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

The cardiovascular applications of nuclear magnetic resonance imaging in coronary artery disease have considerably increased in recent years. Although many applications overlap those of other more cost-effective techniques, such as echocardiography, radionuclide angiography, and computed tomography, magnetic resonance imaging offers unique features not shared by the conventional techniques. Technical advantages are the excellent spatial resolution, the characterization of myocardial tissue, and the potential for three-dimensional imaging. This allows the accurate assessment of left ventricular mass and volume, the differentiation of infarcted tissue from normal myocardial tissue, and the determination of systolic wall thickening and regional wall motion abnormalities. Also inducible myocardial ischemia using pharmacologic stress (dipyridamole or dobutamine) may be assessed by magnetic resonance 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 magnetic resonance imaging in coronary artery disease, potentially unsurpassed by other techniques and certainly justifying the expenses. Consequently, the clinical use of magnetic resonance imaging for the detection of coronary artery disease largely depends on the progress of technical developments.