How to Learn MRI An Illustrated Workbook

How to Learn MRI An Illustrated Workbook Exercise 8: Cine Imaging of the Heart Teaching Points: How to do cardiac gating? What is Steady State Free Precession (SSFP)? What are the basic cardiac views and how to prescribe these images?

Cardiac MRI Imaging is used to evaluate morphology and function of the myocardium, pericardium, valves, coronary arteries, and surrounding structures. It can show the extent of the damage caused by heart attack, valve disease, hypertension, and shunts. It can evaluate cardiac function by measuring cavity volume and ejection fractions. It aids in the diagnosis and management of several cardiovascular diseases and can be used to monitor patient s recovery following treatment. Step : Prep Your volunteer should sign the safety screening form (see exercise 2), consent form, and the HIPPA research privacy form. Review the information on the safety screening form and interview your volunteer to verify the information on the form and to make sure that nothing was overlooked. Ask him/her for any concerns and also explain the nature of exam so that your volunteer knows what to expect. Fig 8. Preparing the room and positioning the posterior cardiac coil Step2: Prepare the scanner room Place the posterior element of the 8 channel cardiac coil on the scanner table and cover the table with a clean sheet and the pillow with clean pillowcase. Lay down the respiratory bellows so the volunteer can lie on top of it.

2 Step : Placement of the ECG electrodes Volunteer should be supine and feet first. Make sure that upper edge of the posterior coil is above the cranial edge of scapula. Prepare the skin of the volunteer for lead placement by cleaning it using alcohol swab to remove oil and shave chest hair if necessary. Note that leads can also be applied on the back which can be more convenient to the volunteer. Dry the area completely before placing the electrodes. Position the leads in configuration avoiding breast tissue. Position the ECG leads (RA, LA, RL and LL) on the chest of the volunteer as shown in Fig 8.2. The leads should not be placed more than to 5 cm apart. Raise the left breast to position the LL lead, for women with large breasts. Proper placement ECG leads is important in any cardiac gated acquisition. Fig 8.2 Placing the ECG leads To display the waveforms, click Gating control on the Rx Manager. Turn on Vector Gating (ECG) and Respiratory Gating to display the waveform on the screen (Fig 8.a). Make sure that R waves are detected, at least 6 heart cycles before you start scanning (Fig 8.4). Reposition the leads if R waves are not detected properly or the R wave amplitude is low (<mv). If some of the R waves are missing trigger marks, go back to the Gating Control window and reduce Cardiac Trigger Level to 5%. The Cardiac Trigger Level allows adjustment, expressed as a percent of the QRS complex, where the signal amplitude must rise about the defined threshold to be detected.

Fig 8. How to turn on the respiratory gating Gating Control Autoview Report Cursor Auto W/L Update Waveform and Gating SelectionC ardiac Sweep Rate Independent Vector Gating Standard Gating (ECG) ECG Noise Filter rd party Monitoring with Gating Respiratory Trigger Lead VCG-I+II Inverted PG Display mm/sec 2mm/sec 4mm/sec Sync Cardiac and Respiratory Sweep Rates Cardiac Trigger Level 5% Gating Reset Record ECG VCG I VCG II 72 72.94 mv.58 mv VCG-I VCG-II Inverted Inverted 6% 7% RESP 2 PG Auto Auto Trigger Level : % Cardiac Trigger Level Annotation: OFF Auto Trigger Volume: 5 Accept What is Cardiac Gating? Cardiac Gating is the technique which allows the same data to be collected at the same points of the cardiac cycle for each repetition of the pulse sequence. It monitors the cardiac cycle prospectively to initiate RF application and retrospectively determine when data were acquired in the R-R interval for creating cine images. Fig 8.4 ECG wave form R wave The ECG waveform represents the electrical activity of the heart that correlates to heart motion (Systole is cardiac contraction & Diastole is cardiac relaxation): P wave - atrial depolarization/systole of atria QRS complex - ventricular depolarization/systole of ventricles **R wave - has strong signal and correlation of the heart muscle activity ST segment - end of the QRS complex and beginning of the T wave, represents period of slow repolarization of the ventricles T wave - ventricular repolarization/diastole of ventricles QT interval - both ventricular depolarization and repolarization; estimates the duration of the ventricular action potential P PR QRS ST QT T

4 Step 4: Positioning the coil Make sure the respiratory bellows is secured tightly around the abdomen before placing the anterior cardiac coil on the volunteer. You can place a pad or cushion on the chest before putting the anterior cardiac coil. The upper edge of the coil should be above the clavicle level. Arms are on the side or placed above the head. To relieve back pressure, place a cushion under the knees. Give your volunteer earplugs and squeeze ball and cover them with a blanket. Fig 8.5 Positioning the anterior cardiac coil Step 5: Landmarking Fig 8.6 Landmarking Landmark at the volunteer s mid-sternum (mid-chest).

5 Step 6: Set your own Three Plane Localizer Click New Series in Rx Manager, Select INRX, and then click View Edit. We suggest the following parameter for your plane localizer (Fig 8.7). Be sure to select Cardiac as the coil type. Click Save series, Download, Prep Scan, give instructions for breath holding, then Scan. Fig 8.7 -Plane Localizer sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description -plane localizer Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options -Plane Fiesta Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2..5.5 Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 28. Freq DIR Flow Comp Shim Unswap Auto TE2 TR.. 5. 6. Pause. Correct Contrast Amf ml Inv. Time Agent TI2 Flip Angle Echo Train Length Bandwidth 6 25. 5 4 9 2. 25. 24. 5. Scanning Range 8 48 Center S/I R/L A/P. L. A.... Bandwidth2. 25. # s: 9 9 9 Table Delta.

6 Step 7: ASSET Calibration Array spatial sensitivity encoding technique (ASSET) is a parallel imaging single breath hold technique done to accelerate data acquisition and determine the sensitivity of all coils in the phased array coil. Copy and Paste Plane loc on your Rx Manager then click View Edit. Set your parameters and fill up the Position, Imaging Parameters, Acquisition Timing, and Scan Timing (Fig 8.8). Click and be sure to prescribe enough slices to cover the whole heart. Click Save Series, Download, Prep Scan, give instructions for breath holding, and then click Scan. Fig 8.8 Calibration sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description Calibration Scan Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Axial gradient Fast Calib Grad Calib Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing. 2..4.4 Graphic RX OFF Image Enhance Users CVs Screen Freq NEX Freq DIR Flow Comp Shim R/L Auto TE2 TR... 6. Pause Correct Contrast Amf ml Inv. Time Agent TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 5 4 9.2.2..2 6. 8. Scanning Range 5 48 Start End s: S/I R/L A/P S27. I2.5 5 R6. P. R6. P. Table Delta.

7 What is Steady-State Free Precession (SSFP) Imaging? This is a gradient-echo sequence which has revolutionized cardiac MRI by increasing SNR with steady state echo magnetization. Normally left over signal at the end of a pulse is spoiled to avoid interfering with the next echo (e.g. spoiled gradient echo). With SSFP, left over signal is re-phased to align and superimposed on the next echo so that signal becomes stronger and stronger with every pulse until reaching steady state. It uses a high flip angle with short repetition time (< 4 ms). FIESTA or Fast Imaging Employing Steady State Acquisition is GE version of SSFP. TR FID FID SE FID+SE SE+STE FID+SE+STE 2SEs+2STEs FID+2SEs+2STEs 2SEs+4STEs FID+2SEs+4STEs Fig 8.9 MR signal becomes a superimposition of free induction decays, spin echoes, and stimulated echoes after applying a series of closely spaced RF pulses.

8 Step 8: Two Chamber, Vertical Long Axis Fiesta (SSFP) Vertical long axis (2C view) shows the anterior and inferior walls clearly, as well as the apex of the left ventricle. Copy and Paste Plane loc on the Rx Manager then click View Edit. Set the parameters (Fig 8.). Go to Graphic Rx, click Select Series, choose -Plane, then click Ok (Fig 8.). Scroll through the images and choose an axial image to prescribe the localizer. Prescribe one slice parallel to ventricular septum, bisecting the left ventricle through mitral valve and apex (Fig 8.2). Adjust the Shim volume to 2 (Fig 8.) and place it properly on the image. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan. Fig 8. 2 Chamber, Vertical long axis Fiesta sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description SCOUT 2C FIESTA Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS Scan Timing Additional Parameters Aquisition Timing TE(s) per scan TE Minimum. 2... Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I On TE2 TR Inv. Time... 5. Gating/ Triggering Pause. Correct Contrast Amf Agent ml TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25. 5 4 9 62.5 25.. 25. 2. 8.. 8. Scanning Range 8 48 Start End s: L2.7 L2.7 S/I R/L A/P P2. S98.6 P2. S98.6 Cardiac s 2 Table Delta.

9 Fig 8. Position small shim volume on heart X Erase Selected Erase All Reset Center Loc Ref Lines Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique : 2.. Accel. Bar: Fat Fat Classic 8. SPECIAL. Cardiac/Resp Numbe of Radial s Water Shime Vol Hide Shim Shim : 2 Freq DIR: Pause: TR: Minimum TR:.9 Radial Partial Radial CW CCW Start: End: L52.7 L52.7 A2.2 A2.2 S8.5 S. s Fig 8. & 8.2 for 2 Chamber, Vertical Long Axis fig 8.2 Prescribe 2 Chamber, Vertical long axis view Fiesta Erase Selected X Erase All Reset Center Loc Ref Lines Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique : 2.. Accel. Bar: Fat Fat Classic 8. SPECIAL. Cardiac/Resp Water Freq DIR: Numbe of Radial s Shime Vol Hide Shim Shim : 2 Pause: TR: Minimum TR:. Radial Partial Radial CW CCW Start: End: L52.7 L52.7 A. A. S4. S4. s Fig 8. 2 Chamber, Vertical Long Axis Fiesta! Diastole 55 msec 92 msec 27 msec Systole 2 msec

Step 9: Short Axis (SA) Fiesta Short Axis (SA) Fiesta is good for volumetric measurements because it shows the cross sections of the left and right ventricle. Copy and Paste Scout 2C Fiesta on the Rx Manager then click View Edit. Set the Parameters (Fig 8.4). Go to, click Select Series, choose 2C Scout Fiesta, and then click Ok. Multiple slices are positioned perpendicular to the long axis of the left ventricle from the two-chamber view and make sure to cover from atria to apex (Fig 8.5). Set shim vol to 2. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan. This is a series of breath holding in expiration. Fig 8.4 SA Fiesta sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description SA FIESTA Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2..2.2 Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I On TE2 TR Inv. Time...5 5. Gating/ Triggering Pause.9 Correct Contrast Amf Agent ml TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25. 5 4 9 62.5 66.7. 66.7 2. 6.. 8. Scanning Range 48 Start End s: S/I R/L A/P R6. L58.2 2 A5. s.4 A62.9 S67.8 Cardiac s 2 Table Delta.

X 6 4 2 8 6 4 2 Fig 8.5 for SA Fiesta Erase Selected Reset Center Loc Ref Lines Erase All 5 9 7 5 Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order 6 4 2 8 6 4 2 ZOOM Copy Rx... 5 9 7 5 Select Series 6 4 2 8 6 4 2 Select image... * SAT Scan Plane: Oblique : 2. Localized image, Accel. Bar: Fat Fat Classic SPECIAL.9 6.. Cardiac/Resp Numbe of Radial s Water Shime Vol Hide Shim Shim : Freq DIR: S/I Locs Before Pause: TR: 2 Minimum TR:.5 5 9 7 5 Radial Partial Radial CW CCW Start: End: R2.6 L66.4 A4.6 A6.2 S7. S9. s 6 Fig 8.6 SA Fiesta! Step : 4 Chamber Long Axis Fiesta Horizontal Long axis (4C view) shows mitral and tricuspid valves and it is best for evaluating the septal and lateral walls and apex of the left ventricle, right ventricular free wall, and chamber size. Copy and Paste SA Fiesta on the Rx Manager, click View Edit, and set the parameters (Fig 8.7). Go to, click Select Series, choose Scout 2C Fiesta, then click Ok. Click the box on the upper left hand, click Select Series, choose SA Fiesta, and then click Ok. Prescribe one slice bisecting the left ventricle through mitral valve and apex on the two-chamber view and one slice in the middle of the left ventricle to the furthest corner of the right ventricle making a horizontal plane on the SA view (Fig 8.8). Set shim vol to 2. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan.

2 Fig 8.7 4 Chamber, Horizontal Long Axis Fiesta sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description 4 CH Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2..2.2 Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim R/L On TE2 TR Inv. Time...5 5. Gating/ Triggering Pause. Correct Contrast Amf Agent ml TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25. 5 4 9 62.5 66.7. 66.7. 6. 4. 8. Scanning Range 48 Start End s: S/I R/L A/P L4.4 L4.4 A27.5 S88.8 A27.5 S88.8 Cardiac s 2 Table Delta.

Erase Selected X Fig 8.8 for 4 Chamber, Horizontal Long Axis Fiesta Erase All Reset Center Loc Ref Lines Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique :. Localized image, Accel. Bar: Cardiac/Resp Numbe of Radial s Radial Partial Radial CW CCW Fat Fat Classic SPECIAL Water Shim : Shime Vol Hide Shim Start: L9. A. End: L9. A.. S49.6 Locs Before Pause: S49.6 6. 4. Freq DIR: S/I TR: Minimum TR:.5 s Fig 8.9 4 Chamber, Horizontal Long Axis Fiesta T = 55 msec T = msec T = 5 msec T = 2 msec Step : Chamber The three chamber view is a good to see the aortic root and aortic valve, left ventricular outflow tract, mitral valve, and both the anteroseptal and inferolateral walls of the left ventricle. Copy and Paste 4 CH on the Rx Manager, click View Edit and set the parameters (Fig 8.2). Go to, click Select Series, choose Scout 2C Fiesta, and then click Ok. Click the upper left hand box, click Select Series, choose SA Fiesta, and then click Ok. Prescribe a slice bisecting the left ventricle through the mitral valve and apex on the two-chamber view and bisect the left ventricular outflow tract, cutting through the aortic root on the most basal short axis view (Fig 8.2). Set shim volume to 2 and position it on the image correctly. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan.

4 Fig 8.2 Chamber sequence parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description CH Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2..2.2 Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I On TE2 TR Inv. Time TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25....6 5. 5 4 9 62.5 66.7. 66.7 Gating/ Triggering. 6.. 8. Scanning Range 48 Start End s: Pause.9 Amf Agent Correct Contrast S/I R/L A/P L.9 L4.5 A.4 S88.8 A9.8 S88.4 ml Cardiac s 2 Table Delta. Erase Selected Erase All X Fig 8.2 for Chamber Reset Center Loc Ref Lines Fallback to SO Report Cursor Update All Keep W/L. Display Normal Reverse Order ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique :. Localized image,4 Accel. Bar: Fat Fat Classic SPECIAL.9 6. 4. Cardiac/Resp Numbe of Radial s Radial Partial Radial CW CCW Water Shim : Shime Vol 4 Hide Shim Start: L2. A. End: L2. A. Freq DIR: S/I Locs Before Pause: TR: Minimum TR:.6 S62.7 s S62.7

5 Fig 8.22 Chamber T = 45 msec T = msec T = msec T = 85 msec Fig 8.2 Imaging planes that can be aligned from the SA Fiesta slice Short Axis4 Chamber View Vertical Long Axis Chamber View

6 Step 2: Aortic Outflow Tract Copy and Paste CH on the Rx Manager, click View Edit and set the parameters (Fig 8.24). Go to Graphic Rx, click Select Series, choose CH, and then click Ok. Prescribe a slice bisecting the ascending aorta and aortic valve on the C view (Fig 8.25). Adjust the shim vol to 2. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan. Fig 8.24 Aortic Outflow Tract Sequence Parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description AORTIC OUTFLOW TRACT Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS Scan Timing Additional Parameters Aquisition Timing TE(s) per scan TE Minimum. 2... Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I Auto TE2 TR Inv. Time...4 5. Gating/ Triggering Pause. Correct Contrast Amf Agent ml TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25. 5 4 9 62.5 2.. 2. 2. 8.. 8. Scanning Range 26 48 Start End s: S/I R/L A/P L.6 L.6 A2.5 S9.4 A2.5 S9.4 Cardiac s 2 Table Delta.

Fig 8.25 for Aortic Outflow Tract 7 Erase Selected Erase All X Reset Center Loc Ref Lines Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique :. Localized image, Accel. Bar: Cardiac/Resp Numbe of Radial s Radial Partial Radial CW CCW Fat Fat Classic SPECIAL Water Shim : Shime Vol Hide Shim Start: L9. A. End: L9. A.. S49.6 Locs Before Pause: S49.6 6. 4. Freq DIR: S/I TR: Minimum TR:.5 s Fig 8.26 Aortic Outflow Tract! Step : Aortic Valve Copy and Paste Aortic Outflow Tract on the Rx Manager, click View Edit and set the parameters (Fig 8.27). Go to, click Select Series, choose CH, and then click Ok. Click the upper left box, click Select Series, choose Aortic Outflow Tract, and then click Ok. Change the spacing to. Prescribe three slices across aortic valve on both the C and Aortic Outflow Tract view as shown on Fig 8.28. Adjust the shim vol to 2. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan.

8 Fig 8.27 Aortic Valve Sequence Parameter Information s Site Accession Number Position Supine ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description AORTIC VALVE Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2... Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I Auto TE2 TR Inv. Time TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25....4 5. 5 4 9 62.5 2.. 2. Gating/ Triggering 2. 8.. 8. Scanning Range 29 48 Start End s: Pause. Amf Agent Correct Contrast S/I R/L A/P L4.8 L4.8 A.9 S64.2 A.9 S64.2 ml Cardiac s 2 Table Delta. Fig 8.28 for Aortic Valve X Erase Selected Reset Center Loc Ref Lines Erase All Fallback to SO Report Cursor Update All Keep W/L 2. Display Normal Reverse Order 2 ZOOM Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique :. Localized image, Accel. Bar: Fat Fat Classic SPECIAL. 6.. Cardiac/Resp Numbe of Radial s Water Shime Vol Hide Shim Shim : Freq DIR: S/I Locs Before Pause: TR: Minimum TR:.6 2 Radial Partial Radial CW CCW Start: End: L2.2 L.4 A294 A29.4 S69. S76. s

9 Fig 8.29 Aortic Valve! Step 4: Right Ventricular Outflow Tract Copy and Paste Aortic Valve on the Rx Manager, click View Edit and then set the parameters (Fig 8.). Go to, click Select Series, plane loc, and then click Ok. Prescribe a slice bisecting the main pulmonary artery on the coronal view (Fig 8.). Set shim vol to 2. Click Save Series, Download, Prep Scan, give instructions for breath holding, then Scan. Accession Number Information s Site Position Supine Fig 8. Right Ventricular Outflow Tract Sequence Parameter ID Name Head Neck/Cervical Entry Coil Feet First 8CARDIAC Auto Start Chest Thoracic Upper Extremities Series Description RIGHT VENTRICULAR OUTFLOW TRACT Abodomen/Lumbar Pelvis LowerExtremities Other Plane Pulse Seq Imaging Options Oblique Fiesta Gat, Seq, Fast Grad 2D Psd Name Full Info HIS/RIS TE(s) per scan TE Scan Timing Additional Parameters Aquisition Timing Minimum. 2... Graphic RX OFF Image Enhance Users CVs Screen Freq NEX 256 92. Freq DIR Flow Comp Shim S/I Auto TE2 TR Inv. Time TI2 Flip Angle Echo Train Length Bandwidth Bandwidth2 6 25....2 5. 5 4 9 62.5 2.. 2. Gating/ Triggering 2. 8.. 8. Scanning Range 25 48 Start End s: Pause. Amf Agent Correct Contrast S/I R/L A/P R6. R6. A2.6 S44.2 A2.6 S44.2 ml Cardiac s 2 Table Delta.

2 2 Fig 8. for Right Ventricular Outflow Tract X Erase Selected Erase All Reset Center Loc Ref Lines Update All. Display Normal Fallback to SO Report Cursor Keep W/L Reverse Order ZOOM 2 Copy Rx... Select Series Select image... * SAT Scan Plane: Oblique :. Localized image, Accel. Bar: Fat Fat Classic SPECIAL.9 6.. Cardiac/Resp Numbe of Radial s Water Shime Vol Hide Shim Shim : 4 Freq DIR: S/I Locs Before Pause: TR: Minimum TR:.6 Radial Partial Radial CW CCW Start: End: L4.5 L2.6 A. A. S8. S9.4 s 2 Fig 8.2 Right Ventricular Outflow Tract! Step 5: Clean up