Assessment of Myocardial Ischemia with Cardiovascular Magnetic Resonance

作者：Heydari Bobak; Jerosch Herold Michael; Kwong Raymond Y^*

来源：Progress in Cardiovascular Diseases, 2011, 54(3): 191-203.

DOI：10.1016/j.pcad.2011.09.004

• Acute coronary syndrome
• Adenosine
• Cardiac magnetic resonance imaging (CMR)
• Chest pain
• Coronary artery disease
• Dobutamine
• Echocardiography
• Ischemia
• Myocardial infarction
• Perfusion
• Persantine
• Regadenoson
• Positron emission tomography
• Single-photon emission computed tomography
• Vasodilators

Assessment of myocardial ischemia in symptomatic patients remains a common and challenging clinical situation faced by physicians. Risk stratification by presence of ischemia provides important utility for both prognostic assessment and management. Unfortunately, current noninvasive modalities possess numerous limitations and have limited prognostic capacity. More recently, ischemia assessment by cardiovascular magnetic resonance (CMR) has been shown to be a safe, available, and potentially cost-effective alternative with both high diagnostic and prognostic accuracy. Cardiovascular magnetic resonance has numerous advantages over other noninvasive methods, including high temporal and spatial resolution, relatively few contraindications, and absence of ionizing radiation. Furthermore, studies assessing the clinical utility and cost effectiveness of CMR in the short-term setting for patients without evidence of an acute myocardial infarction have also demonstrated favorable results. This review will cover techniques of ischemia assessment with CMR by both stress-induced wall motion abnormalities as well as myocardial perfusion imaging. The diagnostic and prognostic performance studies will also be reviewed, and the use of CMR for ischemia assessment will be compared with other commonly used noninvasive modalities.

• 出版日期2011-12