In this review, we describe the solutions and approaches that have been developed to enable diffusion MRI of the heart in vivo, including a dual‐gated stimulated echo approach, a velocity‐ ( M 1) or an acceleration‐ ( M 2) compensated pulsed gradient spin echo approach, and the use of principal component analysis filtering. Recently developed accelerated diffusion‐weighted MR acquisition sequences combined with advanced post‐processing techniques have improved the accuracy and efficiency of diffusion MRI in the myocardium. Diffusion MRI in the heart, however, has proven technically challenging because of the intrinsic non‐rigid deformation during the cardiac cycle, displacement of the myocardium due to respiratory motion, signal inhomogeneity within the thorax, and short transverse relaxation times. Diffusion MRI provides unique information on the structure, organization, and integrity of the myocardium without the need for exogenous contrast agents.
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