Rationale behind Using Stress MRI over Nuclear Imaging for Cardiac Ischemia Evaluation

Introduction: There are different methods for evaluating cardiac ischemia in a noninvasive way, most commonly used is nuclear stress testing. Another commonly performed investigation to evaluate coronary artery disease in symptomatic patients is coronary CT angiography. On one hand, coronary CT angiography provides anatomic information and stress testing using different modalities provides physiologic information. This physiologic information plays an important role in patient management than mere anatomic narrowing seen on CT angiography. Objectives: In this article, we are highlighting the role of cardiac MRI in this critical situation and its value over nuclear stress test. We will also discuss how cardiac MRI can help obtaining more added informations and obtaining differential diagnosis not always possible with nuclear imaging. Discussion: With continued advancement of MRI, stress MRI imaging is becoming another important modality and frequently used now a day to look for cardiac ischemia. This imaging modality provides physiologic information as stress nuclear imaging and also provides anatomic information. Delayed contrast enhanced imaging with MRI helps identifying areas of scar tissue and quantifying areas of viability. With MRI characterization of ischemic vs. non-ischemic cardiomyopathy is possible. Conclusion: On this article, we are highlighting the role of cardiac MRI evaluating cardiac ischemia and its value over nuclear stress test.