SPHP

Localizer

Axial bright blood chest

Axial dark blood chest

VIBE FS PRE

2 chamber CINE

Fake short axis CINE

4 chamber CINE STACK whole heart (0 spacing)

T1 without and with fat saturation

T2 double IR and triple IR

-- INJECT CONTRAST--

3 or 4 slice first pass perfusion through mass

VIBE FS POST

Short Axis Stack CINE through LV

3 chamber CINE

Aorta through plane Phase Contrast

TI scout

3D MDE Short Axis

3D MDE 4 chamber

MDE single shot SAS

MDE single shot 2 chamber

MDE single shot 4 chamber

MDE single shot 3 chamber

**optional MDE segmented

MDE with long TI (~800) through mass

IMPORTANT! Cardiac mass exams are tailored to the specific clinical question. 

Must find the actual mass first, then prepare planes through it.

Consider thin overlapping axial bright blood TrueFISP for localization especially if mass is small (2-3 mm slices, distance factor -50%)

4 chamber CINE STACK through the whole heart without spacing to localize the mass

Tissue characterization with T1 and T2 images, without and with fat saturation (prospectively triggered "capture")

Perfusion runs through the MASS, not LV myocardium

Can do 2 short axis, and 1 or 2 long axis.  Whatever best images the mass.

Have patient hold breath according to when perfusion of mass is expected. i.e. if RA mass, hold breath early

Delayed enhancement (MDE) through LV and mass

Delayed enhancement (MDE) through mass with long inversion time (TI 800-1000). 

* This allows all signal to recover and differentiates a true mass from thrombus

VIBE FS PRE and POST contrast