Interventional cardiovascular magnetic resonance: state-of-the-art

Area of Science:

• Cardiovascular medicine
• Medical imaging
• Interventional cardiology

Background:

• Transcatheter cardiovascular interventions require advanced imaging for guidance.
• X-ray fluoroscopy offers device visualization but poor anatomical detail.
• Magnetic resonance imaging (MRI) provides excellent anatomical visualization and real-time imaging capabilities.

Purpose of the Study:

• To review technical considerations for interventional cardiovascular magnetic resonance (iCMR).
• To summarize current clinical iCMR experiences.
• To explore future applications of iCMR in cardiovascular interventions.

Main Methods:

• Review of technical challenges in adapting devices for iCMR.
• Discussion of innovations in MRI scanner and interventional device technology.
• Summary of contemporary clinical iCMR programs and procedures.

Main Results:

• Existing devices cause artifacts and heating issues in MRI environments.
• Clinical iCMR programs are emerging for hemodynamic and electrophysiology studies.
• Innovations, particularly low-field MRI scanners, may enable complex iCMR procedures.

Conclusions:

• MRI offers significant advantages for cardiovascular interventions, including superior anatomy visualization and radiation avoidance.
• Technical hurdles related to device compatibility and safety are being addressed through innovation.
• Advancements in MRI technology and device design are poised to expand the scope of iCMR procedures.