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In recent years, major technical progress has been achieved in cardiac MRI and CT, and these methods allow complete and non-invasive multiparametric characterization of the cardiovascular system. MRI uses the magnetic properties of the hydrogen nucleus, radio-waves and powerful magnets, whilst CT uses conventional X-rays but novel, either multi-detector spiral or electron beam technology for image generation. Both MRI and CT are gold standard methods for the three dimensional analysis of cardiothoracic anatomy, although MRI is superior in most situations. MRI is a very powerful technique for analysis of global and regional myocardial function, myocardial perfusion and viability imaging. CT, on the other hand, has the advantage for coronary imaging, where the solution is greater than that of MRI, up to 400μm2. At the present time, neither CT nor MRI can replace invasive coronary angiography. The value of coronary calcium scoring by CT remains to be established in prospective large scale clinical trials. It is likely that both MRI and CT will play a major role in diagnostic cardiology in the future. © 2006 Elsevier Ltd. All rights reserved.

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157 - 161