Technologist Track Session 3: Ischemic Heart Disease (2019)-Vasodilator Stress CMR Imaging

Video Transcription

Video Summary

The talk reviewed vasodilator stress perfusion MRI for cardiac risk stratification. It began by noting the major burden of cardiovascular disease and limitations of standard tests like nuclear imaging and stress echocardiography. Stress CMR offers high spatial and temporal resolution, no radiation, and comprehensive assessment of ischemia, function, and viability, though it has contraindications such as non-MRI-compatible devices, renal dysfunction, claustrophobia, and severe asthma.  <br /><br />The speaker explained vasodilator agents—adenosine, dipyridamole, and regadenoson—their mechanisms, dosing, contraindications, and the need to avoid caffeine before testing. The core imaging approach uses first-pass gadolinium perfusion at stress and rest, followed by late gadolinium enhancement. Key technical issues include temporal/spatial resolution, motion, artifacts like the dark subendocardial rim, and proper protocol setup. Interpretation focuses on identifying inducible ischemia and distinguishing artifact from true disease, with recent advances including 3T imaging and motion correction.

Keywords

vasodilator stress perfusion MRI

cardiac risk stratification

stress CMR

gadolinium perfusion

inducible ischemia

late gadolinium enhancement