Technologist Track Session 01: CMR Technical Methods (2018)-Perfusion

Video Transcription

Video Summary

CMR perfusion is used to detect, localize, and quantify myocardial ischemia, which helps assess coronary artery disease and improve prognosis and symptoms. Compared with SPECT, CMR offers higher spatial resolution, better accuracy, no radiation, and the ability to combine perfusion with scar and tissue characterization. The technique relies on pharmacologic stress, usually adenosine or regadenosine, to reveal reduced coronary flow reserve and “steal” in stenotic territories. A typical protocol includes stress perfusion, rest imaging, and late gadolinium enhancement. Good image quality depends on proper ECG/breath-hold coordination, contrast timing, and artifact recognition. Common pitfalls include dark rim artifact, motion, wraparound, hardware problems, and field disturbances. Despite limitations such as fewer slices, claustrophobia, devices, and cost, CMR perfusion is a powerful functional test, with future developments including 3D imaging, free-breathing methods, and automated heart-rate–adapted sequences.

Keywords

CMR perfusion

myocardial ischemia

coronary artery disease

pharmacologic stress

late gadolinium enhancement

dark rim artifact