Plane Selection in CMR

In Memory of Bill Woodward

Craig Broberg, MD

Oregon Health and Science University

Start with Axial Spin Echo Stack

Line up for Vertical Long Axis (VLA)

LA

RALV

RV

mitral valve

apex

Then Line up for short axis scout (SCOUT basal and mid)

Result: VLA

LA

LV

mitral valve

Note: Can be done as non-gated single-phase image (non-cine).

Result: Scout

Basal Mid

RV

Aorta

LV/mitral valve

RV

LV

RV

Scout (basal) VLA

Line up for left ventricular outflow tract (LVOT)

Aorta

LVRV LV

LA

Through maximum diameter of LVThrough apex

LVOT

Line up for Aortic Valve (AoV)

LA

Aorta

LV

RV

Note: plane should be perpendicular to LVOT

Align through center of Aortic valve

AoV

Line up for Four Chamber (4Ch)

VLA SCOUT (mid)

LA

LV

LVRV

Center of mitral valveMax diameter of RV and LV

4 Ch

LA

RA

LV

RV

Make sure both images are set at END Diastole

Line up for Short Axis Stack (SA)

VLA 4 Ch

LA

RA LV

RV

LA

LV

First slice should align with valves

SA (base to apex)

basal

mid

LV

RV

apical

Axial Spin Echo Stack

Line up for Right Ventricular Outflow Tract (RVOT)

LPARPA

MPA

View planes above and below

RVOT

Line up for Pulmonic Valve (PV)

MPA

RV

Pulmonic valve

PV

Pulmonic valve

MPA

RV

Line up for Right Pulmonary Artery (RPA)

Axial Spin Echo Stack

RPA

MPAAorta

RPA

LA

RPA

LV

MPA

Axial Spin Echo Stack

Line up for Left Pulmonary Artery (LPA)

LPA

MPAAorta

LPA

MPALPA

RPA LPA

Line up for Pulmonary Arteries (PAs)

MPARPALPA

MPA

Try to align through center of both RPA and LPA, though may not be possible

PAs

RPA

Aorta

LPA

MPA

4Ch SA (basal)

Line up for RV inflow-outflow (RV IN OUT)

RVOT

RV

RV/Tricuspid

RA

Pulmonic valve (“out”)

Tricuspid valve (“in”)

RV apex

Try to avoid LVOT/AoV here

RV IN OUT

RA

RV

MPA

Tricuspid valve

Pulmonic valve

Aorta

LVOT AOV

Line up for Aortic velocity map (AO FLOW)

RA

RV

Aorta

LV

Sinotubular junction

AO FLOW

RVOT MPA

Line up for pulmonary artery velocity map (PA FLOW)

RV

MPA RV

MPA

Stay above pulmonic valve

PA FLOW