The Cardiovascular Magnetic Resonance Imaging (MRI) Unit has a mix of professional staff, with a team composed of 8 doctors, between specialists in Cardiology and Radiology, 7 radiology technicians and 8 nurses.
In 2015, 1,982 cardiac resonance imaging procedures were performed, of which about 40% with pharmacological stress.
MRI is one of the most recent and innovative diagnostic methods in cardiology. In this field its main applications are:
accurate and reliable evaluation of ventricular volumes, the ventricular ejection fraction and myocardial mass, with techniques already used in echocardiography, but with better definition of the endocardial and epicardial contours; because of this and its excellent reproducibility, it is now considered the gold standard method;
study of myocardial perfusion and contractile reserve, combining the information generally obtained from different examinations such as echo-stress and nuclear medicine tests in a single diagnostic method;
study of myocardial viability by the identification of areas of scarring of the myocardial wall, which is currently fundamental information both for determining the indication for revascularization procedures and for the prognostic stratification of patients with a broad variety of heart disorders.
Thanks to this triple evaluation, MRI can be used in countless clinical contexts such as ischaemic heart disease, dilated cardiomyopathy, myocarditis, hypertrophic cardiomyopathy, arrhythmogenic right ventricular disease, congenital heart disorders, valvulopathies, pericardial diseases and the study of cardiac masses.
In addition to the study of heart disease, MRI is a valid alternative to multidetector CT in the evaluation of vascular diseases, with the enormous advantage of not using ionizing radiation. This makes MRI safer and increases the repeatability of the examination, especially in patients who require regular, long-term follow-up.
The research activity of the Cardiac Imaging Area is deeply integrated with the daily clinical work and includes echocardiography, computed tomography and magnetic resonance.
Regarding recent research projects, our main efforts are focused on:
- new methods in transthoracic and transesophageal 3D-echocardiography demonstrating advantages of 3D vs 2D-echocardiography in the evaluation of right ventricular function, mitral valve prolapse, intraoperative monitoring of cardiac surgery, left atrial function;
- feasibility and accuracy of non-invasive evaluation of coronary arteries, stents and bypass grafting through cardiac computed tomography;
- new technical advances in radiation dose reduction in cardiac computed tomography maintaining a high accuracy in native and stented coronary arteries evaluation;
- cardiac CT and prognosis;
- new bioengineering approaches to cardiac imaging computation, mainly in the field of 3D-echocardiography;
- collaboration with other Units within the framework of a disease-specific multidisciplinary team in the evaluation of patients undergoing electrophysiological approaches, cardiac failure therapies, PCI procedures, cardiac surgery (including percutaneous/transapical aortic valve implantation, mitral clip, left atrial appendage closure).
A recent field of scientific interest is the new real-time 3D-echocardiographic imaging. In particular, our attention is focused on the quantification of novel 3D left ventricular shape indices, able to overcome the limitations relevant to prior 2D indices, to better follow ventricular remodelling after surgery and to study the coupling between left ventricular function and morphology.
Recently, MRI has been integrated in our area and, even though the Unit start-up allowed us only a 2 year experience (with more than 1000 cases per year), has allowed new approaches such as the analysis of the tricuspid valve by an innovative method of acquisition and reconstruction of images of the tricuspid annulus and right ventricle. Interestingly, tricuspid annulus is relatively easily evaluated through this novel MRI method and an accurate dynamic reconstruction has been shown to be feasible.