Clinical Cardiovascular Magnetic Resonance Imaging Techniques
Since the first dedicated cardiovascular magnetic resonance (CMR) clinical services opened in the mid-1990s, CMR imaging has become routine at most medical centers. In recent years, cross-institutional CMR protocols have become more consistent. This chapter focuses on the clinical CMR imaging techniques that we routinely use at our institution and are representative of most high-volume dedicated CMR clinical services. This includes cine imaging to examine contractile function, adenosine stress/rest perfusion imaging to examine coronary flow reserve, and late gadolinium enhancement to examine viability and infarction. Additionally, morphology, blood flow, and angiographic imaging have become more routine within the clinical environment. Through the years our philosophy has been to perform CMR as an “exam menu.” This has allowed us to streamline the clinical service and made it easier to teach CMR to cardiology fellows and trainees. The idea of the examination menu comes from the idea that most clinical CMR procedures can be performed simply by combining one or more items from a predefined menu in a simple consistent manner. Only rarely is it necessary to perform a scan not listed in this menu. This chapter focuses on providing the details of each item on the examination menu, with the emphasis on more practical information for performing these examinations to answer common diagnostic questions in cardiology such as detection of coronary artery disease, diagnosis of nonischemic cardiomyopathy, and the evaluation of aortic diseases.
