Cardiac magnetic resonance (CMR) imaging has made substantial progress over the past decade due to technological improvements in imaging hardware and acquisition techniques. CMR has become a clinically valuable alternative for assessment of all clinical questions in cardiology, like the analysis of cardiac anatomy, morphology, function, perfusion, and viability. But up until now, coronary magnetic resonance angiography (MRA) has remained the last hurdle, mostly due to low spatial resolution and long acquisition time.

Kuncheng Li, MD, and his collaborators from Xuanwu Hospital, Capital Medical University Beijing, PR China, and Debiao Li, PhD, Northwestern University of Chicago, USA, could now demonstrate that whole-heart coronary MRA at 3 Tesla (3 T) with slow infusion of contrast agent allows the noninvasive detection of significant coronary artery stenosis with high sensitivity (94.1 percent) and specificity (82.1 percent) on a per-patient basis compared to invasive coronary angiography.¹ The study was performed on a MAGNETOM^® Trio system using a 12-element matrix coil. 62 patients were successfully studied; mean acquisition time was 9.1 minutes.

Thus, CMR at 3 T could be used for comprehensive assessment of patients with coronary artery disease by integrating anatomical and functional analysis, first-pass myocardial perfusion, viability assessment by use of delayed enhancement, and coronary status – all within the same CMR exam. New developments in CMR, like slow infusion protocols, imaging at higher field strength (3 T), and improvements in data acquisition sequences, for example, whole-heart imaging, are promising to also make coronary MRA a clinically valuable tool.