Clinical Indications and Utilisation Patterns of Cardiac MRI in a Rural Hospital: Highlighting the Clinical Impact and Significance of the Service Delivery Model.

AIM/OBJECTIVE: The aim/objective of the study is to evaluate the clinical indications, utilisation patterns, technical performance, and diagnostic impact of cardiac magnetic resonance imaging (CMR) in a rural general hospital between 2024 and 2025. MATERIALS AND METHODS: This retrospective observational study was conducted in a rural general hospital where CMR was used as part of routine clinical services. All patients undergoing CMR between November 1, 2024, and October 30, 2025, were included (n = 114). Data collected included patient demographics, clinical indications, study type, contrast use, image quality, diagnostic findings, and clinical impact. RESULTS: Of 114 CMR scans, 83 (72.8%) were outpatient studies, with a mean patient age of 52.97 years (approximately 53 years). The most common indications were cardiomyopathy assessment, accounting for 21 (18.4%) cases; myocarditis evaluation, 15 (13.2%) cases; and ischaemia assessment, 12 (10.5%) cases. Furthermore, 111 (97.4%) scans used gadolinium contrast. Image quality was satisfactory or good in 92 (80.7%) of examinations. Myocardial scar or fibrosis was the most common finding, seen in 51 (44.7%) cases, followed by myocarditis, found in 24 (21.1%) cases. CMR provides diagnostic confirmation or exclusion in 46 (40.4%) cases, identifies a new diagnosis in 28 (24.6%) cases, and influences management in 19 (16.7%) cases. No major complications were documented; minor tolerability issues, including breath-holding difficulty, occurred in six (5.3%) examinations. CONCLUSIONS: CMR is a valuable diagnostic tool in rural settings, providing high diagnostic yield and influencing clinical management despite service limitations. These findings highlight the importance of sustaining and expanding rural CMR services to reduce diagnostic inequality.