Assessment of myocardial ischemia and viability using cardiac magnetic resonance

In the past decade, cardiac magnetic resonance (CMR) has evolved dramatically. Its clinical applications are now a major tool in the diagnosis and prognostic assessment of patients with ischemic heart disease. CMR can be used for detection and quantification of ischemia and for viability assessment using different techniques that are now well validated. Scar can be easily detected using contrast enhancement (late gadolinium enhancement). Ischemia detection is usually achieved with stress CMR techniques, whereas prediction for the recovery of function (detection of dysfunctional but viable myocardial segments) can be deduced from scar and stress imaging. Although determination of which approach is better may depend on the population group, the major advantage of CMR is the ability to integrate different information about anatomy, wall motion, myocardial perfusion, and tissue characterization in a single comprehensive examination.