Indications for Pediatric/Congenital Cardiac MRI
Cardiac magnetic resonance imaging (MRI) obtains images of the heart and blood vessels with a magnetic resonance scanner which uses magnets and computers to obtain images. Cardiac MRI does not expose the patient to radiation. A cardiac MRI is not a single test, but consists of multiple different ways of looking at the heart. This can include: a detailed assessment of cardiac anatomy, visualizing the heart in motion, measuring blood vessel and cardiac chamber sizes, measuring the function of the heart, measuring flow through blood vessels, obtaining a 3D picture of the heart, looking for scar within the heart muscle, and evaluating the heart during exercise (medication given to simulate exercise). There are many potential reasons for a patient to be referred for a cardiac MRI. In younger patients, cardiac MRI can add to the information obtained from an echocardiogram by imaging cardiovascular structures that cannot be well visualized by an echocardiogram. In teenagers and adults, it often becomes difficult to see all cardiac structures by echocardiography. In these patients, cardiac MRI can become the primary way to image the heart. We can perform cardiac MRI on many types of pediatric/congenital heart disease. Please discuss with your primary physician or cardiologist whether cardiac MRI would be indicated for you or your child. You can also feel free to call our office 919-668-5582 with any questions.
Contraindications for Pediatric/Congenital Cardiac MRI
The following patients may not undergo cardiac MR imaging:
- Patient with metal fragments in their eyes.
- Patients with retained metal wires in the heart, brain or spine.
- Patients with non-titanium aneurysm clips that are not labeled ‘MR compatible’ by the manufacturer.
- Patients with fever.
- Patients with cochlear implants.
The following patients may possibly undergo cardiac MR imaging if cleared with additional screening:
- Patients with severe renal failure may undergo cardiac MRI but will be unable to receive gadolinium contrast.
- Patients with a history of titanium aneurysm clips or non-titanium clips labeled ‘MR compatible’ may enter the scanner once cleared by a physician responsible for the implant.
Patients with defibrillators or pacemakers.
The following are not contraindications but please let us know if you have any vascular stents or coils, large tattoos, medication patches, metal skin staples or a history of asthma.
About the procedure
We ask that you arrive 30 minutes prior to your examination time to complete necessary paperwork. Your early arrival will help ensure that we are able to perform your test efficiently and safely. If you have to cancel and/or reschedule your appointment for any reason, please contact our office as soon as possible at phone number (919) 668-5582.
An IV catheter will be necessary as some of the images require the injection a contrast agent. For children, we can provide numbing agents (EMLA cream) as necessary for IV placement. Once your test is completed, you may be asked to wait while the images are examined. Once you leave, you may resume your normal activities immediately. A report of the study will be sent to the referring physician. Please contact the office of your primary care physician or cardiologist to discuss the final results.
Patient instructions without general anesthesia:
Because metal interferes with our images, you will need to change into a hospital gown and remove objects such as hearing aids, hair clips, jewelry and glasses. A locked cabinet is provided for your belongings. You will lie flat on your back in the scanner, with a pillow. If you wish, a family member may come into the scanner room with you if they are cleared by our team. The scanner’s magnet which helps create the images makes loud noises during your exam. You will wear a headset to help with the noise and listen to music if you like. The person performing the scan will be in an adjoining room and will use the headset to talk to you and to hear you if you want to talk to us. There will be times when we will ask you to hold your breath for 10 to 20 seconds so that we can get clear pictures. It will be important for you to remain as still as possible for the same reason. A typical scan can last from 1-2 hours but we will make it as short as possible, while still making sure that we obtain all of the necessary information.
Patient instructions for Pediatric/Congenital Cardiac MRI with anesthesia:
In order to obtain accurate information and quality images from a cardiac MRI, it is important that the patient lie very still for 1-2 hours and also hold his or her breath intermittently for 10-20 seconds. Because of this, general anesthesia is often required for young children and also some teenagers/adults with developmental or behavioral problems. Decisions regarding who requires general anesthesia for their cardiac MRI are made on a case by case basis. Please discuss this with your referring physician or call our office to discuss (919) 668-5582.
When your child is scheduled for a cardiac MRI with anesthesia, you will be asked to bring your child to a pre-operative appointment on the day before the scheduled test. This appointment will be on the third floor of the Children’s Health Center at Duke University Hospital (North Campus). You will meet with the pediatric cardiac anesthesia staff and they will assess your child. If your child has an infection, then we may reschedule the cardiac MRI. Lab work or a chest x-ray is necessary in some, but not all cases. The anesthesia staff will discuss the anesthesia process and associated risks. They will also provide instructions as to when your child should stop eating/drinking prior to the cardiac MRI and anesthesia. You will also meet with one of the physicians who will be performing the cardiac MRI, and they will discuss the procedure with you.
On the day of the cardiac MRI you should report to Cardiac MRI on the 7th floor of Duke University Hospital (North Campus). You will be asked to complete some necessary paperwork. Your child will be asked to change into a hospital gown. You will meet the team who will be performing the cardiac MRI. Once the study begins, family members will be asked to wait in the waiting room. The study will last 1-2 hours. Family members will be provided a phone number to call for updates. Once the study is complete, a physician will come to the waiting room to discuss the results with family members and walk them to the recovery room. Your child will be taken to the recovery room where he or she will recover from anesthesia. Once he or she has recovered from anesthesia, he or she will be discharged and can resume normal activities. A report of the study will sent to the referring physician. Please contact the office of your primary care physician or cardiologist to discuss the final results.