This session addressed several “hot” aspects which can explain why cardiologists are looking towards Magnetic Resonance Imaging (MRI) as a new powerful weapon to use in their clinical as well as research activities.
Dr. Laissy, from Paris, showed convincing images obtained in patients with myocarditis. He shortly reported the several studies which have recently evaluated the use of MRI to detect the presence of signs of acute myocardial inflammation such as oedema or the presence of necrotic areas due to a previous episode.
Dr McCrohon, from Sydney, nicely summarised the added potential of MRI in patients with dilated cardiomyopathy. In fact, if no scar within the myocardium is evidenced by MRI, there is a very high possibility that the physician can exclude coronary artery disease as a cause of dilatation.
Dr. Schulz-Menger, from Berlin, managed to let the audience believe that also the diagnosis of Sarcoid heart disease can be reduced to an easy task by MRI. The data she showed were surprisingly clear also to those unaware of MRI. If I can summarize her talk I will suggest that a patient suspected of Sarcoidosis should undergo an MRI examination probably before an invasive biopsy.
Dr. Friedrich from Calgary managed to open a new window inside the presence and the meaning of myocardial oedema within the acute phase of an acute myocardial infarction. Probably, he concluded, this is a new way to address the area at risk and it opens new possibilities in the therapy of myocardial infarction.
Dr. Buser, from Basel, reminded the audience that arrhythmogenic right ventricular cardiomyopathy is a complex disease without any “un-doubtful” signs. Even the presence of fibro-fatty infiltration of the right ventricular free wall cannot be considered as the most accurate marker of the disease. Nevertheless, MRI remains the only real possibility of evaluating patients suspected of being affected by this potentially life threatening disease.
Conclusion
The data and the images which have been reported by the speakers in this session, enforce my idea that MRI is beginning to bring into clinical cardiology the enormous potential that these kinds of images intrinsically have (someone has defined them as “chemical images” as they reflect the chemical composition of the tissues).
I received the impression from the audience that this complex technique is rapidly spreading through our countries and it is considered to have a positive cost/effect ratio. In my opinion it will never reach the level of being considered a true non-invasive approach.
Nevertheless, several aspects can be addressed even better by this non-invasive approach, which is repeatable due to the non-ionising (green) nature of the radio waves which MRI utilises.
The content of this article reflects the personal opinion of the
author/s and is not necessarily the official position of the
European Society of Cardiology.