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Stress perfusion cardiovascular magnetic resonance imaging: a guide for the general cardiologist
  1. Christian Hamilton-Craig1,2,
  2. Martin Ugander3,4,
  3. John P Greenwood5,6,
  4. Rebecca Kozor7
  1. 1 Faculty of Medicine and Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 School of Medicine, Griffith University, Sunshine Coast, Queensland, Australia
  3. 3 Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  4. 4 Department of Clinical Physiology, Karolinska Institute, Stockholm, Stockholm, Sweden
  5. 5 Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  6. 6 Biomedical Imaging Sciences, University of Leeds, Leeds, UK
  7. 7 Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Christian Hamilton-Craig, Faculty of Medicine and Centre for Advanced Imaging, The University of Queensland, Saint Lucia, QLD 4072, Australia; c.hamiltoncraig{at}


Stress cardiovascular magnetic resonance (CMR) is an emerging non-invasive imaging technique for the assessment of known or suspected ischaemic heart disease (IHD). Stress CMR provides information on myocardial perfusion, wall motion, ventricular dimensions and volumes, as well as late gadolinium enhancement (LGE) scar imaging in a single test without ionising radiation. Data from numerous multicentre randomised studies show high diagnostic and prognostic utility, its efficacy as a gatekeeper to invasive coronary angiography and use for guiding coronary revascularisation decisions. Stress CMR is cost-effective across multiple healthcare settings, yet its uptake and usage varies worldwide and is an underutilised technology. New developments include rapid acquisition protocols, automated quantification of perfusion and myocardial blood flow, and artificial intelligence-aided automated analysis and reporting. Stress CMR is becoming more accessible and standardised around the globe and is ready for ‘prime time’ use in the non-invasive assessment of patients with suspected IHD.

  • magnetic resonance angiography
  • coronary artery disease
  • diagnostic imaging

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  • Contributors All authors conceived of the manuscript, wrote the manuscript, critically reviewed the manuscript and submitted the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.