Introduction

Since the first MR images of the heart in the late 1970s there has been much commercial and academic development of cardiovascular MRI techniques, but clinical usage has been relatively limited compared with neurological and musculoskeletal MRI. However, in recent years improvements in MR system hardware, most notably vector ECG gating and high-performance gradients, has led to robust and reliable imaging techniques capable of providing high-quality morphological and functional imaging of the heart. MRI now offers the potential to provide, in a single investigation, more accurate and repeatable data than could be obtained using a combination of other tests, with the added advantage of providing some unique methods for the qualitative and quantitative evaluation of cardiac function.

In this chapter we will:

• review the main artefacts from heart, blood and respiratory motion on standard images and the methods available to avoid them;

• show that cardiac-gated spin echo is used for morphological information;

• show that retrospective or prospective gating of gradient-echo techniques can be used to create cine images which show cardiac function, such as wall contraction and valve motion;

• see the use of velocity mapping using phase-contrast MRA can be used to measure ejection fractions and stroke volumes;

• describe new techniques for myocardial perfusion imaging;

• discuss the difficulties in producing high-quality images of the coronary arteries, one of the biggest challenges in cardiac MRI.