Interventional cardiovascular magnetic resonance: state-of-the-art

Transcatheter cardiovascular interventions increasingly rely on advanced imaging. X-ray fluoroscopy provides excellent visualization of catheters and devices, but poor visualization of anatomy. In contrast, magnetic resonance imaging (MRI) provides excellent visualization of anatomy and can generate...

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Bibliographic Details
Published in:Journal of cardiovascular magnetic resonance 2023-08, Vol.25 (1), p.48-48, Article 48
Main Authors: Rogers, Toby, Campbell-Washburn, Adrienne E., Ramasawmy, Rajiv, Yildirim, D. Korel, Bruce, Christopher G., Grant, Laurie P., Stine, Annette M., Kolandaivelu, Aravindan, Herzka, Daniel A., Ratnayaka, Kanishka, Lederman, Robert J.
Format: Article
Language:English
Subjects:
Ablation
Anatomy
Blood vessels
Cardiac arrhythmia
Cardiac Catheterization
Cardiovascular disease
Catheterization
Catheters
Congenital diseases
Conspicuity
Electrophysiology
Fluoroscopy
Heart
Hemodynamics
Humans
iCMR
Interventional cardiovascular magnetic resonance
Intubation
Invasive cardiovascular magnetic resonance
Ionizing radiation
Magnetic fields
Magnetic Resonance Imaging
Magnetic Resonance Imaging, Interventional
Magnetic Resonance Spectroscopy
Medical imaging
Patients
Pediatrics
Predictive Value of Tests
Pulmonary arteries
Pulmonary hypertension
Radiation
Radiation effects
Review
Safety engineering
Scanners
Software
Transplants & implants
Visualization
X ray imagery
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Description
Summary:Transcatheter cardiovascular interventions increasingly rely on advanced imaging. X-ray fluoroscopy provides excellent visualization of catheters and devices, but poor visualization of anatomy. In contrast, magnetic resonance imaging (MRI) provides excellent visualization of anatomy and can generate real-time imaging with frame rates similar to X-ray fluoroscopy. Realization of MRI as a primary imaging modality for cardiovascular interventions has been slow, largely because existing guidewires, catheters and other devices create imaging artifacts and can heat dangerously. Nonetheless, numerous clinical centers have started interventional cardiovascular magnetic resonance (iCMR) programs for invasive hemodynamic studies or electrophysiology procedures to leverage the clear advantages of MRI tissue characterization, to quantify cardiac chamber function and flow, and to avoid ionizing radiation exposure. Clinical implementation of more complex cardiovascular interventions has been challenging because catheters and other tools require re-engineering for safety and conspicuity in the iCMR environment. However, recent innovations in scanner and interventional device technology, in particular availability of high performance low-field MRI scanners could be the inflection point, enabling a new generation of iCMR procedures. In this review we review these technical considerations, summarize contemporary clinical iCMR experience, and consider potential future applications.
ISSN:1097-6647
1532-429X
DOI:10.1186/s12968-023-00956-7