Magnetic resonance imaging of ischemic heart disease: why cardiac magnetic resonance imaging will play a significant role in the management of patients with coronary artery disease.

The role of magnetic resonance imaging in the diagnosis of ischemic heart disease has great potential impact on patient management, because a number of aspects of ischemic heart disease can be evaluated in one imaging session. High resolution coronary magnetic resonance angiography is currently available, although several technical improvements are awaited to make the technique routinely applicable. A major advance will probably include the availability of magnetic resonance blood pool contrast agents to improve vessel visualization. Contrast media, in combination with either first pass or delayed myocardial scanning, will also play an important role in myocardial perfusion imaging. Functional magnetic resonance assessment of regional and global ventricular function is currently a well-established technique and is considered a new gold standard, which may impact on routine cardiology practice. This review summarizes some of the recent magnetic resonance developments for evaluating various aspects of ischemic heart disease, including magnetic resonance coronary angiography, flow imaging, and imaging of myocardial perfusion and function.