Show AllCardiac MRIs are usually for evaluation of the heart of patients with very specific conditions. At Cincinnati Children's, they are most commonly performed on teenagers and young adults with previously operated congenital heart disease.
A cardiac MRI takes very clear pictures of the heart and blood vessels in the chest, regardless of the patient's size (large size can often limit the quality of other types of imaging, such as ultrasound / echocardiography). In addition, cardiac MRI is able to provide detailed measures of certain heart parameters unavailable by other means.
Who performs Cardiac MRI?
The Cardiac MRI test is performed by a specially trained MRI technologist, with continuous assistance from a pediatric MRI Radiologist and a pediatric MRI Cardiologist. The input of all these personnel is essential for useful studies, and explains why the test is available only at Cincinnati Children's Burnet Campus.
Interpreting Results
The study will be interpreted in detail by both a pediatric MRI cardiologist and pediatric MRI radiologist. Preliminary MRI results will be available to you and your child's pediatric cardiologist immediately after the scan from the MRI cardiologist. The final report, including detailed numerical analysis and movie clips, will be available to your child's pediatric cardiologist within a few days.
Sedation
Most patients do not require sedation. Some young adult patients do have claustrophobia from lying in the magnet for a prolonged period. For these patients, a single dose of oral diazepam (Valium) usually provides adequate anxiety relief for them to tolerate the scan.
Patients also must be able to follow instructions carefully, though no longer need to be able to hold their breath. As long as they can remain still and breathe comfortably, children can generally tolerate a cardiac MRI scan by simply watching a movie (on specially equipped “Virtual Reality” goggles) or listening to music. As such, anesthesia is usually only needed for children less than 5-6 years of age (depending on the maturity level of the child).
When general anesthesia is required, the Division of Anesthesiology runs the sedation, under the guidance of an attending anesthesiologist.
Child has had metal clips/ implants placed. Can he / she still undergo a cardiac MRI?
Usually. The only permanent, implanted devices absolutely not allowed in the MRI scanner are implanted defibrillators, since the powerful MRI magnet can theoretically disrupt the defibrillator function. The magnet does not disrupt function of other metal devices, such as implanted artificial heart valves, metal sternal wire, braces on the teeth, clips, or other devices. Certain selected patients with pacemakers can now also safely undergo MRI studies, though this is reserved for very special circumstances and requires even more planning and personnel.
Any removable metal should be removed as well. However, if your child has had numerous metal devices placed, in his / her chest, artifact from the devices may obscure useful pictures of the heart. Although this does not make the procedure unsafe, it may make it un-useful. Therefore, in patients will several metal devices and / or coils in the chest, a chest X-ray may be performed prior to the MRI so that the MRI radiologist and cardiologist can make sure there will not be too much artifact.
Before coming to the hospital or MRI facility, talk to your child about the scan. Depending on your child's reason for the exam, an IV may be required for the MRI. If an IV is necessary, topical anesthetic will be applied to your child shortly after check-in. Prepare your child as you see fit. The day of the exam, technologists will further explain the scan to your child and answer any questions.
You should receive a phone call to confirm your appointment 24 to 48 hours prior to the MRI exam. We prepare all patients with specific eating and drinking instructions in case an IV will need to be given during the test. You will also be instructed to arrive 30 minutes prior to your scheduled scan to allow time for registration, removal of all jewelry and metal and IV placement if need be.
The MRI machine is a large magnet. Therefore, dress your child in comfortable clothing with no metal snaps or zippers. Remove all metal hair barrettes or rubber bands and earrings. Check any toys or stuffed animals for metal parts before bringing them to the MRI area.
Children are encouraged to bring a favorite music CD or video to watch during the MRI scan.
The MRI machine is a large magnet that is in the shape of a tunnel. Whatever body part that is being scanned needs to be in the center of the tunnel.
While your child is lying on a table in the middle of the tunnel, nothing will touch or hurt him / her as the pictures are being taken. The technologist will explain to your child that when we start to take the pictures, loud knocking or banging noises may be heard. Whenever your child hears the loud noise, he / she will need to hold perfectly still. To protect the child's hearing, earplugs will be given earplugs or special headphones to listen to a CD or video.
The MRI can be as short as 30 minutes, but sometimes can last for up to 2 hours. During that time, your child has to hold perfectly still (like a statue). Several series of pictures will be taken. Pictures could last between 30 seconds to 7 minutes each. The technologist will talk to your child between each set of pictures to assure that he / she is okay.
Parents are welcome to accompany their children into the scan room, as long as you are not pregnant and all jewelry and metal is removed. Parents will be given earplugs during the scan.
Sometimes an IV is also used to give a small amount of contrast material during the test. This is a clear fluid that shows up on the pictures. The IV will remain in place until the scan is completed. If your child experiences any discomfort, please tell the technologist.
If your child is unable to hold still for the pictures and he / she was scheduled for an MRI without sedation, you will most likely need to reschedule your appointment with sedation and return at a different date.
When the MRI pictures are complete, your child will lie on the table a few moments longer while a radiologist checks to make sure there are enough pictures. Sometimes a set of pictures will need to be repeated (this takes 5-10 minutes). Once the doctor checks the pictures and confirms that the scan is complete, the IV will be removed.
Some patients and families may then leave. Other patients and families will instead first be directed to a computer monitor to review the study images with the MRI cardiologist, if your regular cardiologist has requested this consultation. Either way, your regular cardiologist and the MRI cardiologist will confer about the study shortly thereafter, and your cardiologist will arrange follow-up as necessary.
