Diagnostic Capabilities of Magnetic Resonance Imaging in Assessing the Myocardial Perfusion in Cases of Ischemic Disorders

Magnetic resonance imaging (MRI) of the heart has proven itself as an important tool for the evaluation of myocardial perfusion and for the diagnostics of myocardial ischemia. Due to its high spatial resolution and absence of X-ray radiation, MRI of the heart allows for precise diagnosing subendocardial ischemia without any adverse effects, which makes it a valuable method for detecting the ischemic heart disease. Recent advances in cardiac MRI and in post-processing have allowed for moving from qualitative to quantitative evaluation of the stress perfusion cardiac MRI, which has significantly increased the objectiveness and the precision of diagnostics. Quantitative evaluation of myocardial perfusion using the MRI provides a possibility of objective evaluation of myocardial ischemia, which can contribute to improved detection of coronary microvascular dysfunctions. The integration of quantitative perfusion MRI with other methods, such as the kinematic MRI, the delayed increase of gadolinium levels and the T1/T2-mapping, allows for deeper understanding the pathophysiology and improving the prediction of outcomes for various cardio-vascular diseases. The review addresses modern research works on cardiac MRI with regard to diagnostics and predicting of ischemic heart disease, coronary microvascular dysfunctions or non-ischemic cardiomyopathy, focusing on the quantitative approach in the evaluation of myocardial perfusion and its potential use in clinical practice.