Heart MRI

The Cardiac Magnetic Resonance Imaging ( MRI) department of Metropolitan General is certified by the European Association of Cardiovascular Imaging (EACVI) , being one of the few departments in Greece and the few in Europe that hold this distinction.

The accreditation (EACVI Laboratory Accreditation) confirms the high level of services, the integrity of the infrastructure, the scientific competence οf the stuff and the operating protocols based on international standards.

Cardiac Magnetic Resonance Imaging is one of the most important imaging techniques for the diagnosis of cardiovascular disorders. It is based on the use of a strong magnetic field and radio waves for the composition of images of the heart and chest, whereas processing of the captured images is performed with the use of a special software installed in a computer. Most of the time, during the examination, a contrast agent is administered (gadolinium) in order to take more information by the imaged.

Cardiac Magnetic Resonance Imaging is a specialized imaging examination of the cardiovascular system, which gives us high-quality and high-resolution images, so as to be able to study more thoroughly the cardiovascular disorders. It does not expose the patient to radiation and additionally the drug that is used as contrast agent has the fewest side effects of all the other contrast agents that are used in other imaging methods.

Advantages:

Modern cardiac imaging technique
Reliable
Safe / without radiation
Painless / bloodless
No special preparation is needed
It is applied to all patients with cardiovascular disorders *

* except the patients with non-compatible pacemakers – defibrillators, allergy to the contrast agent, end-stage renal insufficiency

Cardiac Magnetic Resonance Imaging - Indications

Coronary artery disease: Assessment of ischemic lesions, of myocardial viability and hypomotility. Evaluation of myocardial ischemia after pharmacological stress test. Coronary vessel anatomy.
Myocarditis: Viral myocarditis (Selection Examination), myocardial involvement in rheumatic diseases
Myocardial mass and cardiac anatomy study: high resolution images
Anatomy of large vessels – aortic aneurysms
Assessment of natural and prosthetic valves: Precise quantification of leaks, reliable valve planimetry
Diagnosis of myocardial and large vessel inflammation
Detection of iron deposition on myocardium
Study of cardiac tumors (primary – secondary)
Monitoring of pericardial diseases
Volumetry and contractility of cardiac cavities (Gold Standard)
Investigation of heart failure causes
Diagnosis – monitoring of cardiomyopathies (dilated, hypertrophic, Non-Compaction, Takotsubo etc)
Study of operated for congenital heart disease adults
Study of right cardiac cavities

Evaluation of myocardial ischemia with Cardiac Magnetic Resonance Imaging (Stress Perfusion CMR)

The evaluation of myocardial ischemia with Cardiac Magnetic Resonance Imaging is based on a quick protocol which gives us information for the myocardial ischemia and also for its viability. This examination is based on a special program available in the Magnetic Resonance Imaging scanner of Metropolitan General. During the examination we can evaluate, in real-time, the myocardial perfusion in stress conditions. The concept of this technique is similar to myocardial perfusion scintigraphy, however, because of the fact that is performed with the assistance of magnetic resonance imaging, it does not expose the patient to radiation, being more reliable than the usual scintigraphy, as it gives us images of higher resolution and it lasts only 25 minutes.

Also, since we are talking about cardiac magnetic resonance imaging, this protocol not only detects the existence or not of ischemia in myocardium, but it is also capable to give answers for any cause hiding behind patient’s complaints, even if these are not coming from myocardial ischemia.

Specialized assessment of myocardial ischemia and viability with:

Reliability: stronger reliability than scintigraphy, stress echo and stress test. Equivalent to ffr-coronography

Speed: duration 25 minutes

Comfort: Pharmacological stress

Safety: No exposure of the patient to radiation

Differential diagnosis: of ischemia from microvascular angina, pericarditis, extracardiac causes of precordial pain etc.

Fig.1: Assessment of myocardial ischemia with cardiac magnetic resonance imaging: the protocol

Stuff
Eleutherios Vidalakis, Cardiologist, specialised in cardiovascular imaging

MYOCARDIAL MAPPING WITH HEART MRI

A new, sensitive method of Covid 19-related myocardial damage detection

Mapping of the myocardium with a heart MRI is an advanced technique of multi-parameter mapping based on T1, T2 and T2* magnetic mapping sequences. This method provides us with high spatial analysis, so that we may be able to quantify lesions in every location within the myocardium. These new techniques are very specialized in detecting diffuse cardiac lesions, while assisting physicians, at the same time, to monitor the progress of myocardial disease, by comparing absolute numbers in successive measurements. Thus, myocardial mapping upgrades heart MRI diagnostic accuracy, by promoting this diagnostic method to reliability levels comparable to classic myocardial biopsies.

When is heart MRI myocardial mapping advisable?

Myocarditis: diagnosis, monitoring and confirmation of full recovery. In 2018 this technique was officially incorporated in the myocardial diagnosis criteria.
Myocardial attacks by autoimmune, rheumatic and systematic inflammatory diseases, such as lupus, rheumatoid arthritis, sarcoidosis, etc.
Heart tumor characterizations
HIV-related myocardial diseases
Amyloidosis, Fabri’s Disease
Differential hypertrophic myocardial conditions
Coronary disease prognosis
Covid 19-related heart lesions

MYOCARDITIS AND COVID-19

One year into the Covid-19 pandemic, our knowledge is continually growing on the coronavirus and the lesions it may cause to the heart. According to international medical studies, the virus may attack the heart causing myocardial infarctions, or the most commonly known inflammatory myocardial condition, namely, myocarditis. Most importantly, myocardial inflammation is frequently non-symptomatic and subclinical, meaning that the patient has no way to know that the infection has affected his/her heart.

So, with just one examination we may investigate whether the coronavirus infection has affected the heart, even in patients with no cardiological symptoms. This fact gives us the opportunity to promptly intervene and protect the myocardium from permanent damage and subsequent symptoms in the future.

Post-Covid 19 patients now have the opportunity to examine their cardiac condition at Metropolitan General, with a specialized heart MRI protocol, based on myocardial mapping techniques, personally adjusted to each ex-Covid-19 patient by Dr. Eleftherios Vidalakis, our specialized Cardiologist and Cardiac Imaging Specialist.

Contact number: (+30)210 650 2510 - 11

Director
Eleftherios Vidalakis, Cardiologist specialized in cardiovascular imaging

Associate
Savvas Loizos, Cardiologist specialized in cardiovascular imaging