Technology insight: MRI of the myocardium

MRI is emerging as the method of choice for the evaluation of a wide variety of cardiovascular disorders. A major advantage of this technique over the other cardiac imaging modalities is the fact that it allows the operator - via special software programs called pulse sequences - to probe a vast array of biological properties while using the same machine. In this review, we provide the reader with a brief overview of the pulse sequence concept and how it enables MRI practitioners to pursue a multifaceted approach to evaluating the myocardium. We discuss how MRI technology makes this imaging method ideally suited to the assessment of cardiac morphology, contractile function, myocardial perfusion and infarction. In addition, we present clinical scenarios in which the performance of multifaceted imaging by MRI can alter clinical decision making.