[Cardiac imaging using MRI and CT].

Recent technical improvements in CT and MRI scanners allow improved imaging of the heart and the coronary arteries. These methods will probably replace some of the traditional diagnostic methods: echocardiograms, nuclear medicine SPECT studies and invasive coronary angiograms. There are several established clinical applications for both CT and MRI. Their adoption, however, has been slow, mainly for two reasons: the technology has not been widely available, and the clinicians lack detailed knowledge about the diagnostic capabilities of each modality. In this paper the main applications of each modality are presented based on the inherent technical advantages. The main indications for cardiac CT are: calcium scoring, anomalies of the coronary arteries, assessment and quantification of arterial stenosis, stent patency evaluation, bypass surgery follow-up, myocardial bridging, pulmonary and cardiac veins assessment (for ablation), characterization of atheromatous plaques (soft, lipoid or calcified), assessment of the lungs, mediastinum and thorax. The main indications for cardiac MRI: functional evaluation of the left and right ventricle, assessment of myocardial viability by perfusion, grading of valvular disease, congenital heart disease diagnosis and post-surgical evaluation, cardiomyopathies, diagnosis of myocarditis, coarctation of the aorta, diagnosis of cardiac tumors and thrombi, and pulmonary veins evaluation. Based on the knowledge of each modality, advantages, performance and cost, the referring physician can use evidence based algorithms that will allow him/her to tailor the appropriate study for each clinical problem.