Cardiac magnetic resonance imaging (MRI), is a non-invasive imaging technology that is used to evaluate the function and structure of the heart and blood vessels. It is based on the same basic principles as conventional MRI, but optimized for evaluating the heart and blood vessels.
Cardiac magnetic resonance imaging can image a large portion of the body, such as the chest, in one session. Because cardiac magnetic resonance imaging also acquires information about the heart rhythm, it can create clear moving images of the heart throughout its pumping cycle. This allows cardiac magnetic resonance imaging to display abnormalities in cardiac chamber contraction and to show abnormal patterns of blood flow in the heart and great vessels. Cardiac magnetic resonance imaging also has the advantage of producing images of the chest and the cardiovascular system from many angles.
Brigham and Women’s Hospital (BWH) offers one of the few multidisciplinary noninvasive cardiovascular imaging programs in the country that includes cardiologists, radiologists, and other imaging experts. The BWH Cardiovascular Imaging Program is a comprehensive, patient-focused imaging program that promotes quality and innovation. The Program combines the treatment, education, and research expertise of multiple disciplines – cardiology, radiology, nuclear medicine, molecular biology, medical physics, and chemistry – and incorporates the use of all available imaging types, including echocardiography, cardiac CT, cardiac MRI, nuclear cardiology, PET/CT, MRI, and ultrasound.
Our patients with heart and vascular conditions have access to top specialists throughout the fields of cardiovascular medicine, cardiac surgery, cardiac imaging, vascular surgery, and cardiac anesthesia. These physicians practice at the BWH Heart & Vascular Center, consistently ranked as one of the top 10 “Cardiology & Heart Surgery” providers in U.S. News and World Report’s annual “America’s Best Hospitals” survey.
Cardiac magnetic resonance imaging may be used to assess signs or symptoms of a variety of conditions, including: atherosclerosis, cardiomyopathy, congenital heart disease, congestive heart failure, aneurysm, valvular heart disease, or a heart tumor.
It is well-suited for evaluating complex cardiac disease, particularly congenital heart conditions, because it can simultaneously assess heart structure and function, heart muscle scars, and blood flow across heart valves or vessels. This multi-component assessment can be useful for planning cardiac surgery to correct a congenital cardiac anomaly or for monitoring a patient.
Cardiac magnetic resonance imaging procedures vary according to what is being evaluated, including:
Assessment of myocardial viability
The myocardium is described as viable if it has been determined that therapy could adequately improve its function. Assessment of myocardial viability, therefore, helps physicians determine the prospective benefits of invasive surgery for patients with coronary artery disease. Most often, this assessment helps to determine if the heart function of a patient who suffers from a weakened heart could improve after open heart surgery. This is done by evaluating cardiac wall thickness and contraction, heart function imaging during a low-dose dobutamine challenge, and imaging of heart muscle scars due to a heart attack. Collectively, these components allow doctors to assess the extent of heart damage, simulate the effects of restored blood flow through heart surgery, and even predict improvement of heart function.
Assessment for myocardial ischemia by pharmacological stress perfusion MRI
Patients who have chest pain are often suspected of having coronary artery disease that reduces blood flow to the heart. Cardiac magnetic resonance imaging combines imaging of heart function, blood flow in the myocardium (known as myocardial perfusion), and myocardial scarring to identify any pattern of coronary artery disease that could be treated well by either surgery or catheter-based coronary stenting. Currently, this type of cardiac magnetic resonance imaging requires the use of a medication that simulates the effects of exercise while the patient is lying inside an MRI scanner.
Assessing new and undiagnosed cardiomyopathy or diagnosing genetic cardiomyopathies or myocarditis
An important and rather common application of cardiac magnetic resonance imaging is assessing the cause of heart failure in patients who had no prior heart conditions. Cardiac magnetic resonance imaging can characterize abnormal conditions of heart muscle by using special MRI software methods (known as pulse sequences). Knowing the cause of heart failure helps physicians choose the appropriate cardiac procedures and/or medications.
Assessing patients with ventricular arrhythmias
Patients with serious arrhythmias can suffer from vastly different cardiac conditions, which, in turn, require different types of care. Cardiac magnetic resonance imaging often can help physicians determine the specific cause of an arrhythmia by assessing patterns of abnormal heart function and myocardial tissue diseases.
Evaluating valvular heart disease
When echocardiography does not produce conclusive results, cardiac magnetic resonance imaging can sufficiently assess the anatomy of abnormal heart valves and the severity of resultant blood flow disorders.
Determining cause of pericardial heart disease
The pericardium is a sac-like structure that holds and protects the heart during the heart’s contractions and relaxations. Determining the cause of pericardial disease is significant, as respective treatments differ vastly, and, in some cases, surgery is necessary. High-resolution cardiac magnetic resonance imaging can detect localized or overall thickening of the pericardium as a result of varying diseases.
Mapping cardiac radiofrequency ablation of common cardiac arrhythmias
Advances in imaging technology have made it possible to capture high-resolution 3-D shapes of cardiac structures (volumetric cardiac mapping) through the use of cardiac magnetic resonance imaging. Mapping heart chambers can improve the precision of ablative treatment of heart arrhythmias and also help reduce the total time necessary to perform the procedure.
The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of cardiovascular services in one location, fostering seamless and coordinated care for all patients.
Prior to an imaging procedure, patients check in at the Cardiovascular Imaging Center in the Shapiro Cardiovascular Center. During the procedure, family and friends can wait in the Shapiro Family Center.
In addition to our cardiovascular imaging experts, patients also benefit from the teamwork of cardiologists, interventional cardiologists, cardiac surgeons, cardiac electrophysiologists, and anesthesiologists, all experts in cardiovascular disorders. These specialists work alongside nurses, physician assistants, physical therapists, dietitians, and social workers to achieve better outcomes for patients.
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