Cardiac MRI

Aka: Cardiac MRI, Coronary Angiography with MRI, MR Angiogram in Coronary Artery Disease, Coronary MRA, MR Coronary Angiogram

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II. Indications

  1. Heart functional studies
    1. Noninvasive Coronary Artery stenosis evaluation
    2. Right and left ventricular function evaluation
    3. Great Vessel evaluation (aorta and vena cava)
    4. Anomalous Coronary Artery evaluation
  2. Heart structural studies
    1. Cardiac mass evaluation
    2. Congenital Heart Disease evaluation

III. Efficacy: Coronary MRA

  1. Test Specificity: 58% (42% False Positive Rate)
  2. Test Sensitivity
    1. Overall sensitivity for >50% coronary stenosis: 88%
    2. Clinically Significant disease: 93%
      1. Left main Coronary Artery Disease
      2. Three vessel Coronary Artery Disease

IV. Advantages

  1. Noninvasive
  2. Relatively sensitive for significant disease
    1. But misses 7% of these cases

V. Disadvantages

  1. Long study (average of 70 minutes, may be >2 hours)
  2. High False Positive Rate (42%)

VI. Interpretation: Findings suggestive of coronary disease

  1. Coronary stenosis and myocardial perfusion
  2. Myocardial metabolism
  3. Wall motion abnormalities on stress testing
  4. Differentiate infarcted from viable Myocardium
    1. Uses delayed hyperenhancement imaging

VII. References

  1. Kim (2001) N Engl J Med 345:1863-9 [PubMed]
  2. Nagel (2003) Circulation 108:432-7 [PubMed]

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