Changes in Practice after 2008 Guidelines-Changes in Practice After 2008 Guidelines

Video Transcription

Video Summary

The speaker reviews changes since the 2008 cardiac MRI guidelines and concludes that most recommendations remain valid. Key updates include improved patient preparation and stress protocols: adenosine dose can be increased when patients have caffeine exposure, and regadenoson offers a fast single-bolus alternative, though it may affect perfusion reserve measurements if recovery is incomplete. There is also a clear move toward 3D imaging, especially for congenital heart disease and complex anatomy. In ARVC, newer diagnostic criteria rely on both regional wall-motion abnormalities and quantitative RV volume/function thresholds, though overlap with normal values requires caution. T1 and T2 mapping are increasingly useful, but local validation and normal ranges are essential before routine use. The speaker emphasizes that MRI protocols should be tailored to the clinical question, with efficient scans for function and viability, while scar imaging remains critical and should prioritize high quality over speed.

Keywords

cardiac MRI guidelines

stress perfusion protocols

3D cardiac imaging

ARVC diagnostic criteria

T1 T2 mapping

scar imaging