Cardiac Imaging: The Future is Now
Five of the top ten imaging-related
expenditures in the U.S. are related to cardiac imaging, with echocardiography
and cardiac catheterization at the top of the list. Despite tremendous
technological advances in recent years and the fact that MR angiography
of the thoracic aorta is the most common MRA procedure performed, clinical
cardiac MR imaging remains remarkably underutilized.
Using state-of-the-art MR scanners,
cardiac MRI can now be performed efficiently and effectively for a wide
variety of indications. Superb high resolution images of the beating heart
can be acquired in 10 sec or less or even in real time, allowing superior
evaluation of ventricular wall motion and function that serves as the
"gold standard" among all imaging techniques. Anatomic imaging
for evaluation of cardiac masses, constrictive pericarditis, cardiomyopathies,
right ventricular dysplasia, and so on is easily and appropriately complemented
by functional imaging to assess the physiologic consequences of pathologies
of the heart. For patients with ischemic heart disease, infarct imaging
with contrast-enhanced MRI has come of age and is a technique commercially
available from all the manufacturers. Stress testing and coronary imaging
in patients with ischemic heart disease are areas under development that
are demonstrating tremendous promise in the near future.
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