Accelerated Cardiovascular Magnetic Resonance: Transforming Diagnostic Efficiency in Cardiac Imaging

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. In patients with known or suspected CAD, cardiovascular magnetic resonance (CMR) imaging plays a crucial role in the detection, localisation, and characterisation of myocardial abnormalities. However, its widespread adoption often faces limitations, including lengthy scan times, patient discomfort, and restricted access due to resource demands. This thesis evaluates the validity and clinical application of accelerated CMR imaging techniques for improving diagnostic efficiency in patients with suspected CAD.Firstly, free-breathing, real-time cine imaging was assessed as an alternative to conventional breath-hold steady-state free precession (SSFP) cine imaging in patients with known or suspected cardiac disease (n=202). It was demonstrated that free-breathing imaging provided comparable diagnostic accuracy while improving tolerability and reducing motion artefacts in patients with compromised breath-holding capacity.Furthermore, the feasibility and diagnostic accuracy of single-shot late gadolinium enhancement (LGE) imaging were evaluated in patients with suspected CAD (n=114). This technique eliminated the need for multiple breath-holds while maintaining high sensitivity and specificity for the detection of myocardial scarring and fibrosis.Moreover, the reproducibility of quantitative perfusion mapping, a novel technique for the absolute quantification of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR), was assessed in a study (n=59). This demonstrated moderate reproducibility of MBF and poorer reproducibility of MPR.