Qualitative and Quantitative Stress Perfusion Cardiac Magnetic Resonance in Clinical Practice: A Comprehensive Review

Stress cardiovascular magnetic resonance (CMR) imaging is a well-validated non-invasive stress test to diagnose significant coronary artery disease (CAD), with higher diagnostic accuracy than other common functional imaging modalities. One-stop assessment of myocardial ischemia, cardiac function, and myocardial viability qualitatively and quantitatively has been proven to be a cost-effective method in clinical practice for CAD evaluation. Beyond diagnosis, stress CMR also provides prognostic information and guides coronary revascularisation. In addition to CAD, there is a large body of literature demonstrating CMR's diagnostic performance and prognostic value in other common cardiovascular diseases (CVDs), especially coronary microvascular dysfunction (CMD). This review focuses on the clinical applications of stress CMR, including stress CMR scanning methods, practical interpretation of stress CMR images, and clinical utility of stress CMR in a setting of CVDs with possible myocardial ischemia.

Automated summary

Stress cardiovascular magnetic resonance (CMR) imaging is a non-invasive stress test that has higher diagnostic accuracy than other common functional imaging modalities for diagnosing significant coronary artery disease (CAD). It provides a cost-effective method for one-stop assessment of myocardial ischemia, cardiac function, and myocardial viability in clinical practice. In addition to CAD, stress CMR also has diagnostic performance and prognostic value for other common cardiovascular diseases (CVDs), especially coronary microvascular dysfunction (CMD). This review focuses on the clinical applications of stress CMR in CVDs with possible myocardial ischemia, including scanning methods, image interpretation, and clinical utility.