Table 2.

Strengths and weaknesses of standard CMR sequences

Sequence	Purpose	Strengths	Weaknesses
Breath hold balanced SSFP cine	Global regional myocardial function and wall thickness	High SNR (T2/T1) image contrast gives reliable blood: myocardium endocardial border definition based on long T2 of blood	Sensitive to field inhomogeneity (off- resonance banding artefact). Unreliable appearance. ECG-mistriggering/Poor breath hold
T2W-TSE with dark blood preparation and fat-suppression by STIR(short tau inversion recovery)	Oedema, Infiltration	Detection of myocardial fluid content by longer T2 relaxation time	Low SNR
			Incomplete blood suppression at endocardial boundary layer
			Unreliability due to diastolic cardiac motion ECG mistriggering
			Poor breathhold
Stress first-pass myocardial perfusion	Cardiomyopathy related perfusion defects/exclusion of concurrent epicardial coronary artery disease	Higher resolution than SPECT	Incomplete myocardial coverage
			“Dark-rim” artefact Cardiac motion during image
Early Gd enhancement (inversion-recovery spoiled gradient-echo	Microvascular obstruction Detection of intracardiac thrombus	High spatial resolution (compared to CMR perfusion)	Dependent on image timing after injection. ECG mistriggering
			Poor breath hold
Late Gd enhancement (inversion recovery spoiled gradient-echo)	Myocardial fibrosis	High T1 contrast of diseased myocardium	Image contrast depends on inversion time adjustment and Gad washout. Ghosting from long T1 fluids (can be suppressed).
			ECGmistriggering
			Poor breath-hold
Real-time or single-shot versions of many sequences above	As above	No breath-holding Tolerates ECG mistriggering	Coarser image resolution.
			Cardiac motion during image.