The Contribution of Cardiac Magnetic Resonance Imaging to the Diagnosis of Cardiac Diseases

Abstract

Background : Cardiac magnetic resonance imaging (MRI) has been established in clinical practice as a valid imaging modality for the diagnosis of various cardiovascular disorders. Objectives : To underline the importance of cardiac MRI as an alternative non - invasive imaging method for the diagnosis and follow-up of cardiac patients based on findings from our own recent experience. Patients and Methods : The study included all cardiac patients referred for cardiac MRI over a period of one year. Cardiac MRI studies were performed with the use of a 1.5-Tesla scanner using a body phased-array coil, breath and ECG-triggering. A lmost all cardiac sequences were gated to the patient’s cardiac cycle. Cine imaging for the evaluation of cardiac volumes and heart motion was performed using a cine breath-hold true short-axis and true four-chamber sequence with whole left ventricular coverage. Black blood imaging for the assessment of morphology was acquired on a true short-axis and true four-chamber view. Depending on the pathology under investigation, special sequences were added to the imaging protocol, such as late-enhancement imaging after gadolinium administration. Results: The study cohort comprised 114 patients who were referred for cardiac MRI with the following indications and clinical diagnoses: myocarditis (n=29), arrhythmogenic right ventricular cardiomyopathy (ARVC; n=27), valvular heart disease (n=23), history of myocardial infarction (n=13; seeking myocardial viability), hypertrophic (n=12), or dilated (n=2), or tako-tsubo (n=1), or non-compaction (n=2) cardiomyopathy, pericardial effusion (n=2) and various intracardiac masses (n=3). Cardiac MRI confirmed the clinical diagnosis and gave further specific information in 52% of myocarditis cases, in 37% of suspected ARVC cases, in 38% of coronary artery disease patients regarding myocardial viability, while it confirmed all other clinical diagnoses (100% match). Conclusions : Cardiac MRI represents a clinically useful imaging method for the diagnosis of various cardiac disorders since it has the capability of providing highly accurate and reproducible measurements of cardiac hemodynamics in addition to the detailed demonstration of cardiac anatomical structures.