Table 1.

CMR value and Pros and Cons compared with other imaging modalities.

Underlying mechanism of the disease	ECG	Chest X-ray	CT scan	Echo	CMR	Nuclear (SPECT/PET)
VHD-Libman-Sacks endocarditis	No	No	Yes, if large	Yes	Yes	PET, yes, if large
Pericardial effusion	No—just a very large one		Yes	Yes	Yes	CT aspect of PET, if large
Pericarditis—inflammation	Severe ones	No	No	No	Yes	PET, if severe
Noncalcified constrictive physiology of the pericardium	No	No	No	Yes	Yes	No
RV dysfunction	Late	Late	Late	Yes, but not always	Yes	No
LV dysfunction	Late	Late	Late	Not subclinical	Yes	Late
Myocardial edema	No	No	No	No	Yes	No
Myocardial ischemia	Yes	No	No	Yes, indirectly	Yes	Yes
Myocardial infarction	No smaller ones	No	No	Yes, not small or subendocardial	Yes	Yes, but not small or subendocardial
Myocarditis	No	No	No	No, just large ones	Yes	SPECT—No* PET—Yes
Coronary artery disease	Yes	No	Yes-CCTA	Not directly	Yes	Not directly
Microvascular dysfunction	Yes	No	No	No	Yes	Only PET
Aortic involvement	No	Large ones	No, in subclinical cases	Aortic root, no in subclinical cases	Yes	No
Pulmonary arteries	No	Late	Yes-CTA till distal branching	Main trunk and branches	Yes-till proximal branching	No
Pulmonary hypertension	Late	Late	Late	Yes	Yes	No
Radiation free	Yes	No	No	Yes	Yes	No
Availability	++++	++++	+++	++++	+++	++
Costs	+	+	++	++	++/+++	+++/++++
Claustrophobia	No	No	Yes—very rare	No	Yes	Yes—rare
Renal function contraindication	No	No	Yes	No	No**	No
Implantable (metal) devices contraindication	No	No	No	No	No**	No
Recommended for routine use in younger people than 65 years old, mainly women—radiation risk	Yes	Yes	No	Yes	Yes	No
Reproducibility	Yes	Yes	Yes	No-operator dependent	Yes	Yes
Prognostic information	No	No	No	Yes	Yes	Yes

^*SPECT had the technique of Gallium-67, currently obsolete due to inherited limitations of the study; Tc⁹⁹m could be helpful in some cases.

^**Currently, there are no absolute contraindications, contrast media could be used in renal impairment, and MRI scanning is possible with implantable devices. See dedicated literature for details and specifications.