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These practice guidelines are recommended by the Asian Society of Cardiovascular Imaging (ASCI), the sole society in Asia designated for cardiovascular imaging, to provide a framework to healthcare providers for suggested essential elements in cardiac magnetic resonance (CMR) examinations of different disease spectra. The guideline is composed of recommendations on the general technique, acquisition of some basic modules, and protocols on stress tests. The protocols for specific diseases are provided in a table format for quick reference to be easily utilized for everyday clinical CMR.
As the healthcare system, resource allocation, and pattern of diseases [1, 2] in Asia are different from those in Western Society, this practice protocol is recommended by the Asian Society of Cardiovascular Imaging (ASCI), the sole society dedicated to cardiovascular imaging in Asia, to provide a frame work for the suggested essential elements in cardiac magnetic resonance (CMR) examinations.
It must be emphasized that this guideline has been built on previously published guidelines from various professional societies [3–6], but is customized for CMR practice in Asia with its unique characteristics and where thalassemia [7–9] and valvular heart disease are common. The ultimate decision regarding the propriety of any specific procedure must be made after mutual communication with the referring physicians; the understanding of individual patient’s condition; and the availability of resources, knowledge and technology provided by their respective centers by the responsible individuals participating and performing the CMR procedures.
The practice protocol starts with recommendations on the general technique and is followed by techniques on the acquisition of some basic modules. Recommended practice protocols on stress tests with separate checklists and monitoring sheets are provided. Protocols for specific diseases are summarized in a table format for quick reference.
See Fig. 1 for a quick reference on the acquisition of major imaging planes described below.
All scans are recommended to be performed as breathhold, multiphase steady state free precession (SSFP) imaging at the end of the expiratory phase using all elements on the cardiac coil. All 17 segments of the heart can be covered by a combination of three short axis and two long axis views (four chambers and two chambers). Scout imaging—multistack three plane localizers: transtransaxial, coronal, sagittal
RV short axis views are acquired in a similar fashion to the LV structure and function module. Use a transaxial stack of cines covering the RV for best identification of the tricuspid valve plane.
Low dose dobutamine infusion at 10 μg/kg for 5–10 min is an alternative to look for contractile reserve only.
The elements of the above practice guidelines recommended by ASCI are based on the currently available acquisition technology and knowledge on specific diseases. ASCI will continue to observe the field and provide the most up-to-date information to assist in the delivery of the best patient care (Table 1).
The working group would like to acknowledge Mr Lawrance Yip, the senior radiographer, Queen Mary Hospital, Hong Kong for the acquisition of images and Dr Stephen CW Cheung, the consultant radiologist, Queen Mary Hospital, Hong Kong for the contribution on the worksheets for stress studies.
Declaration The members of the working group have nothing to declare on the potential conflict of interest.
Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.