UPMC Physician Resources
UPMC Cardiovascular Magnetic Resonance Center
Cardiovascular magnetic resonance (CMR) offers a near comprehensive evaluation of the heart and surrounding structures in any imaging plane, yielding high-resolution images without using ionizing radiation, regardless of body type. CMR exams are known for their high degree of precision, accuracy, and reproducibility.
CMR has been validated in an international, multicenter, double-blind, randomized trial for detecting and assessing myocardial infarction. It also assesses:
- myocardial function (volumes/ejection fraction)
- ischemia (first-pass perfusion)
- presence/extent/severity of myocardial infarction (late gadolinium enhancement) including identification of the culprit vessel in multivessel disease
- myocardial tissue composition
- hypertrophic cardiomyopathy,
- focal or diffuse myocardial fibrosis,
- acute or chronic myocarditis
- iron overload
- restrictive versus pericardial disease (both pericardial thickness and ventricular interdependence)
- cardiac thrombus outside the left atrial appendage
The UPMC Cardiovascular Magnetic Resonance Center at UPMC Presbyterian has the only dedicated CMR in Pennsylvania that is capable of scanning patients up to 550 pounds. The magnet’s shorter and wider opening improves patient comfort.
CMR can be especially useful for patients with:
- obesity or other situations where image quality is poor
- heart failure of unclear cause or severity
- ventricular arrhythmia where CMR can identify substrate robustly for increased risk of sudden death
- viability assessment prior to possible revascularization; and
- older age or advanced comorbidity with higher pretest probabilities of disease
- substrate for cardiac thrombi.
While CMR can characterize virtually all forms of heart disease, it cannot directly visualize nonobstructive coronary artery plaque (in the absence of myocardial infarction or ischemia). Results are read by a multidisciplinary team of radiologists and cardiologists, who are available for consultations.
CMR is thought mistakenly to be expensive. While a rest CMR costs more than an echocardiogram, a stress CMR costs about the same as a stress single photon emission computed tomography (SPECT) scan, and sometimes can obtain the same information as an echocardiogram and a pharmacologic SPECT combined.
Contraindications to CMR include the presence of ferromagnetic materials in the body, certain devices, as well as a glomerular filtration rate < 30 ml/min/1.7 m2 if gadolinium contrast is required for the study. Most prosthetic heart valves, orthopedic implants, and dental work permit safe CMR scanning.