How we scan cardiac anatomy and function using cardiovascular magnetic resonance: a practical video guide

Aims: Fast Strain-encoding (fSENC) is a pulse sequence that enables the acquisition of cardiovascular magnetic resonance images within a few heartbeats and at free breathing to quantify myocardial strain, a deformation parameter of the heart muscle. Strain is gaining importance in heart failure diagnostics, but implementing fast strain-encoding into a routine magnetic resonance protocol has not been thoroughly explored from a practical viewpoint. This video manuscript aims to provide a simple guide for the acquisition of cardiovascular magnetic resonance exams in cardiac patients and to determine the scan-rescan reproducibility of segmental strain analyses. Methods and results: A volunteer was scanned for demonstration purposes on a 1.5T MRI Scanner ('Ingenia, Philips Healthcare, Best, The Netherlands'). The acquisition of cine steady-state free precession (SSFP) and fSENC sequences is demonstrated in a step-by-step fashion, accompanied by a multilingual video tutorial and an image guide. Scan-rescan reproducibility of acquisition-based strain values was excellent between subsequent scans for segmental longitudinal (SLS) [0.93 (0.91-0.95) and circumferential strain (SCS) [0.78 (0.73-0.82) to 0.84 (0.80-0.87)], and good to excellent between scans that were interrupted by a break for SLS [0.80 (0.74-0.85) to 0.84 (0.79-0.87)] and SCS [0.57 (0.46-0.66) to 0.65 (0.56-0.77)]. Conclusion: This multilingual video manuscript provides a practical guide to conducting cardiovascular magnetic resonance exams including SSFP and fSENC, useful for further quantitative analysis to grasp heart function on a global and regional basis.