Magnetic resonance imaging and the future of cardiac imaging

Within the last 5 years, technology for cardiac imaging has improved spectacularly. The choices now include ultrasound with Doppler, single-photon emission computed tomography and positron emission tomography, cine computed tomography, biplane and digital subtraction angiography and magnetic resonance imaging (MRI). MRI is the most expensive noninvasive option, but also provides the best information on chamber size, wall motion, valvular function and great vessel blood flow. It is multiplanar and multiparametric; thus, nearly any clinical problem except detailed coronary anatomy can be addressed, but the very plethora of technical details is daunting. With contrast agents as indicators, relative tissue perfusion of any organ appears achievable, including regional perfusion of the myocardial wall. As patient acceptance is high, MRI may become a major cardiac imaging tool and occupy the central position between office ultrasound and invasive angiography.