Cardiac magnetic resonance imaging: The role of an essential imaging modality in cardiac assessment before surgical debulking

Magnetic resonance imaging (MRI) is an advanced imaging modality with a unique role in cardiovascular medicine. The advent of extremely fast sequences such as echo planar and single-shot fast spin echo allows remarkable quick acquisition times for the MRI. Foundational knowledge of tissue interaction with a characteristic pulse sequence enhances the precise assessment of clinical cases. The use of MRI to evaluate cardiac pathology carries unique challenges due to artifacts caused by the constant dynamic motion of the cardiovascular system. While certain pulse sequences are “standard” for any cardiac MRI exam, custom manipulation via specific pulse sequence selection ensures a complete and thorough exam. This chapter focuses on unique cardiac pathologies that require specific cardiology and cardiothoracic surgical management. Accordingly, the illustrative cases as presented demonstrate the power of precision imaging that provides accurate structural examination and analysis that enhances pre-op planning of surgical debulking of specific targets. Presurgical imaging protocols then become a vital pre-op tool, ensuring each image sequence accurately illustrates and answers relevant clinical questions. MRI has an important role in the pre-op cardiovascular assessment for patients who need targeted surgical debulking.