CMR to Assess Morphology, Function, Perfusion, and Viability

Cardiovascular magnetic resonance (CMR) has become accepted as the “gold standard” for imaging of the morphology, the function, and the viability of the myocardium. Steady-state free precession (SSEP) provides high spatial and temporal resolution, with excellent contrast between blood pool and myocardium. SSFP techniques have generally replaced the use of gradient echo in most situations. Spin Echo Imaging is known as the “black blood” technique, where moving blood is dark and myocardium and other structures are bright. CMR myocardial feature tracking is analogous to echocardiographic speckle tracking that allows quantification of myocardial deformation from standard SSFP images. With recent advances in hardware and software, real time CMR can be performed at an acceptable frame rate. CMR is a versatile and robust platform to comprehensively evaluate cardiac structure and function with applications to evaluate the pathogenesis of disease and response to therapy.