Delineates cardiac structures with high resolution without ionizing radiation. Excellent technique to quantitate LV mass, to characterize the pericardium, myocardial infiltrative disease (e.g., amyloid), great vessels, anatomic relationships in congenital heart disease, abnormal cardiac masses, and to evaluate valvular heart disease as a complement to echocardiography. CMR with delayed gadolinium enhancement (avoid in pts with renal insufficiency) differentiates ischemic from nonischemic cardiomyopathy and is useful in assessing myocardial viability. Pharmacologic stress testing with CMR identifies significant CAD and detects subendocardial ischemia with higher sensitivity than SPECT imaging.

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