MR imaging of myocardial perfusion and viability

Anja Wagner, Heiko Mahrholdt, Udo Sechtem, Raymond J. Kim, Robert M. Judd

Research output: Contribution to journalReview article

Abstract

CMR is a rapidly developing new modality with applications in clinical cardiology for detection and assessment of myocardial ischemia and viability. CMR perfusion results for the detection of ischemia in comparison with stress echocardiography and scintigraphic techniques are reasonable, but all the studies reported to date have been conduced in selected patients. Larger studies in patient populations reflecting a broader spectrum of disease are necessary before perfusion CMR can be envisaged as a clinically reliable and robust diagnostic tool. Other CMR techniques provide a variety of novel methods of obtaining information on postischemic viability. Signs of viability that can be observed by CMR are the absence of late gadolinium-based contrast enhancement in a myocardial region involved in a recent infarct, any sign of wall thickening at rest (which is detectable with high accuracy by CMR), wall thickening after stimulation by low-dose dobutamine, and preserved wall thickness. Conversely, myocardial necrosis is characterized by signal enhancement of the infarct area after injection of Gd-DTPA, reduced wall thickness in chronic infarcts, and absence of a contractile reserve during dobutamine stimulation. Dobutamine CMR and late enhancement contrast-enhanced CMR predict contractile improvement after revascularization.

Original languageEnglish (US)
Pages (from-to)49-66
Number of pages18
JournalMagnetic Resonance Imaging Clinics of North America
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

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Myocardial Perfusion Imaging
Dobutamine
Perfusion
Stress Echocardiography
Gadolinium DTPA
Gadolinium
Cardiology
Myocardial Ischemia
Necrosis
Ischemia
Injections
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

MR imaging of myocardial perfusion and viability. / Wagner, Anja; Mahrholdt, Heiko; Sechtem, Udo; Kim, Raymond J.; Judd, Robert M.

In: Magnetic Resonance Imaging Clinics of North America, Vol. 11, No. 1, 01.01.2003, p. 49-66.

Research output: Contribution to journalReview article

Wagner, Anja ; Mahrholdt, Heiko ; Sechtem, Udo ; Kim, Raymond J. ; Judd, Robert M. / MR imaging of myocardial perfusion and viability. In: Magnetic Resonance Imaging Clinics of North America. 2003 ; Vol. 11, No. 1. pp. 49-66.
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