Advanced cardiac imaging, using cardiac magnetic resonance imaging (MRI) and 
multidetector computed tomography (CT), is increasingly used in the work-up of 
athletes with suspected abnormalities on screening. Both imaging modalities 
produce highly accurate and reproducible structural and functional cardiac 
information. Cardiac MRI has the advantage of imaging without radiation exposure 
or the use of iodine-containing contrast agents, but is sometimes not possible 
due to claustrophobia or other contraindications. Although cardiac MRI can rule 
out coronary artery anomalies, multidetector CT is superior to cardiac MRI for 
visualising the full extent of the coronary arteries and atherosclerotic 
coronary artery disease. For patients less than 35 years of age, cardiac MRI is 
the first option after initial echocardiography for further assessment of 
cardiomyopathies, myocarditis and coronary anomalies, which are major causes of 
sudden cardiac death in young athletes. For athletes over 35 years of age the 
most common cause of sudden cardiac death is coronary artery disease, whereby 
cardiovascular screening requires further diagnostic modalities and may include 
multidetector CT.