Table 1.

General information pertaining to the CMR report

	Recommended	Recommended if acquired/if present	Optional
Administrative	Site of service Scanner	N/A	Site ID Accreditation entity and status
Demographics	Unique patient ID Patient date of birth (DOB) or age in years Patient sex Reasons for limited examinations Summary of test findings Physician signature and date (electronic signature and date must be clearly labeled) Adequate description of test	Comparison with previous related studies	Patient Race/Ethnicity
Study referral data	Referring physician	N/A	Referring physician provider number Referring physician specialty
Scheduling and performance of study	Date of procedure Personnel involved in procedure	N/A	Time of procedure
Listing of sequences used	Black-blood Late gadolinium enhancement (LGE) Edema Cine Strain Perfusion Flow Iron MR angiography	N/A	N/A
History and risk factors	Height (in or cm) Weight (lb or kg) Body surface area (BSA) Heart rate (beats per min) Rhythm Blood pressure brachial or femoral (specify which) arterial cuff systolic and diastolic blood pressure (mmHg)	For studies using contrast agents, value and date of the most recent serum creatinine and estimated glomerular filtration rate (eGFR)	N/A
Non-imaging findings associated with examinations
Studies requiring 12-lead electrocardiogram	Interpretation Rhythm Ventricular rate Presence of Q-waves ST segment T-wave abnormalities	N/A	N/A
Tests incorporation stress testing	Heart rates and rhythm Oxygen saturation Maximum predicted heart rate response for age Each should be recorded during following points in time and more frequently as clinically indicated: at pre-test baseline, at each level of stress, after recovery	N/A	Systolic and diastolic blood pressures
Studies utilizing vasoactive or positive inotrope pharmacological cardioactive agents	Type of agent Quantity of agent Duration of agent Route of administration Associated medications and presence/absence of any side effects	N/A	N/A
Studies utilizing contrast agents	Type and name of contrast agent Volume of agent Route of administration Dosage of agent and presence/absence of any side effects	N/A	N/A
Studies utilizing sedation	General anesthesia Continuous display (hemodynamic or electric) Recording of heart rate and rhythm and/or blood pressure Type, volume, route of administration Any side effects Patient’s cardiovascular and pulmonary response Reason for administration	N/A	N/A
Reporting criteria for CMR examinations	Standardized report format agreed upon in facility Final report reviewed by interpreting member of medical staff Final interpretations verified and signed by medical staff (manual or electronic) within 2 business days of study for routine studies, but reported on the same day for patients referred for major acute issues Permanent record of interpretation Defined mechanism whereby results which demonstrate urgent or life-threatening findings are communicated to appropriate healthcare professionals	If preliminary reports are issued, preliminary nature must be indicated	N/A