Magnetic Resonance

Cardiac MRI

Magnetic Resonance Imaging (MRI) is a powerful medical imaging modality, which can assist in the assessment of ischemic heart disease in one single scan session.

The exquisite image quality, soft tissue contrast, and short scan times of modern MRI scanners make Cardiac MR (CMR) a method of choice to assist in the diagnosis of congenital heart disease, valvular diseases, pericardial disease, cardiomyopathies, heart failure and a wide range of vascular diseases¹.

A diagnostic CMR study with the Achieva CV provides a wealth of physiological information that you could otherwise only obtain with the combined use of several other imaging modalities.

A typical CMR study may contain:

Cardiac Anatomy – Exquisite imaging of even the most complex congenital diseases, with two-dimensional slices in any orientation, or represented as highly-realistic, 3D volume renderings (including endoscopic views).
Heart Function – Detailed cine acquisitions with excellent image quality and frame rates rivaling those of ultrasound. These can be performed in real-time or with ‘delayed reconstruction’, and are used to assess global and regional wall motion, including quantitative longitudinal and circumferential strain.
Quantitative flow measurements – Identifies valve problems such as regurgitation, stenosis or shunts.
Myocardial Health² – Identifies healthy myocardium at rest and stress, and helps determine potential benefits of revalscularization therapy.
Coronary artery imaging – Provides a detailed view of the coronary artery tree in various formats, to support the indications found during the functional analysis.

Comprehensive insight

Our Achieva CV has been designed to efficiently address each of these clinical tests (anatomy, function, flow, myocardial health and coronary angiography) in order to obtain an efficient and accurate clinical study – then summarized in a comprehensive clinical report.

One can easily imagine the benefits of using a single imaging modality that not only helps to determine the cause of CAD, but also provides valuable information for decisions about treatment.

Detailed views of wall motion abnormalities are possible with ultra-fast (cine) acquisitions – and non-invasive myocardial tagging techniques can be used for quantitative regional wall motion studies.
Accurate and fast edge detection algorithms help to delineate the epi- and endocardial boundaries, which then provide all the quantitative function parameters, such as ejection fraction, thickness and thickening parameters, etc. for both left and right ventricle.
Regions of abnormal wall motion (under rest and/or stress) may be directly related to injured myocardium, or even to a coronary angiogram.

Innovative tools

All of this is made possible with the extensive set of cardiac MR tools available on the Achieva CV system.

Achieva’s Cardiac Plus package provides high-quality imaging of the heart and surrounding vessels, including robust Vector ECG triggering, multi-phase imaging, quantitative flow, and arrhythmia compensation methods.
The Cardiac Pro package adds to that: multi-slice / multi-phase imaging and extensive quantitative flow analysis. Our revolutionary k-t BLAST option can be added to dramatically decrease scan times while maintaining high image quality.
The Cardiac Specialist package paves the way to top-notch cardiac imaging, including myocardial health, tagging and real-time imaging with SENSE.
The Coronary Artery Imaging package combines a number of sophisticated imaging technologies, enabling fast, simple, free-breathing coronary imaging in just 2 to 5 minutes. And although the acquisition requires no breathholds for the patient, the result is a breathtaking, ultra-realistic 3D rendering of the heart and coronary vessels.

Interventional Cardiac MR

The highly advanced Achieva I/T Cardiovascular consists of an Achieva CV combined with a cardiovascular X-ray system. A surgery table with a (mobile) X-ray system is positioned in-line with the MR scanner, and a floating table top allows rapid transition of the patient between the two systems.

This revolutionary approach, usually referred to as XMR, has demonstrated great potential, in particular in the field of pediatric cardiac MR, where radiation dose and contrast agents are sources of serious concern.

The combination of x-ray and MR in a single diagnostic setup greatly improves diagnostic accuracy, because of the added physiologiocal information provided by MR. Together they can help reduce radiation dose and the use of contrast. And thanks to the anatomical ‘roadmap’ information obtained by MR, it can allow for faster and more efficient X-ray catheterization procedures.

[Rev. 2006-10-04]

Related Links

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+ FieldStrength magazine

1. M. Breeuwer, Quantification of atherosclerotic heart disease

with cardiac MRI, MedicaMundi 49/2 2005/8

2. Requires administration of gadolinium DTPA contrast agent –

not approved by FDA in the U.S.

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It is widely accepted that

cardiovascular MR is the best non-invasive technique that we have to assess cardiac anatomy and systolic function, both at rest and with pharmacological stress.

- Warren Manning, MD

Beth Israel Deaconess

Medical Center

Boston, Massachusetts, USA