Cardiac magnetic resonance imaging

Cardiac magnetic resonance imaging (CMR) has become an extremely valuable tool in the detection of cardiac pathology because of its accuracy in assessing cardiac structure and function, and its ability to provide tissue characterization. In this chapter we discuss the role of CMR in the evaluation of athletes, in whom it can be challenging to differentiate physiological changes from underlying myocardial pathology. It is fundamental to distinguish athletes undergoing CMR because of concerning symptoms from athletes evaluated for screening purposes with little pre-test probability for disease. We will briefly highlight state-of-the-art imaging sequences and post-processing techniques that are being used to assess cardiac morphology, function, and viability in athletes. Finally, we will discuss CMR findings present in inherited and acquired cardiomyopathies and how to distinguish these from physiological changes observed in highly trained athletes.