Imaging sequences for first pass perfusion - A review

Myocardial perfusion imaging sequences and analysis techniques continue to improve. We review the state-of-the-art in cardiovascular magnetic resonance first pass perfusion pulse sequences including the application of parallel imaging. There are a wide range of sequence designs and parameters to consider when optimizing an acquisition protocol. The interdependence of these parameters forces the user to make compromises. We describe the technical issues and provide insights into the various performance tradeoffs. We also review the basic design for T1-weighted first pass myocardial perfusion imaging and go on to discuss the tradeoffs associated with various schemes to provide multi-slice coverage. Artifact mechanisms are discussed and related to sequence design and parameters. The selection of quantitative versus qualitative analysis affects various performance requirements, such as spatial and temporal resolution and linearity of enhancement. Understanding the interaction between the pulse sequence parameters and resulting image quality is important for improving myocardial perfusion imaging.