Cardiac MRI
What each cardiac MRI sequence shows, how to read late gadolinium enhancement patterns (ischaemic, myocarditis, DCM, HCM, amyloid, sarcoid, Fabry), mapping and T2*, the Lake Louise criteria, and safety with devices, kidneys and pregnancy.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Cardiac MRI (CMR) is the reference standard for ventricular volumes and ejection fraction, especially the RV, and the best non-invasive test for tissue characterisation: scar, oedema, infiltration and iron.
- The workhorse is late gadolinium enhancement (LGE). Where the enhancement sits in the wall tells you the cause.
- Use it for unexplained cardiomyopathy, MINOCA, suspected myocarditis, HCM, ARVC, infiltration, congenital heart disease, masses and pericardial disease. Stress perfusion CMR is an option for chronic coronary syndromes.
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Sources
- Medicare Benefits Schedule items 63385, 63390 and 63395 (cardiac MRI for specified conditions)AU/NZAustralian Government Department of Health, Disability and Ageing (MBS Online), accessed November 2026
- Schulz-Menger J, Collini V, Gröschel J et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis. Eur Heart J 2025;46(40):3952-4041. doi:10.1093/eurheartj/ehaf192European Society of Cardiology, 2025
- Arbelo E, Protonotarios A, Gimeno JR et al. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J 2023;44:3503-3626. doi:10.1093/eurheartj/ehad194European Society of Cardiology, 2023
- Vrints C, Andreotti F, Koskinas KC et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415-537European Society of Cardiology, 2024
- Ferreira VM, Schulz-Menger J, Holmvang G et al. Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations (updated Lake Louise criteria). J Am Coll Cardiol 2018;72:3158-76Journal of the American College of Cardiology, 2018
- Kramer CM, Barkhausen J, Bucciarelli-Ducci C et al. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update. J Cardiovasc Magn Reson 2020;22:17Society for Cardiovascular Magnetic Resonance, 2020
- Weinreb JC, Rodby RA, Yee J et al. Use of intravenous gadolinium-based contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology 2021;298:28-35American College of Radiology and National Kidney Foundation, 2021
- Nagel E, Greenwood JP, McCann GP et al. Magnetic resonance perfusion or fractional flow reserve in coronary disease (MR-INFORM). N Engl J Med 2019;380:2418-28New England Journal of Medicine, 2019
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy