Cardiovascular MR imaging includes the complete anatomical display of the heart with CINE imaging of all phases of the heartbeat. Ultrafast techniques make breath hold three-dimensional coverage of the heart in different cardiac axes feasible. Cardiac MRI provides reliable anatomical and functional assessment of the heart and evaluation of myocardial viability and coronary artery disease by a noninvasive diagnostic imaging technique.
Cardiovascular MRI offers potential advantages over radioisotopic techniques because it provides superior spatial resolution, does not use ionizing radiation, has no imaging orientations constraints and contrast resolution better than echocardiography. It also offers direct visualization and characterization of atherosclerotic plaques and diseased vessel walls and surrounding tissues in cardiovascular research.
MRI perfusion approaches measure the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents and assess the extent of injury after a myocardial infarction and the presence of myocardial viability with a technique based on late enhancement. Extracellular MRI contrast agents, like Gd-DTPA, accumulate only in irreversibly damaged myocardium after a time period of at least 10 minutes.
This type of patients may also have an implanted cardiac stent, bypass or a cardiac pacemaker and special caution should be observed on the MRI safety and the contraindications. While a number of coronary stents have been tested and reported to be MRI compatible, coronary stents must be assessed on an individual basis, with the medical team weighing the risks and benefits of the MRI procedure.

Cardiac MRI overview:

Cardiovascular MRI has become one of the most effective noninvasive imaging techniques for almost all groups of heart and vascular disease.

An iron-based contrast agent with large molecular size, which prevents diffusion into body tissues and will be developed for MR imaging of the liver (taken up by macrophages), tumor microvasculature and microvessel permeability. The blood half live of the particles with 11-20 nm diameter is 3-4 hours.
At this time the development of Clariscan™ is discontinued.

See also NC100150 Injection and Ultrasmall Superparamagnetic Iron Oxide.

Combidex® is the brand name (same as Sinerem®) for an ultrasmall superparamagnetic iron oxide (USPIO) in the development pipeline to detect metastatic disease in lymph nodes. Metastatic lymph nodes show less uptake of this MRI contrast agent, which results in less signal decrease and allows the differentiation of normal lymph nodes from normal-sized, metastatic nodes. Combidex® has also potential to be used as a functional molecular imaging agent.
In March 2005, AMAG Pharmaceuticals Inc received an approvable letter from the U.S. Food and Drug Administration with respect to Combidex subject to certain conditions.
See also Ferumoxtran, Drug Development and Approval Process USA, Molecular Imaging and Classifications, Characteristics, etc.

(MRI-CA) Coronary angiography with dobutamine stress tagging (MR images are taken after the heart has been stressed by using a medication called dobutamine). Investigational noninvasive imaging as a diagnostic tool for evaluating stenosis, anatomy and flow effects in coronary arteries with dobutamine stress.

For Ultrasound Imaging (USI) see Stress Echocardiogram at Medical-Ultrasound-Imaging.com.

Duty cycle is the time during which the gradient system can be run at maximum power. The duty cycle is based on the total time and includes the cool down phase. The duty cycle on the RF pulse during MRI is restricted based on the specific absorption rate (SAR) limit.
SAR limits restrict radio frequency heating effects. The specific absorption rate increases with field strength, radio frequency power and duty cycle, type of the transmitter coil and body size. The especially in high and ultrahigh magnetic fields, important SAR issue can be readily addressed by reducing the RF duty cycle due to longer repetition times (TR) and the use of parallel imaging techniques. A TR longer than the minimum needed provides time for the tissue to cool down, but for the cost of a longer scan time. A parallel imaging technique reduces the RF exposure and the scan time.

See also High Field MRI.