Non-interventional cardiac diagnostics: computed tomography, magnetic resonance and real-time three-dimensional echocardiography. Techniques and clinical applications.

New cardiovascular imaging modalities, including computed tomography (CT), magnetic resonance (MR) imaging and real-time three-dimensional echocardiography, have great potential for providing important and additional information concerning cardiac function and pathology. With significant and extremely fast technical improvements, non-invasive cardiac imaging has become a focal point in the diagnosis of cardiac disease. Thereby CT has been shown to allow the visualization of coronary arteries concerning calcifications, significant stenoses and coronary plaques, whereas MR imaging demonstrated its ability to evaluate cardiac morphology and function as well as perfusion imaging and viability assessment. As CT and MR, real-time three-dimensional echocardiography has increasingly progressed in the last years offering the potential for routine clinical application, e.g. in the evaluation of valve disease, the assessment of left ventricular thrombi or the guidance of intracardiac catheter placement. This article will provide a brief overview of each technique, possible clinical applications and their perspectives. Because both, CT and MR, have been successfully applied to visualize the coronary arteries, this article focuses on the abilities and limitations of CT and MR coronary artery imaging.