Magnetic resonance imaging for ischemic heart disease

Abstract

Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.

Feasibility of perfusion cardiovascular magnetic resonance in paediatric patients

“…The clinical impact of perfusion CMR as a non-invasive technique for the assessment of ischemic heart disease is rapidly increasing [10]. In children CAD is much less frequent than in adults and mainly related to congenital heart defects and their surgical repair, or to inflammatory disease affecting the coronary arteries.…”

Myocardial infarction quantification with Manganese‐Enhanced MRI (MEMRI) in mice using a 3T clinical scanner

“…In cardiac magnetic resonance imaging (MRI), extracellular contrast agents such as various gadolinium (Gd 3þ ) chelates, are now routinely used in clinical practice, as well as in research protocols to assess myocardial perfusion or interstitial space remodeling (1)(2)(3). Intracellular MR contrast agents can provide additional information on the cellular metabolism.…”

Advanced Noninvasive Cardiac Imaging using Cardiac Magnetic Resonance Imaging in the Diagnosis and Evaluation of Coronary Artery Disease

“…Since myocardial perfusion MRI has a high spatial resolution, it provides more accurate evaluation of myocardial ischemia, allowing detection of subendocardial ischemia in patients with mild-to-moderate CAD (15), as well as detection of diffuse subendocardial ischemia in patients with multivessel disease (balanced ischemia) (16), which might be missed by SPECT. Previous multicenter, multivendor head-to-head comparison trials have suggested that perfusion MRI is a valuable alternative to SPECT for the detection of significant anatomic CAD, with superior diagnostic performance, especially in multivessel disease (17)(18)(19).…”