Utility of MRI as the primary imaging tool in hypertension

Background In patients with early onset or drug resistant hypertension (HTN) exclusion of secondary causes with imaging and endocrine testing is recommended. Traditionally a combination of echocardiography, renal ultrasound and renal CT angiography are used to investigate patients. Magnetic resonance imaging (MRI) is the gold standard imaging modality for the quantification of cardiac volumes and masses, with the benefit of being non-invasive and non-ionising. MRI can sensitively screen for renal artery stenosis and accurately evaluate renal artery anatomy. This is of particular relevance in the age of interventional therapies for resistant hypertension such as renal denervation. We proposed that a single MRI visit could provide all the imaging required in the routine evaluation of patients with HTN.