field inside works with radio waves and hydrogen atoms in your body to create cross-sectional images — like slices in a loaf of bread. The MRI machine also can produce 3D images that can be viewed from different angles. MRI is a noninvasive way for a medical professional to examine your organs, tissues and skeletal system. It produces high-resolution images of the inside of the body that help diagnose a variety of conditions.