Cardiovascular Magnetic Resonance Imaging and MR-Conditional Cardiac Devices

This chapter provides a condensed review of the basic principles of magnetic resonance imaging (MRI) and introduces the reader to some of the concepts and terminology necessary to understand the use of MRI to study the heart. We then proceed to describe a

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24

Michael D. Eggen and Cory M. Swingen

Abstract

This chapter provides a condensed review of the basic principles of magnetic resonance imaging (MRI) and introduces the reader to some of the concepts and terminology necessary to understand the use of MRI to study the heart. We then proceed to describe a wide range of MRI cardiac applications, both in vivo and ex vivo, which should interest the biomedical engineer. While the capabilities of cardiac MRI are quite extensive, our choice of topics for this chapter is rather judicious, as cardiac MRI has evolved to the point where entire books are published on the subject. Keywords

MRI • CMRI • Magnetic resonance imaging • Myocardial viability • Myocardial perfusion • Myocardial function • Morphology • Blood flow velocity • Fiber structure • Interventional MRI • Wall motion • Wall thickening • Myocardial strain • MR-Conditional pacemaker • MR-Conditional ICD

24.1 Introduction “Magnetic resonance imaging” (MRI) of the heart has rapidly become very popular worldwide, because of its clinical versatility and flexibility, i.e., since it allows one to acquire information on anatomical structure and function simultaneously. An additional benefit of MRI is that patients are not subjected to any ionizing radiation or invasive procedures (e.g., catheterization). Recently, many specialized MR techniques have become available for cardiovascular imaging Electronic supplementary material:  The online version of this chapter (doi:10.1007/978-3-319-19464-6_24) contains supplementary material, which is available to authorized users. Videos can also be accessed at http://link.springer.com/book/10.1007/978-3-319-19464-6_24. M.D. Eggen, PhD (*) Medtronic, 8200 Coral Sea Street NE, Mounds View, Minneapolis, MN 55112, USA e-mail: [email protected] C.M. Swingen, PhD Department of Medicine, University of Minnesota, Minneapolis, MN, USA

and thus may potentially replace other types of imaging modalities. As such, cardiac MR may become the “one-stop shop” for imaging, as it is able to: (1) measure myocardial blood flow; (2) differentiate viable from nonviable myocardial tissue; (3) depict the structure of peripheral and coronary vessels (magnetic resonance angiography); (4) measure blood flow velocities (MR velocity mapping); (5) examine metabolic energetics (MR spectroscopy); (6) assess myocardial contractile properties (multislice, multiphase cine imaging, MR tagging); and/or (7) guide interventional procedures with real-time imaging (interventional MRI). The capabilities of MRI as a tomographic imaging modality to capture, with high spatial resolution, the anatomy of 3D structures were already well appreciated before the first attempts were made to apply MRI to the heart. Yet cardiac motion, compounded by respiratory motion and turbulent blood flow in the ventricular cavities and large vessels, initially imposed formidable barriers to the acquisition of artifact-free images that could depict cardiac anatomy with sufficient detail. It has taken well over a decade for cardiac MR

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