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Cardiovascular magnetic resonance
  1. Dudley Pennell
  1. Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, London, UK
  1. Dr Dudley Pennell, CMR Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UKd.pennell{at}

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Cardiovascular magnetic resonance (CMR) is a new field in cardiology. CMR has enormous potential because of its major attributes of high image quality and resolution combined with non-ionising radiation and versatility. With recent major technological advances there has been a quantum leap in acquisition speed and image quality that makes its use in ischaemic heart disease robust and clinically valuable. This review will focus on the current clinical indications for CMR, starting with those that are well established, and moving on to the developing indications that are expected to reach clinical maturity soon; finally, the less advanced uses of CMR will be briefly summarised.

Key points

  • CMR is a rapidly growing new speciality in cardiovascular medicine

  • CMR uses radio waves to generate images and is very safe

  • CMR is versatile and can assess anatomy, function, flow, and several tissue characteristics

  • The latest generation of CMR scanners allow real time scanning

  • Applications of CMR in coronary artery disease are increasingly useful clinically

  • The high reproducibility of CMR functional measurements has found significant research application in research into mechanisms of disease, and new drugs

Fundamentals of cardiovascular magnetic resonance

What is magnetic resonance?

Magnetic resonance (MR) is a fundamental property of some elements which contain an uneven number of nucleons (protons plus neutrons in the nucleus), and was first described in 1946. These atoms have a property known as net spin, and they absorb radio waves at a resonant frequency which is linearly related to the ambient magnetic field. Nearly all CMR is currently performed at the resonant frequency of hydrogen (63 MHz at 1.5 Tesla) because it is abundant and yields high signal. However, other nuclei can also be interrogated: phosphorus-31, carbon-13, sodium-23, potassium-39, and fluorine-19. These nuclei give lower signal and usually are only examined using MR spectroscopy, a technique which shows the spectrum of the radio signal. Important results in …

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