Advertisement

Cardiac magnetic resonance imaging and its electrocardiographs (ECG): tips and tricks

  • Marcelo Souto Nacif
  • Anna Zavodni
  • Nadine Kawel
  • Eui-Young Choi
  • João A. C. Lima
  • David A. Bluemke
Original Paper

Abstract

All cardiac magnetic resonance (CMR) techniques aim to create still depictions of a dynamic and ever-adapting organ. Most CMR methods rely on cardiac gating to capture information during fleeting periods of relative cardiac quiescence, at end diastole or end systole, or to acquire partial images throughout the cardiac cycle and average these signals over several heart beats. Since the inception of clinical CMR in the early 1980s, priority has been given to improving methods for image gating. The aim of this work is to provide a basic understanding of the ECG acquisition, demonstrate common ECG-related artifacts and to provide practical methods for overcoming these issues. Meticulous ECG preparation is essential for optimal CMR acquisition and these techniques must be adaptable to the individual patient.

Keywords

Magnetic resonance imaging ECG Trigger 

Notes

Acknowledgments

Funded by the National Institutes of Health (NIH) Intramural program.

Conflict of Interest

The authors declare that they have no competing interests.

References

  1. 1.
    Lanzer P, Botvinick EH, Schiller NB et al (1984) Cardiac imaging using gated magnetic resonance. Radiology 150:121–127PubMedGoogle Scholar
  2. 2.
    Amoore JN, Ridgway JP (1989) A system for cardiac and respiratory gating of a magnetic resonance imager. Clin Phys Physiol Meas 10:283–286PubMedCrossRefGoogle Scholar
  3. 3.
    McNamara MT, Higgins CB (1984) Cardiovascular applications of magnetic resonance imaging. Magn Reson Imaging 2:167–183PubMedCrossRefGoogle Scholar
  4. 4.
    Osbakken M, Yuschok T (1986) Evaluation of ventricular function with gated cardiac magnetic resonance imaging. Cathet Cardiovasc Diagn 12:156–160PubMedGoogle Scholar
  5. 5.
    Stark DD, Higgins CB, Lanzer P et al (1984) Magnetic resonance imaging of the pericardium: normal and pathologic findings. Radiology 150:469–474PubMedGoogle Scholar
  6. 6.
    Brau AC, Wheeler CT, Hedlund LW, Johnson GA (2002) Fiber-optic stethoscope: a cardiac monitoring and gating system for magnetic resonance microscopy. Magn Reson Med 47:314–321PubMedCrossRefGoogle Scholar
  7. 7.
    Dimick RN, Hedlund LW, Herfkens RJ, Fram EK, Utz J (1987) Optimizing electrocardiograph electrode placement for cardiac-gated magnetic resonance imaging. Invest Radiol 22:17–22PubMedCrossRefGoogle Scholar
  8. 8.
    Dinsmore RE (1987) Quantitation of cardiac dimensions from ECG-synchronized MRI studies. Cardiovasc Intervent Radiol 10:356–364PubMedCrossRefGoogle Scholar
  9. 9.
    Laudon MK, Webster JG, Frayne R, Grist TM (1998) Minimizing interference from magnetic resonance imagers during electrocardiography. IEEE Trans Biomed Eng 45:160–164PubMedCrossRefGoogle Scholar
  10. 10.
    Park H, Park Y, Cho S, Jang B, Lee K (2009) New cardiac MRI gating method using event-synchronous adaptive digital filter. Ann Biomed Eng 37:2170–2187PubMedCrossRefGoogle Scholar
  11. 11.
    Shetty AN (1988) Suppression of radiofrequency interference in cardiac gated MRI: a simple design. Magn Reson Med 8:84–88PubMedCrossRefGoogle Scholar
  12. 12.
    Amparo EG, Higgins CB, Farmer D, Gamsu G, McNamara M (1984) Gated MRI of cardiac and paracardiac masses: initial experience. AJR Am J Roentgenol 143:1151–1156PubMedGoogle Scholar
  13. 13.
    Yamamura J, Frisch M, Ecker H et al (2010) Self-gating MR imaging of the fetal heart: comparison with real cardiac triggering. Eur Radiol 21:142–149PubMedCrossRefGoogle Scholar
  14. 14.
    Chia JM, Fischer SE, Wickline SA, Lorenz CH (2000) Performance of QRS detection for cardiac magnetic resonance imaging with a novel vectorcardiographic triggering method. J Magn Reson Imaging 12:678–688PubMedCrossRefGoogle Scholar
  15. 15.
    Finn JP, Nael K, Deshpande V, Ratib O, Laub G (2006) Cardiac MR imaging: state of the technology. Radiology 241:338–354PubMedCrossRefGoogle Scholar
  16. 16.
    Gatehouse PD, Firmin DN (2000) The cardiovascular magnetic resonance machine: hardware and software requirements. Herz 25:317–330PubMedCrossRefGoogle Scholar
  17. 17.
    Wendt RE III, Rokey R, Vick GW III, Johnston DL (1988) Electrocardiographic gating and monitoring in NMR imaging. Magn Reson Imaging 6:89–95PubMedCrossRefGoogle Scholar
  18. 18.
    Becker M, Frauenrath T, Hezel F et al (2010) Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T. Eur Radiol 20:1344–1355PubMedCrossRefGoogle Scholar
  19. 19.
    Larson AC, White RD, Laub G, McVeigh ER, Li D, Simonetti OP (2004) Self-gated cardiac cine MRI. Magn Reson Med 51:93–102PubMedCrossRefGoogle Scholar
  20. 20.
    Odille F, Uribe S, Batchelor PG, Prieto C, Schaeffter T, Atkinson D (2010) Model-based reconstruction for cardiac cine MRI without ECG or breath holding. Magn Reson Med 63:1247–1257PubMedCrossRefGoogle Scholar
  21. 21.
    Ridgway JP (2010) Cardiac magnetic resonance physics for clinicians: part I. J Cardiovasc Magn Reson 12:71PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. (Outside the USA) 2011

Authors and Affiliations

  • Marcelo Souto Nacif
    • 1
    • 2
    • 3
  • Anna Zavodni
    • 1
  • Nadine Kawel
    • 1
  • Eui-Young Choi
    • 2
  • João A. C. Lima
    • 2
  • David A. Bluemke
    • 1
    • 4
  1. 1.Radiology and Imaging SciencesNational Institutes of Health Clinical CenterBethesdaUSA
  2. 2.Division of CardiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Radiology DepartmentUniversidade Federal FluminenseNiteróiBrazil
  4. 4.National Institute of Biomedical Imaging and BioengineeringBethesdaUSA

Personalised recommendations