Assessment of cardiac anatomy using nuclear magnetic resonance imaging

Nuclear magnetic resonance imaging has emerged in the past few years as a completely noninvasive method for medical imaging of internal organs. Because of the loss of signal intensity by motional nuclei (hydrogen) using most proton imaging techniques, flowing blood within the cardiovascular system generates little or no signal and consequently there is high natural contrast between blood and the walls of blood vessels or cardiac chambers. However, motion during imaging also complicates cardiac imaging because signal is lost from the nuclei in the moving cardiac structures. Consequently electrocardiographic gating of data acquisition is required for nuclear magnetic resonance imaging of the heart. Distinct advantages of nuclear magnetic resonance imaging in relation to other imaging modalities are good contrast between soft tissues and the capability for characterization of specific tissues by estimation of magnetic relaxation times. Early in vitro studies measuring relaxation times of myocardial tissue samples of excised hearts indicate that nuclear magnetic resonance imaging will be capable of discriminating infarcted from normal myocardium. Recent studies using electrocardiographically gated nuclear magnetic resonance imaging of dogs with acute infarction showed the infarct as a region of high intensity on spin-echo images. Initial clinical experience with electrocardiographically gated nuclear magnetic resonance imaging (0.35 tesla) in patients has clearly defined internal cardiac anatomy without the use of contrast media. This technique has demonstrated the consequence of previous myocardial infarction such as regional wall thinning, aneurysm, thrombus and contractile dysfunction, a number of pericardial abnormalities and the morphology of hypertrophic and congestive cardiomyopathies.