Cardiac MRI is a wonderful technology for assessing patients with heart disease. Most tests are performed in 30 minutes. MRI does not use ionizing radiation. Many studies don’t even require an injection. Others (such as perfusion and viability imaging) require a small injection of gadolinium contrast.
Listed below are several of the more common indications for cardiac MRI.
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Quantifying left and right ventricular function
• Heart failure
• Arrythmogenic right ventircular dysplasia (ARVD)
• Pulmonary hypertension
Defining cardiac anatomy
Myocardial Perfusion: for suspected ischemic heart disease (e.g. angina)
• Constrictive pericarditis
• Cardiac neoplasm or thrombus
• Congenital heart disease
• Demonstrating the presence of a patent foramen ovale (PFO)
Quantifying blood flow
• Valvular disease (e.g. aortic regurgitation, mitral regurgitation, aortic stenosis, etc.)
• Shunts: ASD, VSD, PAPVR, and PDA
Assessing myocardial scar / viability
• Identifying hibernating myocardium before revascularization
• Differentiating cardiomyopathy from old myocarditis
Coronary Artery MRA: for anomalous coronary arteries
Special consideration should be made for patients:
• That are poor echo candidates (e.g. bad echo windows)
• That are poor nuclear candidates (e.g. obesity, large breasts, small size / women).
• Where quantification is important
• Who want to avoid a more invasive test (e.g. TEE, cardiac catheterization)
• Who want one comprehensive test rather than multiple tests
Click here to see the 2006 ACC/ AHA / ACR Appropriateness Criteria for Cardiac MRI