Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing

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. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post Processing of the Society for Cardiovascular MR (SCMR). The aim of the task force is to recommend requirements and standards for image interpretation and post processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate.

Ventricular Arrhythmias in Young Competitive Athletes: Prevalence, Determinants, and Underlying Substrate

“…According to the protocols recommended by the Society for Cardiovascular Magnetic Resonance,19 we acquired steady‐state free precession sequence (true FISP) cine images in sequential short‐axis views (slice thickness, 6 mm; gap, 0 mm), standard 4‐, 3‐, and 2‐chamber views, a long‐axis view of the right ventricle, and a dedicated view for the right ventricular outflow tract. LV volume, wall thickness, and systolic function were calculated from the short‐axis cine images, excluding papillary muscles from the myocardium.…”

“…The presence of myocardial edema on T2‐weighted images was diagnosed using a dark blood preparation on sequences to reduce artifacts and surface coil reception field inhomogeneity; moreover, to avoid misdiagnosis of subendocardial edema resulting from “slow‐flow artifacts,” T2‐weighted images were compared with the corresponding cine images, using a side‐by‐side approach on the same cardiac phase. Semiquantitative analysis was performed using regional T2‐ratio method, and myocardial edema was diagnosed in the presence of an increased signal intensity (ie, >2 SDs above skeletal muscle), as recommended 19. All edematous regions were confirmed in 2 perpendicular views.…”

“…Inversion times were adjusted to null normal myocardium using the Look‐Locker sequence, and images were repeated in 2 separate phase‐encoding directions to exclude artifacts. Myocardial late gadolinium enhancement (LGE) was assessed with an automated thresholding and considered present if signal intensity was >3 SDs above remote myocardium in 2 orthogonal views 19. Isolated junctional LGE was not considered because it is a common and nonpathologic finding in athletes 20…”

3T MRI investigation of cardiac left ventricular structure and function in a UK population: The tayside screening for the prevention of cardiac events (TASCFORCE) study

“…Papillary muscles were included in the LVM if visually indistinguishable from the myocardial wall, but otherwise assigned to the left ventricular blood pool. As far as possible (within the constraints of the software capability) the adopted methodology was performed as per the guidance notes provided by Schulz‐Menger et al23 …”

Incidence of sustained ventricular tachycardia and ventricular fibrillation in patients with cardiac scar zones and low vs. normal left ventricular ejection fraction

“…Cardiac MRI analyses were performed according to the recommendations of the task force for post-processing of the Society for Cardiovascular MR [10]. Offline Cardiac MRI analyses were performed using the software Qmass MR Enterprise Solution (version 7.4, Medis, the Netherlands).…”