Cardiac MRI With and Without Contrast

Key Differences in Cardiac MRI Protocols

The American College of Radiology recommends that contrast-enhanced cardiac MRI provides tissue characterization and risk stratification based on fibrosis detection, while non-contrast cardiac MRI primarily evaluates cardiac morphology and function 1, 2
Non-contrast cardiac MRI provides assessment of cardiac morphology including ventricular volumes, ejection fraction, and wall motion 3, 4
Non-contrast cardiac MRI can evaluate valvular disease and pericardial disease 4
Contrast-enhanced cardiac MRI includes all capabilities of non-contrast cardiac MRI and enables late gadolinium enhancement (LGE) imaging for detection of myocardial fibrosis, scar, and infarction 2, 5, 6
The American College of Radiology suggests that contrast-enhanced cardiac MRI provides critical tissue characterization for various cardiomyopathies 1, 2
Contrast-enhanced cardiac MRI allows risk stratification in multiple cardiac conditions 1, 5
Contrast-enhanced cardiac MRI can detect small areas of myocardial infarction (even <2% of LV mass) that predict adverse cardiac events 6

Assessment of ventricular function (ejection fraction, volumes) can be performed using non-contrast cardiac MRI 3, 4
Evaluation of wall motion abnormalities can be performed using non-contrast cardiac MRI 4, 7
Basic morphological assessment of cardiac chambers can be performed using non-contrast cardiac MRI 2, 5
Detection of myocardial fibrosis in various cardiomyopathies, such as hypertrophic cardiomyopathy, restrictive/infiltrative cardiomyopathy, dilated cardiomyopathy, arrhythmogenic cardiomyopathy, and inflammatory cardiomyopathy, can be performed using contrast-enhanced cardiac MRI 1, 2, 5
Risk stratification for adverse cardiac events can be performed using contrast-enhanced cardiac MRI 6