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Last Updated: 1/4/2002
Only done on the Symphony system.
Consent for viability study (only if referred for equivocal
nuclear medicine scan).
EKG leads. Make sure you get a good tracing before you
start with HIGH POSITIVE R PEAKS.
Right sided IV.
Coils: phased array over chest.
All patients get NC O2.
25-30 cc Gadolinium contrast (*).
Use more if the patient is obese.
Do entire study at end-expiration, if you think patient
can do it; else do entire study at end-inspiration
Follow specific research protocol sheet to run the case.
| Sequence |
Plane |
Comment |
Film # |
| Scout |
|
|
0 |
| True Fisp |
|
3 Plane TrueFISP scout (BH) |
0 |
| DB HASTE |
AX |
20 slices (BH) |
2 |
| Scouts: 2 Chamber, 4 chamber and
short axis |
|
One slice each (BH) |
0 |
| Perfusion |
Short Axis |
SET UP: History to short axis scout,
center in mid LV
Use perfusion Fisp, 6 slices, 8mm, distance factor of 25%
Change acq window to 10% less than 2 RR (1400-1600 ms)
Run 5 test measures first (BH) |
0 |
| Inject 25- 30 cc gad |
|
|
0 |
| Perfusion |
Short Axis |
8 second scan delay, 30 measures
(BH as long as possible) |
0 |
| 9-slice fisp |
Short axis |
History to perfusion, center in
mid LV
Change acq window to 10% less than 1 RR (600-900 ms) |
0 |
| CINES: 4 chamber, 2 chamber and
short axis |
4 chamber |
True FISP cine with 3 slices per
BH
8mm 0.25 distance factor; Slice posn shift 30 mm/3 short axis |
2 (1/ slice pos) |
| Flow Quant |
Obl Ax |
Aortic root (perpendicular to flow),
Set acq window
Venc 250 (unless patient has AS, then use Venc 500) |
0 |
| TI mapping |
Short ax |
Choose TT, nulled myocard (acq
window 10% less than 1 RR) |
|
| Viability |
All planes |
3 slices/BH, set inversion time
according to T1 mapping
History to 4 chamber, 2 chamber and short axis cines
Set acq window to 10% less than 1 RR |
2 |
| Viability |
Short Axis 3D |
History to central slice of short
axis slices, BIGGER FOV
Set acq window; Set inversion time according to T1 mapping |
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Helpful hints:
- 2 chamber-use 4 chamber and coronal as scouts
- Short Axis-use 2-chamber and axial as scouts
- 4 chamber-short axis and 2 chamber scout
- For all cardiac sequences, must set acquisition window
(typically 10-15% less than 1 RR interval (one heart beat), typically
600-900 ms!!!!!!
(*) The use of gadolinium contrast material for these
applications represents off-label usage in the U.S. Outside the U.S.,
please consult your country's regulations for local guidelines.
NOTE: These protocols apply to Siemens
Symphony (with Quantum gradients) and Sonata systems. While they reflect
the protocols used at NYU Medical Center, NYU is not responsible for their
application elsewhere.
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