Clinical use of cardiac magnetic resonance imaging

PURPOSE: To review the uses of cardiac magnetic resonance (CMR) imaging in the management of patients with heart disease. EPIDEMIOLOGY: CMR has applications in the evaluation of congenital heart defects, which are present in more than 1 million adults in the United States; cardiomyopathies, which account for approximately 20% of all sudden deaths in younger adults; and coronary artery disease, which is the single leading cause of death in the United States. REVIEW SUMMARY: The superior resolution of CMR provides detailed information about cardiac function, chamber volumes, myocardial mass, and valvular function. An additional important property of CMR is its usefulness for assessing the direction and velocity of blood flow. CMR has become the gold standard technique for use in evaluating right ventricular volumes, systolic function, and degree of pulmonary valve regurgitation in patients with tetralogy of Fallot. It also is used often to assess coarctation of the aorta. CMR has become an important component in determining appropriate intervention for atrial septal defects as well as to diagnose and monitor myocarditis, restrictive cardiomyopathy, and hypertrophic obstructive cardiomyopathy. Delayed gadolinium-hyperenhanced CMR images obtained soon after myocardial infarction can distinguish between reversible and irreversible myocardial dysfunction. TYPE OF AVAILABLE EVIDENCE: Prospective cohort studies, unstructured reviews. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: CMR is expected to make increasingly important contributions to the management of patients with cardiovascular defects and disease.

Duke Scholars

Author Anna Lisa Chamis Medicine, Cardiology

Author Raymond J. Kim Medicine, Cardiology