Cardiac MRI Testing For Children - Pierangelo Renella, MD
To assist physicians of diagnosing congential heart defects in children, they often use cardiac MRI which provides non invasive evaluation for complex conditions. We learned from Dr. Pierangelo Renella of Children's Hospital of Orange County about this test. A cardiac MRI is an advanced imaging technique, is a non invasive technique which basically uses the power of a powerful magnet to focus certain molecules in your body. The energy released is then used to create an image, it's very different from the other forms of advanced imaging such as CT scanning for an example. CT scanning uses radiation to do the same thing. MRI does not use any radiation and for that reason it's a very safe procedure.
Cardiac MRI as an advanced imaging technique is usually necessary in patients in which standard imaging has not answered all the questions the doctors need to be able to care for them appropriately. The most common example of this are patients with very complex structural heart lesions that either have had surgery or will require surgery. The cardiac MRI can fill in some of the gaps the surgeon needs in order to perform the surgery the most safely and most effectively. Cardiac MRI is very well suited for children because children are born with heart defects that are very different from adult heart defects. They're born with usually structural heart disease and in that sense the cardiact MRI, because of it's capability to get a 3D pictures of the heart structures and 3D pictures of the vessels that are outside of the heart, makes that technique very well suited for especially patients with complex heart diseases. For that reason often surgeons will request a cardiac MRI to get a good road map of the different heart structures in 3 dimensions with functional and flow data so that they can plan their surgeries appropriately. Dr.
Renella tells us at what age children can have this test. The patients need to be about 8 or 9 years old to be able to lay still because you really do have to lay still and have to be able to follow breath holding instructions, be able to hold your breath when the technologist asks you. Here at CHOC we have a unique situation where we have a technologist and a cardiologist and radiologist; all three involved in the scan such that the scan becomes optimized and efficient, we do it in as little time as possible because the patient will need to lay there still and be following instructions for about 45 to 60 minutes to get all of the information that we need and for that reason it really does take a team to perform a good cardiac MRI.
But the children actually handle this very well. One way we get around this is we have a virtual movie system where we have these goggles that are placed over the head and they can actually see a movie or listen to music whichever their preference, while the MRI is going and they have a technologist in their ear by a microphone that can give them instructions. According to Dr. Renella, the technology is getting better and better. The beauty of cardiac MRI as an advanced technique is that you can really see the heart from any different angle you choose and in any thin plane that you choose so you can make the slices as thick or thin, as far as the image is concerned, as you'd like and in that way you can see very fine structures and the motion of very fine structures but you can also see the heart in its entirety and we do a technique called volume rendering where we actually make a cast of the whole heart and you can actually spin it on the screen and it looks very much like a real heart and so which ever, whether you need to see the surface of the heart, the blood vessels around the heart or even in the inside of the heart, we can basically manipulate the image even after the fact. Advanced imaging is a very satisfying field because you do ride the wave of the latest advancements of technology and you can often foresee advancements in other areas based on whats happening. It molds MRI, molds physics, mathematics, medicine, imaging all in one and for that reason it's extremely exciting and up in coming.
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