The Top Ten Cases in Cardiac MRI and the Most Important Differential Diagnoses

Noninvasive imaging plays a central role in the diagnosis of heart failure, assessment of prognosis, and monitoring of therapy. Cardiovascular magnetic resonance (CMR) offers a comprehensive assessment of heart failure patients and is now the gold standard imaging technique to assess myocardial anatomy, regional and global function, and viability. Fur‐ thermore, it allows assessment of perfusion and acute tissue injury (edema and necrosis), whereas in nonischemic heart failure, fibrosis, infiltration, and iron overload can be detected [1]. The American College of Cardiology/American Heart Association have recently updated their guidelines for imaging techniques used to assess patients with HF [2]. According to it, two-dimensional echocardiography is currently the imaging modality most commonly used in clinical practice to meet the ACCF/AHA requirements. It provides a good general assess‐ ment of LV function but is limited in patients with poor acoustic windows, it requires geo‐ metric assumptions in quantifying global LV systolic function, and its ability to provide specific tissue characterization is modest. CMR is the gold standard to LV and RV global and regional dysfunction, dilation, viability and what is the underlying etiology of HF. CMR makes it particularly well suited to studying the RV, which is difficult to assess with echo‐ cardiography.