Cardiac MRI

Cardiac MRI consists of using MRI to study heart anatomy, physiology and pathology.

The main advantages of cardiac MRI in comparison with other techniques are:

  • better definition of soft tissues
  • use of different types of sequences improves diagnostic accuracy
  • no ionising radiation

The main limitation of MRI, compared to cardiac CT, is the poorer evaluation of the coronary arteries.

In addition, cardiac MRI employs some particular imaging planes.

Dark blood imaging involves spin echo sequences. Its main advantage is a fast acquisition that minimises respiratory and cardiac movement artefacts. Its main issue is a low signal/noise ratio and, therefore, a deficient spatial resolution. 

These can be T1, T2, or proton density weighted sequences:

  • T1 weighted sequences achieve better anatomic definition
  • T2 and PD weighted sequences reach better tissue characterization

White blood imaging involves gradient echo sequences and steady-state free precession MRI (SSFP). In practice, the difference between the two is that SSFP is less vulnerable to the T2* effect.

The main advantage of white blood imaging is its fast acquisition. It can obtain movement sequences and allows studying cardiac function and movement.

The most usual sequence of this group is phase contrast imaging. It encodes flux direction and speed, similarly to CSF flow studies.

These imaging techniques use additional 180º pulses to null signal from blood and other tissues, and, therefore, improve contrast.

The most used sequence is STIR.

These are T1 weighted, gradient-echo sequences. Image acquisition is performed 3 minutes after gadolinium contrast administration. If there is a hypoenhanced area, this implies a zone of myocardial infarction that is non-viable.

These are T1 weighted, gradient-echo sequences. Image acquisition is performed 10 minutes after gadolinium contrast administration. 

Focal myocardial fibrosis has a delayed gadolinium contrast wash out. So hyperenhancement indicates a myocardial scar, thus an evolved myocardial infarction.

Usually, an extra inversion pulse is used to improve contrast between fibrosis and the surrounding myocardium.

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Article information

rID: 41244
Section: Physics, Approach
Synonyms or Alternate Spellings:
  • Cardio-MRI
  • Heart MRI

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Cases and figures

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    Case 1: hypertrophic cardiomyopathy with cor triatriatum
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    PSIR sequence wit...
    Case 2: myocardial contusion
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    Corresponding lat...
    Case 3: fulminant myocarditis
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