PEPconnect

MR Cardiovascular Anatomy and Localization Techniques

This Web Based Training will provide you with the background information you need to understand MR Cardiac anatomy, physiology, and localization of cardiac structures.

Course Objectives: By the end of this course you will be able to:
  • Identify the various structures of the heart
  • Describe the heart's role in blood circulation
  • Identify the right and left coronary arteries
  • Perform localization techniques to obtain different cardiac views
  • Identify the cardiac anatomy within a MR image
Learn @ Siemens ID:

This concludes the course MR Cardiovascular Anatomy and Localization Techniques.  You should now be able to: - Identify the various structures of the heart - Describe the heart's role in blood circulation - Identify the right and left coronary arteries - Perform localization techniques to obtain different cardiac views - Identify the cardiac anatomy within a MR image By the end of this course you will be able to: - Identify the various structures of the heart - Describe the heart's role in blood circulation - Identify the right and left coronary arteries - Perform localization techniques to obtain different cardiac views - Identify the cardiac anatomy within a MR image Slightly Left of Midline Halfway from Sternal Notch to Xiphoid Coronary arteries supply heart muscle with oxygen-rich blood: - Left Coronary Artery (LCA)      - Left Anterior Descending (LAD)      - Circumflex Artery (CX) - Right Coronary Artery (RCA) Anterior View of Coronary Arteries   Right Coronary Artery Left Coronary Artery Left Lateral View of Coronary Arteries   Right Coronary Artery Left Coronary Artery Chambers and Great Vessels Valves Coronary Arteries Aortic Outflow Cine Four Chamber Cardiac Localizers - Multi-Plane Localizer The lines below represent the axial slices required to capture a range of views of the heart as seen in the image on the right. Localization: - Parallel to ventricular septum in transverse view - Bisect longest dimension of left ventricle chamber - Use large Field of View to avoid wrap Localization: - Parallel to long axis in 2 chamber view - Bisect mitral valve and bisect apex - Use large Field of View to avoid phase wrap Localization: - Perpendicular to long axis on 2 and 4 chamber views - Adjust gap to cover from atria to apex - Use large Field of View to avoid phase wrap Localization: - Bisects LV apex and mitral valve in 4-chamber view - Through mid LV chamber in short axis view - Parallel to ventricular septum in both views - Use large Field of View to avoid phase wrap Localization: - Parallel to long axis in 2-chamber view, bisecting mitral valve and apex - Through mid LV chamber and RV apex (1) in mid axis view - Avoid LV outflow tract (2) in basal short axis view - Use large Field of View to avoid phase wrap Localization: - Parallel to long axis, bisecting mitral valve and apex - Bisect LV outflow tract (arrow) in basal short axis view - Use large Field of View to avoid phase wrap Localization: - Parallel to ventricular septum and bisect tricuspid (1) in 4-chamber view - Bisect RV outflow tract (2) and right atrium (3) in basal short axis views - Use large Field of View to avoid phase wrap Localization: - Slight oblique angle through pulmonary artery on transverse view (1) - Bisect pulmonic outflow tract on right ventricular inflow view (2) - Use large Field of View to avoid phase wrap Localization: - Bisect ascending aorta and aortic valve on 3-chamber view - Use large Field of View to avoid phase wrap   Localization for the Right Coronary Artery (RCA): - Acquire a stack of 2D axial localizers from a coronal localizer - Use 3-point tool (arrows) to create slab orientation along RCA from base to apex - Again use 3-point tool to fine tune the location of the slab - Resulting images should lay out RCA in-plane with Thin-MIP Localization for Left Anterior Descending Artery: Acquire a stack of 2D coronal localizers through aortic root Position axial oblique 3D slab along the LAD from its origin (arrow) toward apex Use 3-point tool (arrows) to identify the origin, mid, and distal points along LAD Resulting images should lay out LAD in-plane with Thin-MIP Cardiac Anatomy - Location - Pulmonary & Systemic Circulation - Gross Anatomy - Electro Physiology - Coronary Anatomy Aorta Left Atrium   Pulmonary Artery Left Ventricle Right Ventricle Right Atrium Pulmonary Circulation (Right Heart) Removes metabolic waste products from blood Reoxygenates blood Systemic Circulation (Left Heart) Delivers oxygen and nutrients to body     Lung Body Pulmonary Vein Aorta Pulmonary Artery Superior Vena Cava Inferior Vena Cava Pulmonary (Right Heart)   Systemic (Left Heart)   Left Atrium Left Ventricle Right Atrium Right Ventricle Superior vena cava Right pulmonary artery Pulmonary trunk Right atrium Right pulmonary veins Fossa ovalis Pectinate muscles Tricuspid valve Right ventricle Chordae tendineae Trabeculae carneae Inferior vena cava Aorta Left pulmonary artery Left atrium Left pulmonary veins Mitral (bicuspid) valve Aortic valve Pulmonary valve Left ventricle Papillary muscle Interventricular septum Epicardium Myocardium Endocardium Primary nerve fibers within heart that stimulate cardiac muscle: - SinoAtrial Node (SA) - AtrioVentricular Node (AV) - Bachmann’s Bundle - Right Bundle Branch - Left Bundle Branch   Bachmann's Bundle Left Bundle Branch Conduction Pathways Right Bundle Branch Atrioventricular (AV) Node Posterior Internodal Tract Middle Internodal Tract Anterior Internodal Tract Sinoatrial (SA) Node The Electrical System of the Heart Coronary arteries supply heart muscle with oxygen-rich blood: - Left Coronary Artery (LCA)      - Left Anterior Descending (LAD)      - Circumflex Artery (CX) - Right Coronary Artery (RCA)   1. Pulmonary trunk   2. Left coronary artery   3. Circumflex artery   4. Anterior interventricular artery   5. Great cardiac vein   6. Marginal artery   7. Small cardiac vein   8. Anterior cardiac veins   9. Atrial arteries 10. Right coronary artery 11. Ascending aorta 12. Aortic arch 13. Coronary sinus 14. Small cardiac vein 15. Right coronary artery 16. Marginal artery 17. Middle cardiac vein 18. Posterior cardiac veins 19. Posterior interventricular artery 20. Circumflex artery 21. Great cardiac vein   Right Ventricle Ventricular Septum Left Ventricle Papillary Muscles LV Outflow Tract Anterior Wall Left Ventricle Cavity Apex Left Atrium Mitral Valve Posterior Wall Right Ventricle Right Atrium Tricuspid Valve Atrial Septum Ventricular Septum Left Ventricle Mitral Valve Left Atrium Ascending Aorta Aortic Valve Cordae Tendonae Left Ventricle Left Atrium Mitral Valve Ascending Aorta Superior Vena Cava Right Atrium Tricuspid Valve Pulmonary Outflow Right Ventricle Posterior RV Wall Pulmonic Valve Right Ventricular Outflow Tract Aortic Arch Pulmonary Artery Left Ventricle Localization: - Position across aortic valve in left ventricular outflow tract and aortic views Open Closed Right Ventricle Tricuspid Valve Right Atrium Posterior Cusp Left Atrium Right Cusp RVOT Comissure Left Cusp Descending Aorta Localization: - Position across mitral valve in 2-chamber, 3-chamber and 4-chamber views Open Closed Pulmonic Valve Anterior Leaflet Right Atrium Inferior Vena Cava Comissure Posterior Leaflet Localization: - Position across tricuspid valve (arrows) in right ventricular inflow and 4–chamber views Open Closed Right Leaflet Tricuspid Valve Orifice Posterior Leaflet Mitral Valve Left Leaflet Localization: - Position across pulmonic valve (arrow) in right ventricular outflow tract view   Closed Open Ascending Aorta Right Atrium Left Atrium Pulmonic Valve Descending Aorta