In the last years, cardiac MRI techniques have progressively improved. No other noninvasive imaging modality provides the same degree of contrast and temporal resolution for the assessment of cardiovascular anatomy and pathology. Contraindications MRI are the same as for other magnetic resonance techniques.
The primary advantage of MRI is extremely high contrast resolution between different tissue types, including blood. Moreover, MRI is a true 3 dimensional imaging modality and images can be obtained in any oblique plane along the true cardiac axes while preserving high temporal and spatial resolution with precise demonstration of cardiac anatomy without the administration of contrast media.
Due to these properties, MRI can precisely characterize cardiac function and quantify cavity volumes, ejection fraction, and left ventricular mass. In addition, cardiac MRI has the ability to quantify flow (see flow quantification), including bulk flow in vessels, pressure gradients across stenosis, regurgitant fractions and shunt fractions. Valve morphology and area can be determined and the severity of stenosis quantified. In certain disease states, such as myocardial infarction, the contrast resolution of MRI is further improved by the addition of extrinsic contrast agents (see myocardial late enhancement).
A dedicated cardiac coil, and a field strength higher than 1 Tesla is recommended to have sufficient signal. Cardiac MRI acquires ECG gating. Cardiac gating (ECGs) obtained within the MRI scanner, can be degraded by the superimposed electrical potential of flowing blood in the magnetic field. Therefore, excellent contact between the skin and ECG leads is necessary. For male patients, the skin at the lead sites can be shaved. A good cooperation of the patient is necessary because breath holding at the end of expiration is practiced during the most sequences.

See also Displacement Encoding with Stimulated Echoes.
For Ultrasound Imaging (USI) see Cardiac Ultrasound at Medical-Ultrasound-Imaging.com.

See also the related poll results: 'In 2010 your scanner will probably work with a field strength of' and 'MRI will have replaced 50% of x-ray exams by'

Cardiovascular MR imaging includes the complete anatomical display of the heart with CINE imaging of all phases of the heartbeat. Ultrafast techniques make breath hold three-dimensional coverage of the heart in different cardiac axes feasible. Cardiac MRI provides reliable anatomical and functional assessment of the heart and evaluation of myocardial viability and coronary artery disease by a noninvasive diagnostic imaging technique.
Cardiovascular MRI offers potential advantages over radioisotopic techniques because it provides superior spatial resolution, does not use ionizing radiation, has no imaging orientations constraints and contrast resolution better than echocardiography. It also offers direct visualization and characterization of atherosclerotic plaques and diseased vessel walls and surrounding tissues in cardiovascular research.
MRI perfusion approaches measure the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents and assess the extent of injury after a myocardial infarction and the presence of myocardial viability with a technique based on late enhancement. Extracellular MRI contrast agents, like Gd-DTPA, accumulate only in irreversibly damaged myocardium after a time period of at least 10 minutes.
This type of patients may also have an implanted cardiac stent, bypass or a cardiac pacemaker and special caution should be observed on the MRI safety and the contraindications. While a number of coronary stents have been tested and reported to be MRI compatible, coronary stents must be assessed on an individual basis, with the medical team weighing the risks and benefits of the MRI procedure.

Cardiac MRI overview:

Cardiovascular MRI has become one of the most effective noninvasive imaging techniques for almost all groups of heart and vascular disease.

An iron-based contrast agent with large molecular size, which prevents diffusion into body tissues and will be developed for MR imaging of the liver (taken up by macrophages), tumor microvasculature and microvessel permeability. The blood half live of the particles with 11-20 nm diameter is 3-4 hours.
At this time the development of Clariscan™ is discontinued.

See also NC100150 Injection and Ultrasmall Superparamagnetic Iron Oxide.

Contrast enhanced GRE sequences provide T2 contrast but have a relatively poor SNR. Repetitive RF pulses with small flip angles together with appropriate gradient profiles lead to the superposition of two resonance signals.
The first signal is due to the free induction decay FID observed after the first and all ensuing RF excitations.
The second is a resonance signal obtained as a result of a spin echo generated by the second and all addicted RF-pulses.
Hence it is absent after the first excitation, it is a result of the free induction decay of the second to last RF-excitation and has a TE, which is almost 2TR. For this echo to occur the gradients have to be completely symmetrical relative to the half time between two RF-pulses, a condition that makes it difficult to integrate this pulse sequence into a multiple slice imaging technique. The second signal not only contains echo contributions from free induction decay, but obviously weakened by T2-decay. Since the echo is generated by a RF-pulse, it is truly T2 rather than T2* weighted. Correspondingly it is also less sensitive to susceptibility changes and field inhomogeneities.
Companies use different acronyms to describe certain techniques.
Different terms (see also acronyms) for these gradient echo pulse sequences:
CE-FAST Contrast Enhanced Fourier Acquired Steady State,
CE-FFE Contrast Enhanced Fast Field Echo,
CE-GRE Contrast Enhanced Gradient-Echo,
DE-FGR Driven Equilibrium FGR,
FADE FASE Acquisition Double Echo,
PSIF Reverse Fast Imaging with Steady State Precession,
SSFP Steady State Free Precession,
T2 FFE Contrast Enhanced Fast Field Echo (T2 weighted).
In this context, 'contrast enhanced' refers to the pulse sequence, it does not mean enhancement with a contrast agent.

(CE MRA) Contrast enhanced MR angiography is based on the T1 values of blood, the surrounding tissue, and paramagnetic contrast agent.
T1-shortening contrast agents reduces the T1 value of the blood (approximately to 50 msec, shorter than that of the surrounding tissues) and allow the visualization of blood vessels, as the images are no longer dependent primarily on the inflow effect of the blood. Contrast enhanced MRA is performed with a short TR to have low signal (due to the longer T1) from the stationary tissue, short scan time to facilitate breath hold imaging, short TE to minimize T2* effects and a bolus injection of a sufficient dose of a gadolinium chelate.
Images of the region of interest are performed with 3D spoiled gradient echo pulse sequences. The enhancement is maximized by timing the contrast agent injection such that the period of maximum arterial concentration corresponds to the k-space acquisition. Different techniques are used to ensure optimal contrast of the arteries e.g., bolus timing, automatic bolus detection, bolus tracking, care bolus. A high resolution with near isotropic voxels and minimal pulsatility and misregistration artifacts should be striven for. The postprocessing with the maximum intensity projection (MIP) enables different views of the 3D data set.
Unlike conventional MRA techniques based on velocity dependent inflow or phase shift techniques, contrast enhanced MRA exploits the gadolinium induced T1-shortening effects. CE MRA reduces or eliminates most of the artifacts of time of flight angiography or phase contrast angiography. Advantages are the possibility of in plane imaging of the blood vessels, which allows to examine large parts in a short time and high resolution scans in one breath hold. CE MRA has found a wide acceptance in the clinical routine, caused by the advantages: