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The use of magnetic resonance in myocardial ischaemia
Massimo De Filippo1, Jonathan J Sudberry, Daniele Borgia
1Section of Radiological Sciences, Department of Clinical Sciences, University of Parma, Parma Hospital, Parma, Italy. massimo.defilippo@unipr.it
Insights
Coronary artery disease (CAD) remains a leading cause of death, necessitating advanced noninvasive diagnostic imaging. While coronary angiography is the gold standard for lumen assessment, cardiac MRI offers comprehensive noninvasive evaluation of heart function and viability.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Cardiovascular diseases (CVDs), particularly coronary artery disease (CAD), are the leading causes of mortality in Europe and the US.
- Effective identification and management of cardiovascular risk factors are crucial but insufficient to curb mortality rates.
- There is a critical need for reliable, noninvasive diagnostic imaging methods for early detection of CAD.
Purpose of the Study:
- To highlight the importance of noninvasive diagnostic imaging for early coronary artery disease (CAD) detection.
- To compare the capabilities of current diagnostic tools for assessing cardiac ischemia.
- To evaluate the potential of Magnetic Resonance (MR) imaging in diagnosing CAD.
Main Methods:
- Review of current diagnostic standards for cardiac ischemia and coronary artery disease.
- Discussion of the role of coronary angiography as the gold standard for coronary lumen assessment.
- Exploration of the noninvasive capabilities of Magnetic Resonance (MR) imaging in cardiac assessment.
Main Results:
- Coronary angiography remains the gold standard for evaluating coronary arterial lumen, especially for smaller vessels and in the context of cardiac motion.
- Magnetic Resonance (MR) imaging is a noninvasive technique capable of providing precise global and regional cardiac function assessment.
- MR imaging can evaluate intra-cardiac flow, myocardial perfusion, and overall heart viability.
Conclusions:
- Despite the established role of coronary angiography, noninvasive methods like MR imaging are essential for comprehensive early CAD diagnosis.
- Cardiac MR imaging offers a noninvasive alternative for assessing myocardial function, perfusion, and viability, complementing traditional angiography.
- Advancements in noninvasive imaging are vital for improving the diagnosis and management of coronary artery disease.
Abstract:
Despite the efforts that have been made at an international level to identify and control cardiovascular risk factors, cardiopathies and, in particular, coronary artery disease (CAD), remain the principal cause of death in Europe and the United States. These data confirm the importance and necessity of noninvasive, reliable diagnostic imaging of early CAD. Coronary angiography is still the hinge, around which all instrumental and laboratory investigations turn, for cardiac ischaemia today. Indeed, it still holds the role of "gold standard" for the study of the coronary arterial lumina, particularly the smaller vessels due to their complex spatial geometry and because of cardiac motion. At present, with the exception of the study of the coronary arterial lumen, MR is a non-invasive examination, already capable of supplying precise global and regional function, the evaluation of the intra-cardiac flow, myocardial perfusion and the overall viability of the heart.
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