MRI - Cardiac MRI
Axial SSFP
2ch Cine SSFP
4ch Cine SSFP
3ch Cine SSFP
Short axis Cine SSFP
Short axis STIR
Short axis T1 mapping
Short axis Perfusion - stress
Short axis Cine SSFP - stress
Short axis Perfusion - rest
2ch IRGE
4ch IRGE
3ch IRGE
Short axis IRGE
Based on the cardiac MRI results what would be your further recommendations?
The patient will likely benefit from revascularization, especially since he has symptoms and good viability of the myocardium.
Heart rate: ~70 bpm at rest -> 90 bpm during stress perfusion after Adenosin 140 µg/kg/min
Image quality: mild to moderate respiratory artifacts, otherwise no limitations
Morphology and functional analysis (endo-volume):
LV-EDVI: 75 mL/m²
LV-ESVI: 38 mL/m²
LV-SVI: 37 mL/m²
LV-EF: 49%
cardiac output: 5.8 L/min
cardiac index: 2.6 L/min/m²
LV-ED wall mas index (without papillary muscles): 67 g/cm
septum and inferior wall thickness: 9 and 8 mm
Findings:
Mild hypokinesia in basal inferoseptal and inferior segments.
No evidence of focal myocardial oedema on STIR.
Mildly elevated T1 mapping values in septal and inferior segments (z-score: 2-3).
Small subendocardial perfusion defect under Adenosin stress in inferoseptal and inferior midventricular segments not visible during rest.
No intracavitary thrombi.
Impression:
Cardiac MRI findings are consistent with mild myocardial ischaemia in midventricular inferioseptal and inferior segments.
Norma viability of the myocardium. No signs of infarction or myocardial scar tissue.
Mildly elevated T1 mapping values possibly mild myocardial oedema.
Exam courtesy: Jeanette Moses & Tobias Jahn (medical imaging technologists)