Patient Prep Checklist

1. Upon arrival, the patient completes all necessary paperwork including the MRI screening form and any relevant consent forms.
2. A staff member (typically the MRI technologist or nurse) interviews the patient to ensure preparation instructions were followed and to check for MRI contraindications.
3. The patient changes into a hospital gown and is encouraged to use the restroom.
4. The patient’s chest is prepped for ECG electrode placement. For best electrode contact, it is important to apply an abrasive gel to the skin and shave chest hair, if necessary. For those who are less experienced, an impedance meter may be used to check electrode contact. (It should be less then 20K outside of the magnet.)
5. Place an intravenous catheter if the study is to be done with contrast. A second intravenous catheter, preferably in the other upper extremity, may be required for adenosine stress perfusion imaging.
6. The MRI technologist or nurse explains the cardiac MRI procedure to the patient, including breath hold instructions.
7. After the patient is positioned supine on the MRI table, the ECG leads are connected to the electrodes, the respiratory bellows is secured around the patient’s waist, and the appropriate imaging array (coil) is applied.
8. Optional additional monitoring equipment are applied (e.g. pulse oximeter, blood pressure cuff, etc).
9. Provide the patient with hearing protection such as earplugs or headphones.
10. Make the patient as comfortable as possible by using a cushion under their legs. Leave the patient’s arms by his sides.
11. The ECG signal should be evaluated prior to sliding the patient into the bore. If the signal is not robust then consider repositioning the electrodes or switch to peripheral gating using the pulse oximeter.
12. Remind the patient on the importance of following the breath holding instructions.
13. Move the patient into the magnet and landmark in the mid chest.
14. Check the ECG triggering on the scanner console. If the triggering is not excellent, consider repositioning the electrodes or switching to peripheral gating.
15. Begin the cardiac MRI exam with the proper localizer.

For greatest efficiency, steps 1-6 may be performed outside of the MRI scan room.