Advances in clinical applications of cardiovascular magnetic resonance imaging

Abstract

Cardiovascular magnetic resonance (CMR) is an evolving technology with growing indications within the clinical cardiology setting. This review article summarises the current clinical applications of CMR. The focus is on the use of CMR in the diagnosis of coronary artery disease with summaries of validation literature in CMR viability, myocardial perfusion, and dobutamine CMR. Practical uses of CMR in non-coronary diseases are also discussed.

PET/MRI of Inflammation in Myocardial Infarction

“…Emerging hybrid PET/MRI has considerable potential for cardiovascular imaging because it combines PET, a highly sensitive and quantitative modality that can follow rare molecular events (8, 9), with MRI, which non-invasively assesses cardiovascular anatomy and function, infarct size, perfusion, myocardial strain and metabolism with excellent spatial and temporal resolution (10-14). Combining both modalities could enhance preclinical research by providing multidimensional “systems” data and is also likely to directly impact clinical imaging (15-17).…”

Assessing the Prognostic Value of Cardiovascular Imaging

“…Whereas several studies have examined the diagnostic accuracy of stress CMR, only recently have sufficient numbers of patients been collected to assess the prognostic value of this approach [1][2][3][4][5] (Table). 6 The validation of stress CMR is more complex than that of previous modalities, inasmuch as a routine study would include rest function and structure, stress perfusion, and viability images (as well as, potentially, rest perfusion). In this issue of Circulation, Steel and colleagues 5 report on the complementary prognostic values of stress myocardial perfusion and LGE imaging using stress perfusion CMR in 254 patients with known or suspected CAD who were followed up for a mean of 1.4 years.…”

Non-invasive imaging of microvascular damage

“…In fact, based on physical phenomenon of magnetic resonance and utilizing magnet 30 000-60 000 times the strength of the Earth's magnetic field, CMR detects the location and the physical properties of protons in the body, with high spatial and temporal resolution. 22 To generate adequate signals at CMR, magnetization is manipulated applying a brief radiofrequency pulse to flip the protons alignment in the transverse plane. Once the radiofrequency pulse is completed, protons return to their alignment and the rate at which the protons alignment recover determined the relaxation time (T1) of the tissue.…”