Cardiac MRI with contrast: what shows?
Cardiac MRI with contrast allows to obtain a very accurate image of any of its structures (ventricles, Atria, the aortic orifice and others). It is obtained under the influence of a magnetic field, scanning the body at different levels. This study provided invaluable assistance in the diagnosis of a myocardial, acute forms of ischemic heart disease, valvular heart disease (e.g., aortic stenosis, valve insufficiency), etc.
The essence of the method lies in the fact that the pre-injected vein contrast with gadolinium and then doing a series of shots for 10-12 cycles of cardiac contraction. MRI shows damaged fibers of the myocardium a large amount of contrast received by them (the so detected heart attack).
Magnetic resonance imaging of the heart is obligatory in the following cases (indications for):
- Valvular heart disease – congenital and acquired, when there is loss of a valve. Purchased are often formed after suffering rheumatism (in this disease in the first place is a defeat of the mitral valve, and the second aortic valve).
- Coronary spasm organic (for example, on the background of atherosclerosis) or functional nature (for example, when the cardiac form of dystonia). This allows to determine the indications for CABG and stenting, when it is possible to save the patient’s life and improve its quality.
- Inflammation of the heart and its membranes.
- Any form of ischemic heart disease, including detection of heart attack.
- Cardiomyopathy – damage heart cells, which suffers from their function.
- Condition after prosthetic (replacement) any valve for the evaluation of hemodynamics.
- MRI as a preparatory stage to prosthetics.
- Assessment of pulmonary arteries.
Existing contraindications to MRI do not allow it to all patients. There are situations where under no circumstances it is impossible to do and when removing them, gives the opportunity to explore the heart of this method.
So, when the MRI should be abandoned? These situations include:
- The heart is controlled by the pacemaker.
- The catheters inserted into the cavity of the heart.
- Implanted pump for insulin.
- The metal structure after stenting.
- Steel prostheses in the heart.
Thus, a number of contraindications associated with the presence in the body of metal prostheses. Under the influence of a magnetic field can increase the temperature, leading to overheating. So when you want to explore the heart and have similar contraindications, MRI is usually replaced by CT. So, computed tomography shown after stenting, aortic valve replacement etc. If the work of the heart is controlled by the pacemaker, it is also possible to hold either x-ray or a CT scan.
Also from the MRI should be abandoned, if:
- A person’s weight more than 150 kg (in this case, there are technical reasons).
- The feeling of fear growing in a confined space (in this case, you can take tranquilizers, which will give the opportunity to conduct research).
- The period of pregnancy up to 14 weeks, after this period in difficult to diagnose cases, preference is given to MRI.
- The condition when a man cannot long is in a horizontal position.
- Tattoos that contain metal if they are located in the area of the survey or close to it.
The preparatory phase
MRI of the heart do without special training. Before you can study and eat, and drink water. But you should not overeat, as it increases the risk of unpleasant symptoms after injection of contrast such as nausea and vomiting. In the preparatory phase it is also recommended to remove all metal items, which can distort the picture and lead to different artifacts.
Features of the study
After the doctor found out that the person has no contraindications (it was not produced stenting, there is no pacemaker, etc.), the patient is injected contrast. After 15-20 minutes then proceed directly to scanning. Man is placed on the table-couch, in which the scanning of the heart at different depths. After the study the patient is given a conclusion on the basis of which exhibited the diagnosis (in combination with other data). So performed a comprehensive diagnosis of infarction, lesions of the aortic valve and the other, defining the situations shown stenting, etc.
Risks in MRI
Magnetic resonance imaging of the heart you can do virtually all patients who have indications for its implementation. This is due to the good tolerability of the procedure, as well as a minimum percentage of various complications.
Thus, following administration of contrast only 1% of the patients can be observed nausea and vomiting. Rarely may experience more severe manifestations of allergic type reactions angioedema and anaphylaxis. To avoid this, it is necessary to inform the doctor about any previously observed the reactions of intolerance of one or another drug.
The results of the study
MRI shows the degree of accumulation of contrast material in the damaged cardiomyocytes. Based on the obtained images, one can detect the following pathological processes:
- The implications of earlier myocardial infarction in the remaining scar;
- Areas of necrosis of the myocardium, which is characteristic of the acute heart attack;
- The presence of incorrect pacemaker and impaired wave propagation of the pulse, when, without replacement of pacemaker, artificial, a person can die;
- The narrowing of the coronary vessels (on the basis of the obtained results, the doctor determines whether the patient-specific stenting or not);
- The presence of irregular blood flow between chambers of the heart, indicating the defects of the walls, as well as malformations of aortic and other valve;
- Contractility of different parts of the heart (during a heart attack it is significantly reduced);
- Inflammatory processes in the heart muscle;
- Cardiomyopathy, which may manifest aortic insufficiency, if affects the left ventricle, for example;
- Abnormal structure of the heart vessels – aneurysms, which are the reason for stenting.