Magnetic resonance imaging: A new approach for evaluating coronary artery disease?

The cardiovascular applications of NMR imaging in coronary artery disease have increased considerably in recent years. Although many applications overlap those of other more cost-effective techniques such as echocardiography, radionuclide angiography, and computed tomography, NMR imaging offers unique features not shared by conventional techniques. The technical advantages are excellent spatial resolution, characterization of myocardial tissue, and the potential for three-dimensional imaging. This allows accurate assessment of left ventricular mass and volume, differentiation of infarcted tissue from normal myocardial tissue, and determination of systolic wall thickening and regional wall motion abnormalities. Also inducible myocardial ischemia by means of pharmacologic stress (dipyridamole) may be assessed with NMR imaging. Future technical developments include real-time imaging and noninvasive visualization of the coronary arteries. These advances will have a major impact on the application of NMR imaging in coronary artery disease, potentially unsurpassed by other techniques and certainly justifying the expense. Consequently the clinical use of NMR imaging for the detection of coronary artery disease largely depends on the progress of technical developments.