Which imaging modality is most accurate for measuring left ventricular ejection fraction?

• A. Echocardiography
• B. Cardiac MRI
• C. Nuclear ventriculography
• D. CT angiography

Answer: (A)

Cardiac MRI is the most accurate way to measure left ventricular ejection fraction because it provides precise, reproducible quantification of LV volumes with excellent endocardial border definition in multiple planes, resulting in an accurate EF without relying on geometric assumptions. This high spatial resolution and 3D assessment make MRI the gold standard reference for LV function. Echocardiography is widely used and very practical, but its accuracy can be limited by operator technique and patient factors that affect image quality. Nuclear ventriculography and CT angiography can estimate EF as well, but they involve radiation and, in the case of CT, provide less precise volumetric data than MRI.