Myocardial magnetic resonance imaging using extracellular gadolinium contrast agents

Bolus intravenous injection of extracellular gadolinium contrast agents permits the study of the myocardial first pass and of the late enhancement of the myocardium in patients with coronary artery disease. The most developed clinical applications concern the assessment of viability. Viability seems compromised in case of a slow of the signal during the first pass or of a transmural late enhancement of the myocardium. From the first-class myocardial curves, it is possible to assess the myocardial perfusion and the effect of vasodilator drugs like dipyridamole or adenosine. Absolute myocardial blood flow can also be calculated. Nevertheless, the routine use of magnetic resonance imaging for myocardial perfusion imaging requires improved imaging sequences covering the whole myocardium at a high temporal rate, new contrasts agents and robust software. Availability of better amagnetic instrumentation for monitoring and for resuscitation is also mandatory. (author)