Cardiovascular magnetic resonance imaging (CMR)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Eli V. Gelfand, M.D.[2]; Caitlin J. Harrigan [3]

Overview

• CMR-Related Definitions
• ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 Appropriateness Criteria for Cardiac Magnetic Resonance Imaging
• ACR Practice Guideline for the Performance and Interpretation of Cardiac Magnetic Resonance Imaging (MRI)
• Basic MRI Physics
• CMR Image Acquisition Protocols
• Standard Image Orientation
• Normal Cardiac Anatomy as Viewed by CMR
• Contrast CMR
• Cine CMR
• Myocardial Tagging
• Flow Quantification by CMR
• CMR in Valvular Heart Disease
• CMR in Dilated Cardiomyopathy and Hypertrophic cardiomyopathy

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

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CMR may be used for assessment of patients with LV dysfunction or hypertrophy or suspected forms of cardiac injury not related to ischemic heart disease. When the diagnosis is unclear, CMR may be considered to identify the etiology of cardiac dysfunction in patients presenting with heart failure, including evaluation of dilated cardiomyopathy in the setting of normal coronary arteries, patients with positive cardiac enzymes without obstructive atherosclerosis on angiography, patients suspected of amyloidosis or other infiltrative diseases, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, or syncope or ventricular arrhythmia.

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• CMR in Cardiac Masses
• CMR in Pericardial Disease
• CMR in Congenital Disease
• CMR in Athlete's Heart
• CMR in Cardiac Sarcoidosis
• CMR in Cardiac Amyloidosis
• CMR in Hemochromotosis
• Coronary MRI
• Peripheral Vascular MRA
• Atherosclerosis/Plaque Imaging with CMR
• CMR Risk Factors: NSF
• CMR in Heart failure

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

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CMR may be used for assessment of LV and RV size and morphology, systolic and diastolic function, and for characterizing myocardial tissue for the purpose of understanding the etiology of LV systolic or diastolic dysfunction. The writing committee recognizes the potential capabilities of spectroscopic techniques for acquiring metabolic information of the heart when evaluating individuals with heart failure.

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• CMR in Coronary artery disease

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

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CMR may be used for identifying coronary artery anomalies and aneurysms and for determining coronary artery patency. In specialized centers, CMR may be uniquely useful in identifying patients with multivessel coronary artery disease without exposure to ionizing radiation or iodinated contrast medium.

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• CMR in Ischemic heart disease

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

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The combination of CMR stress perfusion, function, and LGE allows the use of CMR as a primary form of testing for identifying patients with ischemic heart disease when there are resting ECG abnormalities or an inability to exercise, defining patients with large vessel coronary artery disease and its distribution who are candidates for interventional procedures, or determining patients who are appropriate candidates for interventional procedures. Assessment of LV wall motion after low-dose dobutamine in patients with resting akinetic LV wall segments is useful for identifying patients who will develop improvement in LV systolic function after coronary arterial revascularization. The writing committee recognizes the potential advantages of spectroscopic techniques for identifying early evidence of myocardial ischemia that may or may not be evident using existing non-CMR methods. Myocardial infarction/scar LGE-CMR may be used for identifying the extent and location of myocardial necrosis in individuals suspected of having or possessing chronic or acute ischemic heart disease.

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• CMR in Myocardial infarction

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

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LGE-CMR may be used for identifying the extent and location of myocardial necrosis in individuals suspected of having or possessing chronic or acute ischemic heart disease.

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