Abstract
Magnetic resonance imaging (MRI) provides a unique noninvasive imaging technology to assess the anatomy and physiology of atherosclerotic disease burden without the use of ionizing radiation. Cardiac MRI has an established role and is increasingly utilized clinically in rest and stress myocardial perfusion imaging, viability assessment and infarct detection. Peripheral angiography, with and without contrast enhancement, is currently a more mature application than coronary magnetic resonance angiography (MRA). Technical limitations, particularly related to MRI’s limited spatial resolution for accurately imaging the relatively smaller coronary vessels, preclude the widespread use of coronary MRA at this time. However, the sensitivity and negative predictive value are relatively high for the identification of left main or multi-vessel disease. Compared with native coronary arteries, coronary artery bypass grafts are more static, are generally of larger caliber and have a more linear course, making them better suited than native coronary arteries for assessment by magnetic resonance angiography. Further research and development are needed before coronary angiography for a complete cardiac atherosclerosis assessment is a viable diagnostic tool. The ability to identify vulnerable plaque is an area of growing interest and MRI has emerged as a promising non-invasive modality to characterize plaque composition. Cardiovascular MRI offers a unique comprehensive assessment of both plaque anatomy and physiology. Ultimately, the most significant contribution of atherosclerosis imaging will be in its ability to predict risk, modify therapy and improve clinical outcomes. Cardiovascular MRI has a promising future in this area.
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Woods, K.M., Weissman, G. (2013). Atherosclerosis Imaging Using Cardiovascular Magnetic Resonance. In: Taylor, A., Villines, T. (eds) Atherosclerosis: Clinical Perspectives Through Imaging. Springer, London. https://doi.org/10.1007/978-1-4471-4288-1_11
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