Vanderbilt MRI Core Curriculum

Revised: 5/2010

Level 1:General training (1 month) should provide the cardiovascular trainee with a working knowledge of CMR methods and their diagnostic utility.

Level 2:Specialized training (at least 3 months) designed to provide the trainee in cardiovascular diseases withthe skills necessary to independently interpret CMR imaging studies.

Level 3:Advanced training is provided for those who ultimately wish to be responsible for the operation of aCMR laboratory. Level 3 criteria must include adequate levels of patient care, teaching, and research. (From Task Force 12 COCATS 3)

Technical / Reading / Interpretation
Level 1 /
  • Watch MRI safety video
  • Understand contraindications to MRI
  • Observe MRI techs perform different studies
  • Routine (cine, still-frame)
  • Contrast-enhanced
  • Stress
  • MRA
  • Basic Physics understanding
  • T1, T2,
  • source of artifacts (motion, arrhythmia, metal)
  • Basic post-processing
  • Biological effects
/
  • Identify typical cardiac structures in multiple views
  • Compare orientations with other modalities (ie echo).
  • Identify wall regions in multiple views
  • Understand standard views/protocols
  • Describe and identify normal chamber dimensions

Level 2 /
  • Understand the physics behind MRI imaging
  • Image formation (k-space, gradient echo, spin echo, fast spin echo, spiral, SSFP, parallel imaging)
  • Specialized imaging sequences including flow and motion, phase imaging, time of flight, contrast agents, MR tagging etc.
  • Hardware components including coil design, receiver coils and digital sampling.
  • Specific applications and indications
  • ECG and pulse gating
  • Respiratory motion suppression
  • Stress agents
  • Imaging of structure and tissue characterization (T1, T2, spin echo)
  • Flow imaging (velocity-encoded techniques)
  • Pharmacologic stress testing
  • Magnetic resonance angiography
/
  • Assess left ventricular function qualitatively
  • Identify native valve pathology
  • Quantify diastolic function
  • Assess stenotic severity of valve pathology
  • Assess regurgitant severity in valve disease
  • Interpret stress MRI
  • Assess myocardium in nonischemic and nonischemic cardiomyopathies
  • Identify functional abnormalities in pericardial disease
  • Evaluation of congenital heart disease

Level 3 /
  • Build upon the physics from Level 2
/
  • Advanced studies including spectroscopy with P31
  • Evaluation of complex congenital heart disease

MRICOCATS Requirements:

Total months Number Read

Level 1 1 50

Level 2 3 150

Level 3 12 300

Recommended Reading:

Cardiovascular MRI: Physical Principles to Practical Protocols by Vivian Lee, published by Lippincott Williams &Wilkins

Cardiovascular Magnetic Resonance by Manning and Pennell, published by Churchill Livingstone.

Cardiovascular MRI & MRA by Higgins and de Roos, published by Lippincott Williams & Wilkins

Handbook of Cardiovascular Magnetic Resonance Imaging edited by Pohost and Nayak, published by Informa

MRI Principles by Mitchell, published by Saunders

Question and Answers in Magnetic Resonance Imaging by Elster and Burdette, published by Mosby

CMR-SAP through the Cardiosource ACC website (all fellows have free access)

SCMR website

Articles and links provided on VUMC Knowledge Map

Cases/Teaching files
  • Cardiomyopathy
  • Amyloid
  • ARVD
  • Pericardial Disease
  • Valve
  • Aortic stenosis
  • Aortic insufficiency
  • Mitral stenosis
  • Mitral regurgitation
  • Congenital heart disease
  • Cardiac Tumors/Masses