cmr⁴² is a vendor-independent workstation solution for comprehensive evaluation of Cardiovascular MR (CMR) images. It is designed to be used in clinical settings as well as for experimental and clinical research.

cmr⁴² has full functionality for viewing and simple measurements, but is mostly focused on tools needed for clinical CMR, including short axis and long axis ventricular function analysis, myocardial tissue characterization, dynamic signal intensity analysis and evaluation of velocity encoded images. The tools have been developed by very experienced CMR readers and are optimized for clinical workflow. Its intuitive graphical user interface with multi-cine display capabilities facilitate a fast and efficient quantitative evaluation of CMR studies. The program framework is designed for the fast integration of new approaches for quantitative analysis in CMR (and potentially other fields of medical MRI).

cmr⁴² provides full DICOM connectivity and therefore can be used as a standalone application with easy integration into existing network environments including Picture Archiving and Communication Systems (PACS), which are widely used in hospitals.

Analyze flow and flow velocity including peak jet flow analysis and automatic pressure gradient calculation.

• Evaluate flow velocity-encoded images.
• Displays synchronized phase and magnitude image.
• Provides up to four regions of interest, with synchronized contours.
• Calculates and displays quantitative in an interactive diagram.
• Offers baseline correction.
• Offers automatic contour detection and forwarding.
• Automatically displays maximum and minimum velocities; option to defining the number of pixels used for calculation.
• Displays velocity values as a color-coded overlay in the magnitude image

Analyze LV function faster and better in long axis or short axis views with contour detection and reference windows.

All modules provide enhanced display functionality for additional visual assessment (i.e. synchronized cine display, synchronized zoom, slider for browsing the phases). Contours can be drawn manually or via semi-automatic contour detection.

Short axis image stack (3D) function analysis

• This module uses a contiguous stack of short axis cine slices.
• A reference view for viewing the slice positions with a perpendicular (long axis) slice is automatically displayed.
• Thumbnails of all images of the whole set used for the evaluation are displayed.
• This module also provides contour definition tools for the right ventricular borders.

Biplanar and Triplanar long axis function analysis

• Slices in a 2-chamber view and a 4-chamber view are used to calculate left ventricular volumes, function and mass with the standard area-length method.
• A short axis slice is added for the triplanar model.

Multiple Long - Radial long axis function analysis

• The module uses a set of 3 or more long-axis cines with radial orientation around a central rotational axis (anatomical long axis of the heart).
• The module additionally provides a reference-window to control the current slice position in a reference slice (e.g. in a short-axis cine image).

Discover the heart of the matter. Use the preview window to see all sequences on a glance and use the mouse over action including cine-preview.

• Display all series of a particular study;
• Apply filters for specific slice orientations;
• Select series for case review discussions;
• Present a selection in a slide show mode.

Quantify myocardial scar and edema using our integrated semi-automatic algorithms with modifiable thresholds.

Late Gadolinium Enhancement Module*

• Quantitative evaluation of late enhancement images for assessment of fibrosis.
• Threshold-based color-coded display of signal intensity values.
• Calculation of absolute volume (in ml), absolute mass (in grams) and relative proportion of abnormal myocardium (as % of total LV mass)
• Evaluation of “no-reflow” areas.
• Automatic contour-forwarding to other images.

Early Enhancement Module*

• Calculation of normalized contrast enhancement and signal intensity ratios between different tissues such as myocardium and skeletal muscle (early Gadolinium enhancement).
• Automatic forwarding of contours to the corresponding pre- or post-contrast slice.

* The Tissue Characterization Module is not available in the USA since the use of contrast agents for Cardiac MR procedures is not FDA-approved. A non-diagnostic version of cmr⁴², intended to be used only for scientific research, is available on request.