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Cardiac MRI: The Basics
Tobi Pledger, DVM, MS, RT (R)(MR)(CT)
Cardiovascular MRI Technologist, Duke Cardiovascular Magnetic Resonance Center, Duke University Hospital.
Address correspondence to: Tobi Pledger, Cardiovascular MRI Technologist, Duke University Hospital, 2301 Erwin Drive, Durham, NC 27710. E-mail: firstname.lastname@example.org
Disclosures: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.
Cardiac magnetic resonance imaging (MRI) has become the gold standard for assessing congenital heart disease, regional and global ventricular function, anatomy and function of heart valves, and myocardial infarction and viability. It also is becoming increasingly important for diagnosing heart disease, which is the leading cause of death in the United States. It provides diagnostic information that can complement ultrasound examination, and both modalities have the advantage of not employing ionizing radiation. Indications for physicians to order cardiac MRI examinations include coronary artery disease, cardiomyopathy, arrhythmias, congenital abnormalities, valve stenosis or regurgitation, and inflammatory and infiltrative heart disease. MRI technologists performing cardiac MRI need to be familiar with MRI physics, cardiac anatomy, and electrocardiographic gating. This article contains a brief review of cardiovascular anatomy and physiology and briefly explains some of the more common pathologies of the cardiovascular system that may be encountered. Cardiac anatomy is challenging to image because of cardiac and respiratory motion, and nonstandard imaging planes that are oblique to true sagittal, transverse, and coronal planes. Patient safety is the same as for any MRI examination, but the technologist may encounter a higher percentage of cardiac and vascular implants in this patient population. Cardiovascular MRI is categorized into 3 primary types of examinations: function and viability, dynamic contrast-enhanced stress perfusion, and magnetic resonance angiography. Artifacts that are unique to cardiac MRI are discussed, and images of several of these artifacts are included.
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