SCMR Mid-Year Meeting: Myocardial Perfusion CMR-Stress CMR

Video Transcription

Video Summary

The transcript is from a cardiovascular MRI session focused on stress perfusion, artifacts, gadolinium use, and case-based interpretation.<br /><br />Dr. Andrew Arai reviewed updated chest pain guidelines and emphasized that CMR is useful not just for detecting CAD, but for assessing ischemia, infarct, microvascular disease, and prognosis. He highlighted the value of combining stress perfusion with late gadolinium enhancement (LGE), noting that patients with both ischemia and LGE have worse outcomes than those with either alone. He also stressed that quantitative perfusion can uncover disease missed by qualitative reading, especially in multivessel or microvascular disease.<br /><br />Dr. Michael Salerno discussed dark rim artifact, explaining its main contributors: motion, Gibbs ringing, and sequence timing. He showed that artifact is influenced by spatial and temporal resolution and can often be reduced by shorter temporal footprints, better spatial resolution, and careful sequence design. He also reviewed other common MRI artifacts, including device-related distortion, gating errors, aliasing, chemical shift, SSFP banding, and slice mispositioning.<br /><br />Dr. Karen Ordovas focused on gadolinium safety and properties. She explained contrast relaxivity, noted that modern group 2 agents have extremely low NSF risk, and discussed current recommendations that renal function testing is often unnecessary if only group 2 agents are used. She also reviewed allergic reactions, gadolinium retention, and the special role of gadobutrol in cardiac imaging.<br /><br />Dr. Patricia Rodriguez Lozano presented several cases illustrating how quantitative perfusion and LGE can help diagnose ischemia, prior infarction, myocarditis, sarcoidosis, and possible immune-checkpoint-inhibitor-related disease.<br /><br />The session ended with more cases from Dr. Arai illustrating how perfusion quantification can validate or reveal disease, while also showing how artifacts and hemodynamics can complicate interpretation.

Keywords

cardiovascular MRI

stress perfusion

late gadolinium enhancement

ischemia

coronary artery disease

microvascular disease

quantitative perfusion

dark rim artifact

gadolinium safety

NSF risk

group 2 gadolinium agents

MRI artifacts

myocarditis

sarcoidosis

case-based interpretation