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Alternative namesMagnetic resonance imaging - cardiac; NMR - cardiac; Nuclear magnetic resonance - cardiac; MRI of the heart
DefinitionA noninvasive procedure that uses powerful magnets and radio waves to construct pictures of the heart.
Magnetic resonance imaging ( MRI ) produces pictures of the heart without exposure to ionizing radiation (X-rays). The heart may be scanned by itself, or a heart MRI may be part of a chest MRI .
How the test is performed
Since MRI makes use of radio waves very close in frequency to those of ordinary FM radio stations, the scanner must be located within a specially shielded room to avoid outside interference. The patient will be asked to lie on a narrow table which slides into a large tunnel-like tube within the scanner. In addition, small devices may be placed around the head, arm, or leg, or adjacent to other areas to be studied. These are special body coils which send and receive the radio wave pulses, and are designed to improve the quality of the images. If contrast is to be administered, an IV will be placed, usually in a small vein of the hand or forearm. A technologist will operate the machine and observe you during the entire study from an adjacent room.
Several sets of images are usually required, each taking from 2 to 15 minutes. A complete scan, depending on the sequences performed, and need for contrast enhancement may take up to one hour or more. Newer scanners with more powerful magnets utilizing updated software and advanced sequences may complete the process in less time.
How to prepare for the test
No preparatory tests, diets, or medications are usually needed. An MRI can be performed immediately after other imaging studies. Depending on the area of interest, the patient may be asked to fast for 4 to 6 hours prior to the scan.
Because of the strong magnets, certain metallic objects are not allowed into the room. Items such as jewelry, watches, credit cards, and hearing aids can be damaged. Pins, hairpins, metal zippers, and similar metallic items can distort the images. Removable dental work should be taken out just prior to the scan. Pens, pocketknives, and eyeglasses can become dangerous projectiles when the magnet is activated and should not accompany the patient into the scanner area.
Because the strong magnetic fields can displace or disrupt the action of implanted metallic objects, people with cardiac pacemakers cannot be scanned and should not enter the MRI area. MRI also should not be used for people with metallic objects in their bodies such as inner ear (cochlear) implants, brain aneurysm clips, some artificial heart valves, older vascular stents, and recently placed artificial joints. Sheet metal workers, or persons with similar potential exposure to small metal fragments, will first be screened for metal shards within the eyes with X-rays of the skull. The patient will be asked to sign a consent form confirming that none of the above issues apply before the study will be performed.
A hospital gown may be recommended, or the patient may be allowed to wear clothing without metal fasteners.
How the test will feel
There is no pain. The magnetic field and radio waves are not felt. The primary possible discomfort is the claustrophobic feeling that some experience from being inside the scanner. The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises during normal operation. Ear plugs are usually given to the patient to reduce the noise. A technologist observes the patient during the entire procedure and may be spoken to through an intercom in the scanner. Some MRI scanners are equipped with televisions and special headphones to help the examination time pass.
Excessive movement can blur MRI images and cause certain artifacts. If the patient has difficulty lying still or is very anxious, an oral or intravenous sedative may be given. There is no recovery time, unless sedation was necessary. After an MRI scan, you can resume normal diet, activity, and medications.
Why the test is performed
MRI provides detailed pictures of the heart and blood vessels and can distinguish tissues from moving blood. It can differentiate between heart muscle and surrounding tissues and can clarify findings from previous X-rays or CT scans. MRI excels at showing the heart from multiple imaging planes. MRI is useful in the diagnosis of congenital abnormalities, abnormal growths, and tumors.
What abnormal results mean
The sensitivity of MRI depends, in part, on the experience of the radiologist.
What the risks are
There is no ionizing radiation involved in MRI, and there have been no documented significant side effects of the magnetic fields and radio waves used on the human body to date. However, because the effects of strong magnetic fields on a fetus are not well documented at this time, pregnant women are usually advised to avoid MRI scans.
MRI is usually not recommended for acute trauma situations, because traction and
The most common MR intravenous contrast agent, gadolinium, is very safe, and although there have been documented allergic reactions to it, this is extremely rare. If sedation is used, there are associated risks of oversedation. The technologist monitors the patient's vital signs, including heart rate and respiration, as needed.
Special considerationsMRI is more accurate than CT scan or other tests for certain conditions, but less accurate for others. Disadvantages include the high cost, long duration of the scan, and sensitivity to movement. People with claustrophobia or who are confused or anxious may have difficulty lying still for the relatively long scan times. MRI is not portable and is incompatible with metallic implants, life support devices, traction apparatus, and similar equipment.
MRI is superior in most cases in which differentiation of soft tissues is necessary. It can view organs without obstruction by bone and foreign bodies. It is capable of showing the tissues from multiple viewpoints and is a non invasive way to evaluate blood flow.
Update Date: 5/2/2003Benjamin Taragin, M.D., Department of Radiology, Columbia Presbyterian Medical Center, New York, NY. Review Provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT