Advanced Cardiac Imaging: Cardiac Magnetic Resonance (CMR) Course

Lesson 1 • Contrast Agents in CMR

Reviews gadolinium-based contrast agent pharmacokinetics and tissue distribution. Provides the pharmacological foundation for late gadolinium enhancement and perfusion imaging.

Lesson 2 • Cardiac-Specific MRI Challenges

Addresses motion from cardiac contraction and respiration as primary image quality threats. Introduces gating and triggering strategies used throughout CMR protocols.

Lesson 3 • MRI Signal and Tissue Contrast

Covers proton spin behaviour, T1/T2/T2* relaxation, and how tissue properties determine contrast. Establishes the physical basis for all subsequent CMR sequence design.

Lesson 4 • K-Space and Image Reconstruction

Explains k-space filling strategies and Fourier transform reconstruction. Links raw data acquisition to final image quality and artifact patterns.

Lesson 1 • Standard CMR Protocol Design

Presents evidence-based protocol structures for common clinical indications. Learners match protocol components to diagnostic questions efficiently.

Lesson 2 • Localizer and Scout Imaging

Teaches rapid localizer acquisition and cardiac axis identification from scout images. Accurate axis planning is essential for reproducible standard cardiac views.

Lesson 3 • Breath-Hold Instruction and Compliance

Trains techniques for coaching patients through breath-holds and managing non-compliance. Directly impacts image quality in all breath-held CMR sequences.

Lesson 4 • Patient Screening and Safety

Covers implant compatibility screening, contraindication assessment, and emergency procedures. Ensures safe patient management before and during every CMR study.

Lesson 1 • Aortic and Pericardial Imaging Planes

Presents oblique sagittal aortic views and pericardial assessment planes. Completes the anatomical survey required for comprehensive CMR reporting.

Lesson 2 • Short-Axis Stack Acquisition

Covers complete short-axis stack planning from base to apex for volumetric analysis. The short-axis stack is the cornerstone of CMR ventricular quantification.

Lesson 3 • Standard Long-Axis Views

Teaches acquisition and interpretation of two-chamber, three-chamber, and four-chamber views. These planes are the primary reference for ventricular and valvular assessment.

Lesson 4 • Right Heart and Outflow Tract Views

Addresses RVOT, pulmonary valve, and right heart-specific imaging planes. Essential for congenital and pulmonary hypertension evaluations.

Lesson 1 • Cine SSFP Sequence Optimisation

Details steady-state free precession sequence parameters and optimisation strategies. SSFP cine is the reference standard for CMR functional assessment.

Lesson 2 • Regional Wall Motion Assessment

Covers visual and quantitative methods for segmental wall motion scoring. Integrates with ischaemia and cardiomyopathy evaluation in later chapters.

Lesson 3 • Endocardial and Epicardial Contouring

Teaches manual and semi-automated contouring rules for both ventricles across the cardiac cycle. Consistent contouring methodology is critical for measurement reproducibility.

Lesson 4 • Sources of Measurement Variability

Identifies inter- and intra-observer variability sources and mitigation strategies. Reproducibility knowledge is essential for serial patient monitoring.

Lesson 1 • Artifacts and Pitfalls in Tissue Imaging

Identifies common artifacts in LGE and mapping sequences and their diagnostic mimics. Artifact recognition prevents misdiagnosis in tissue characterisation studies.

Lesson 2 • Integrated Tissue Characterisation Approach

Combines LGE, T1, T2, and T2* findings into a unified diagnostic framework. Learners apply the Lake Louise Criteria and cardiomyopathy tissue signatures.

Lesson 3 • Late Gadolinium Enhancement Imaging

Covers inversion recovery sequence design, TI scout optimisation, and LGE pattern recognition. LGE is the reference standard for myocardial fibrosis and scar detection.

Lesson 4 • T2 and T2* Mapping for Oedema and Iron

Addresses T2 mapping for myocardial oedema and T2* mapping for iron quantification. Provides quantitative tools for myocarditis and haemosiderosis assessment.

Lesson 1 • Visual and Quantitative Perfusion Analysis

Teaches visual perfusion scoring and semi-quantitative signal intensity analysis. Quantitative perfusion reserve provides objective ischaemia thresholds.

Lesson 2 • First-Pass Perfusion Sequence Design

Covers saturation recovery gradient echo and EPI perfusion sequences and their trade-offs. Sequence design determines spatial coverage and artifact susceptibility.

Lesson 3 • Dobutamine Stress Wall Motion CMR

Addresses high-dose dobutamine cine protocol for inducible wall motion abnormalities. Provides an alternative ischaemia test when vasodilator stress is contraindicated.

Lesson 4 • Integrating Perfusion with LGE Findings

Combines stress perfusion defects with LGE scar maps to distinguish ischaemia from infarction. This integration guides revascularisation decision-making.

Lesson 1 • Phase-Contrast Flow Quantification Principles

Explains velocity encoding, VENC selection, and phase-contrast sequence design. Accurate VENC selection is fundamental to artifact-free flow measurement.

Lesson 2 • 4D Flow CMR Fundamentals

Introduces three-directional velocity encoding and haemodynamic visualisation techniques. 4D flow extends conventional phase-contrast to complex flow pattern analysis.

Lesson 3 • Aortic and Pulmonary Flow Measurement

Covers aortic and pulmonary artery flow plane prescription and net forward volume calculation. Enables Qp:Qs shunt ratio quantification for congenital disease.

Lesson 4 • Mitral and Tricuspid Valve Assessment

Teaches indirect mitral regurgitation quantification and tricuspid regurgitation assessment. Indirect methods using stroke volume differences complement direct flow measurements.

Lesson 1 • Ischaemic Heart Disease CMR Protocol

Structures the complete ischaemia CMR study from stress perfusion through LGE viability assessment. Provides a systematic workflow for coronary artery disease evaluation.

Lesson 2 • Structured CMR Reporting Standards

Teaches structured report components, quantitative measurement tables, and clinical impression writing. Standardised reporting ensures actionable communication with referring clinicians.

Lesson 3 • Cardiac Masses and Thrombus

Covers tissue characterisation of benign and malignant cardiac masses and thrombus detection. CMR multi-contrast approach differentiates tumour from thrombus reliably.

Lesson 4 • Myocarditis and Inflammatory Disease

Applies Lake Louise Criteria and updated parametric mapping to myocarditis diagnosis. Covers pericarditis, sarcoidosis, and systemic inflammatory disease patterns.