Dynamic cardiac MR imaging: Techniques and applications

Current state-of-the-art dynamic or cine cardiac MR imaging is a time-effective study that offers a comprehensive evaluation of cardiac structure and function at rest. The major limitation at present is its inability to screen for coronary artery disease and evaluate ventricular function under stress. The future promises routine quantification of aortic, pulmonic, and other vascular flow rates, ultrafast (seconds) to real-time imaging, and paramagnetic or magnetic susceptibility perfusion markers. With the combination of real-time imaging and magnetic perfusion agents, imaging to detect coronary artery disease should also be possible. The use of pharmacologic stress or possibly physical stress with real-time imaging may also make this a reality in the not-too-distant future. MR coronary angiography remains a theoretical possibility but requires significant technologic advances, and is thus more remote. Existing and developing technology, however, seems to indicate that in the near-to-intermediate term, dynamic MR imaging will be an effective tool for evaluating almost all major types of cardiovascular disease.