MRI of myocardial infarction with tissue tagging

Myocardial tagging with MRI has been available for three decades as a method for direct noninvasive quantification of regional myocardial motion for assessing the impact of ischemia, electrical asynchrony, and heart failure, among other conditions. In recent years, new developments in imaging sequences, hybrid techniques, and automated postprocessing have brought tagging closer to clinical application. Improvements in acquisition strategies have increased tag-tissue contrast and persistence, making automated tag detection easier and more robust. Imaging techniques such as harmonic phase MRI and displacement encoding with stimulated echoes that quantify pixel-by-pixel myocardial motion have simplified postprocessing. Parallel imaging and the increased signal-to-noise ratio available at the higher field strengths of new clinical scanners have moved the assessment of cardiac function into the real-time imaging domain. All of these developments have made myocardial motion mapping with tagged MRI a gold standard for the quantification of regional function within the research world, with potential to become an extremely valuable clinical technique.