Current and future applications of cardiovascular magnetic resonance imaging.
Magnetic resonance imaging (MRI) is one of the newest and most exciting imaging techniques for the cardiovascular system. Its present clear-cut clinical indications include the diagnosis of pericardial disease, aortic disease, cardiac masses, congenital heart disease, anomalous coronary arteries, and right ventricular dysplasia. However, the indications for cardiovascular MRI are growing as its spatial resolution and versatility is increasingly acknowledged. MRI is now recognized as the gold standard measure of left ventricular size and global and regional function. Valvular function can be interrogated in a straightforward fashion. Indications that are now available in some institutions and will be more widespread in the near future include magnetic resonance dobutamine stress testing and magnetic resonance perfusion imaging with or without vasodilator stress. Coronary artery imaging for diagnosis of the severity of disease remains in development, as does imaging of coronary flow and flow reserve. Other exciting applications currently being investigated include real-time imaging and intravascular MRI, enabling imaging from the inside of vessels outward, thereby enhancing the ability to image atherosclerotic plaque. The applications of MRI to the cardiovascular system are rapidly expanding and will continue to do so in the new millennium.