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Updated: Sep 27, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Magnetic resonance coronary angiography in the era of multimodality imaging
E Androulakis1, R Mohiaddin2, K Bratis3
1CMR Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Insights
Cardiovascular magnetic resonance (CMR) offers comprehensive, non-invasive assessment of heart function and tissue properties. Ongoing research aims to establish CMR as a robust, routine technique for cardiovascular disease diagnosis in adults.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
Background:
- Cardiovascular magnetic resonance (CMR) is the gold standard for non-invasive ventricular dimension and ejection fraction measurement.
- CMR provides comprehensive assessment of myocardial tissue properties and stress perfusion in a single examination.
- CMR is established for pediatric coronary assessment, particularly in congenital heart disease and vasculitis like Kawasaki disease.
Purpose of the Study:
- To review current clinical applications of magnetic resonance coronary imaging in adult and pediatric populations.
- To discuss ongoing research and future developments in CMR for cardiovascular disease.
- To highlight CMR's potential as a safe, non-radiating alternative to computed tomography coronary angiography.
Main Methods:
- Review of current clinical applications of magnetic resonance coronary imaging.
- Discussion of established imaging techniques and ongoing research.
- Focus on technical challenges and sequence development in CMR.
Main Results:
- CMR is a safe, non-radiating technique with established roles in pediatric cardiology.
- Significant progress is being made in CMR sequence development and overcoming technical challenges.
- Wider clinical implementation as an alternative to computed tomography coronary angiography is still under development.
Conclusions:
- CMR offers a comprehensive, non-invasive approach to cardiovascular assessment.
- Further development is needed to establish CMR as a routine clinical tool for cardiovascular disease, especially in adults.
- CMR holds significant promise for future cardiovascular imaging applications.
Abstract:
Cardiovascular magnetic resonance is currently the reference standard for non-invasive measurements of ventricular dimensions and ejection fraction, and may offer a comprehensive assessment of all myocardial tissue properties (including oedema, fibrosis, fat, iron, and protein deposition), as well as of stress perfusion, conveniently as part of a single examination. It also has a well-established role for coronary assessment in paediatric patients, especially with congenital heart disease and vasculitides, such as Kawasaki disease, and it should be considered as a first-line technique in these cases. Despite being recognised as a safe, non-radiating, and non-contrast technique, it is yet to be implemented widely in clinical use as an efficient alternative to computed tomography coronary angiography. Currently impressive progress is being made in the development of sequences and overcoming technical challenges, which are thoroughly discussed in this article, while further development is required to convert this into a robust, non-invasive technique for routine clinical decision-making in cardiovascular disease, particularly in adult patients. In this review, we will summarise current clinical applications of magnetic resonance coronary imaging, both in adult and paediatric populations, with reference to currently established imaging techniques, focusing also on ongoing research and future development.
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