Magnetic Resonance Imaging

Cardiac magnetic resonance imaging MRI is used as both a functional and anatomical cardiac imaging test. It offers excellent soft tissue detail and the ability to quantify cardiac function. MRI scans can be performed with or without gadolinium contrast depending on what information is needed. Unlike computed tomography (CT), MRI does not use X-ray radiation, but patients with metal implants may have contraindications for MRI use because MR will heat up most metal objects. MRI exams usually take much longer than CT scans. How does MRI work? MR creates images by using powerful magnets to polarize hydrogen atoms in water (the body is made of of more than 80% water) so they face in one direction. A radiofrequency pulse is then used to ping these atoms, causing them to wobble, or resonate. The MRI coils detect this and computers can assemble images from the signals. Basic MRI scans will focus on the resonance of fat and water in two different sequences, which highlight and contrast different features in the anatomy.

Abbott’s FreeStyle Libre 3 integrated continuous glucose monitoring (iCGM) system

Abbott CGM sensors can now be worn during common imaging procedures

Sensors from the FreeStyle Libre 2 and Libre 3 continuous glucose monitoring systems can now be worn during X-rays, CT scans and MRI scans. The news represents a shift in policy from the FDA, one that came after the agency reviewed extensive testing data.

The American Society of Echocardiography (ASE) has shared new recommendations for performing medical imaging exams on heart failure patients with surgically implanted left ventricular assist devices (LVADs) and temporary mechanical circulatory support (TMCS) devices. The guideline, published in full in the Journal of the American Society of Echocardiography, represents ASE’s first update on the topic since 2015.[1]

ASE shares new guideline on imaging patients with implanted devices

The new guideline details the best imaging strategies for a variety of clinical scenarios. 

The Society of Cardiovascular Magnetic Resonance (SCMR) recently launched HeartMRI.org, which provides includes a general information and videos for patients and referring physicians.

SCMR launches cardiac MRI educational video to assist referring physicians 

The Society of Cardiovascular Magnetic Resonance launched a new website aimed at patients and referring physicians that includes pamphlets and videos on cardiac MRI. 

Ron Blankstein, MD, FACC, FASNC, MSCCT, FASPC, associate director, cardiovascular imaging program, director, cardiac computed tomography, Brigham and Women’s Hospital, and a professor of medicine and radiology, Harvard Medical School, explains a few of the recent advancements in cardiac MRI, nuclear imaging and computed tomography.

Exploring major breakthroughs in cardiac imaging

Ron Blankstein, MD, director of cardiac computed tomography for Brigham and Women’s Hospital, details recent developments in cardiac MRI, nuclear imaging and CT.

CMR of a patient showing evidence of myocardial hypertrophy

MRI results help cardiologists predict heart failure risk

"This breakthrough suggests that heart MRI could potentially replace invasive diagnostic tests," one specialist said. 

Some of the abandon leads and various shapes and positions on the wires from the study. None of these patients had any safety issues related the abandoned leads. Image courtesy of RSNA

MRI in patients with abandoned pacemaker and ICD leads

Abandoned metal wire leads for pacemakers and ICDs did not present a serious safety issue in a study of 80 patients, but a handful of patients did experience a significant change in the composite of capture threshold, sensing or lead impedance.

The American Society of Nuclear Cardiology (ASNC) is asking Congress to repeal the appropriate use software provision mandate, which physicians say is an obstacle to efficient care.

ASNC asks Congress to officially repeal the AUC mandate for advanced medical imaging

Medicare rescinded the provision in the 2024 Medicare Physician Fee Schedule, but the law remains on the books. 

Emily Lau, MD, Mass General Hospital, discusses sex differences in cardiovascular presentations of women.

CVD presents differently in women than it does in men—guidelines should reflect that

Emily Lau, MD, a women's health expert with Massachusetts General Hospital, thinks major changes are needed in how we diagnose CVD in women. "Our guidelines need to be more precise and offer sex-specific recommendations," she says.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.