Cardiovascular magnetic resonance: What clinicians should know about safety and contraindications. (15th May 2021)

• Record Type: Journal Article
• Authors: Barison, Andrea; Baritussio, Anna; Cipriani, Alberto; De Lazzari, Manuel; Aquaro, Giovanni Donato; Guaricci, Andrea Igoren; Pica, Silvia; Pontone, Gianluca; Todiere, Giancarlo; Indolfi, Ciro; Dellegrottaglie, Santo
• Is Part Of: International journal of cardiology. Volume 331(2021)
• Page Start: 322
• Page End: 328
• Publication Date: 2021-05-15
• Subjects: Cardiovascular magnetic resonance -- Safety -- Contraindications -- Gadolinium -- Cardiac electronic devices -- Stressors; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.02.003
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Cardiovascular magnetic resonance (MR) is a multiparametric, non-ionizing, non-invasive imaging technique, which represents the imaging gold standard to study cardiac anatomy, function and tissue characterization. Faced with a wide range of clinical application, in this review we aim to provide a comprehensive guide for clinicians about MR safety, contraindications and image quality. Starting from the physical interactions of the static magnetic fields, gradients and radiofrequencies with the human body, we will describe the most common metal and electronic devices which are allowed (MR-safe), allowed under limited conditions (MR-conditional) or contraindicated (MR-unsafe). Moreover, some conditions potentially affecting image quality and patient comfort will be mentioned, including arrhythmias, claustrophobia, and poor breath-hold capacity. Finally, we will discuss the pharmacodynamics and pharmacokinetics of current gadolinium-based contrast agents, their contraindications and their potential acute and chronic adverse effects, as well as the safety issue concerning the use of vasodilating/inotropic agents in stress cardiac MR. Highlights: Cardiac magnetic resonance (MR) is a safe, versatile, non-invasive imaging technique. MR uses three magnetic fields: static, gradient and radiofrequency magnetic fields. All items can be classified as MR-safe, MR-conditional or MR-unsafe. Current gadolinium-based contrast agents can be safely used in nearly all patients. Common vasodilating/inotropic agents can be used for stress cardiac MR.