Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

Authors

  • Ted Trajcheski American Hospital Pristina, Pristina, Kosovo
  • Lulzim Brovina American Hospital Pristina, Pristina, Kosovo
  • Biljana Zafirova Department of Anatomy, Medical Faculty, University Ss. Cyril and Methodius, Skopje, Macedonia https://orcid.org/0000-0002-9776-6664
  • Lada Trajceska Department of Nephrology, University Clinic of Nephrology, Medical faculty, University Ss. Cyril and Methodius, Skopje, Macedonia https://orcid.org/0000-0001-8388-5921

DOI:

https://doi.org/10.3889/oamjms.2021.6085

Keywords:

Cardiac magnetic resonance imaging, Late gadolinium enhancement, Adenosine magnetic resonance stress perfusion, Quality assessment, Artifacts

Abstract

BACKGROUND: Cardiac magnetic resonance (CMR) as advanced diagnostic tool for the heart has been introduced in our institution since September 2019.

AIM: We report on the first fifty consecutive patients using this imaging modality.

METHODS AND MATERIALS: Strict protocol for CMR procedure, imaging quality assessment, contraindications, and informed consent were established. Patients selected for CMR were enrolled in a prospective registry. Visualizing the heart chambers, heart muscle and heart valves, resulted in acquiring complex imaging of the heart structure and function. When applicable, patients received gadolinium contrast agent for Late Gadolinium Enhancement (LGE). Adenosine was used for stress induced myocardial perfusion study. In this study, we report on the initial CMR procedures in the first 15 months.

RESULTS: The age of the patients ranges from 17 to 82 and the number of male and female patients was well balanced. No absolute contraindications were met in any patient. Relative contraindications were noted but did not prevent from performing the scan. Different cardiac pathologies were encountered in the examined patients. Most common was the ischemic heart disease – 19 (38%). We had 15 (30%) out of 46 (92%) CMR procedures with LGE showing fibrotic scaring. Quality image assessment was scaled from poor to excellent. Most of the assessments were graded very good and good (46% and 48%), no poor, and very poor noted.

CONCLUSION: CMR has been successfully introduced in Kosovo as excellent imaging tool for diagnosing and characterizing a nearly exhaustive spectrum of heart diseases.

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References

Shah S, Chryssos ED, Parker H. Magnetic resonance imaging: A wealth of cardiovascular information. Ochsner J. 2009;9(4):266-77. PMid:21603453

Bhuva AN, Moralee R, Moon JH, Manistry CH. Making MRI available for patients with cardiac implantable electronic devices: Growing need and barriers to change. Eur Radiol. 2020;30:1378-84. https://doi.org/10.1007/s00330-019-06449-5 PMid:31776746 DOI: https://doi.org/10.1007/s00330-019-06449-5

Kramer CM, Barkhausen J, Bucciarelli-Ducci C, Flamm SD, Ki RJ, Nagel E. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update. J Cardiovasc Magn Reson. 2020;22(1):17. https://doi.org/10.1186/s12968-020-00607-1 PMid:32089132 DOI: https://doi.org/10.1186/s12968-020-00607-1

Shehata ML, Basha TA, Hayeri MR, Hartung D, Teytelboym OM, Vogel-Claussen J. MR myocardial perfusion imaging: Insights on techniques, analysis, interpretation, and findings. Radiographics. 2014;34(6):1636-57. https://doi.org/10.1148/rg.346140074 PMid:25310421 DOI: https://doi.org/10.1148/rg.346140074

Hamirani YS, Kramer CM. Cardiac MRI assessment of myocardial perfusion. Future Cardiol. 2014;10(3):349-58. https://doi.org/10.2217/fca.14.18 PMid:24976472 DOI: https://doi.org/10.2217/fca.14.18

Doltra A, Amundsen BH, Gebker R, Fleck E, Kelle S. Emerging concepts for myocardial late gadolinium enhancement MRI. Curr Cardiol Rev. 2013;9(3):185-90. https://doi.org/10.2174/1573403x113099990030 PMid:23909638 DOI: https://doi.org/10.2174/1573403X113099990030

Greenwood JP, Motwani M, Maredia N, Brown JM, Everett CC, Nixon J, et al. Comparison of cardiovascular magnetic resonance and single-photon emission computed tomography in women with suspected coronary artery disease from the clinical evaluation of magnetic resonance imaging in coronary heart disease (CE-MARC) Trial. Circulation. 2014;129(10):1129-38. https://doi.org/10.1161/circulationaha.112.000071 PMid:24357404 DOI: https://doi.org/10.1161/CIRCULATIONAHA.112.000071

Munn Z, Pearson A, Jordan Z, Murphy F, Pilkington D, Anderson A. Patient anxiety and satisfaction in a magnetic resonance imaging department: Initial results from an action research study. J Med Imaging Radiat Sci. 2015;46(1):23-9. https://doi.org/10.1016/j.jmir.2014.07.006 PMid:31052060 DOI: https://doi.org/10.1016/j.jmir.2014.07.006

Mathew RC, Löffler AI, Salerno M. Role of cardiac magnetic resonance imaging in valvular heart disease: Diagnosis, assessment, and management. Curr Cardiol Rep. 2018;20(11):119. https://doi.org/10.1007/s11886-018-1057-9 PMid:30259253 DOI: https://doi.org/10.1007/s11886-018-1057-9

Ghadimi M, Sapra A. Magnetic resonance imaging contraindications. In: Stat Pearls. Treasure Island, FL: Stat Pearls Publishing; 2020.

Wolff SD, Schwitter J, Coulden R, Friedrich MG, Bluemke DA, Biederman RW, et al. Myocardial first-pass perfusion magnetic resonance imaging: A multicenter dose-ranging study. Circulation. 2004;110(6):732-7. https://doi.org/10.1161/01.cir.0000138106.84335.62 PMid:15289374 DOI: https://doi.org/10.1161/01.CIR.0000138106.84335.62

Klinke V, Muzzarelli S, Lauriers N, Locca D, Vincenti G, Monney P, et al. Quality assessment of cardiovascular magnetic resonance in the setting of the European CMR registry: Description and validation of standardized criteria. J Cardiovasc Magn Reson. 2013;15(1):55. https://doi.org/10.1186/1532-429x-15-55 PMid:23787094 DOI: https://doi.org/10.1186/1532-429X-15-55

Dickstein K. Clinical Utilities of Cardiac MRI an Article from the E-Journal of the ESC Council for Cardiology Practice. Vol. 6; 2008. Available from: https://www.escardio.org/journals/e-journal-of-cardiology-practice/volume-6/clinical-utilities-of-cardiac-mri. [Last accessed on 2021 Apr 10]

Lohrke J, Frenzel T, Endrikat J, Alves FC, Grist TM, Law M, et al. 25 years of contrast-enhanced MRI: Developments, current challenges and future perspectives. Adv Ther. 2016;33(1):1-28. https://doi.org/10.1007/s12325-015-0275-4 PMid:26809251 DOI: https://doi.org/10.1007/s12325-015-0275-4

Ainslie M, Miller C, Brown B, Schmitt M. Cardiac MRI of patients with implanted electrical cardiac devices. Heart. 2014;100(5):363-9. https://doi.org/10.1136/heartjnl-2013-304324 PMid:23872585 DOI: https://doi.org/10.1136/heartjnl-2013-304324

Irnich W, Irnich B, Bartsch C, Stermann W, Gufler H, Weiler G. Do we need pacemakers resistant to magnetic resonance imaging? Europace. 2005;7(4):353-65. https://doi.org/10.1016/j.eupc.2005.02.120 PMid:15944094 DOI: https://doi.org/10.1016/j.eupc.2005.02.120

Steinberg DH, Staubach S, Franke D, Sievert H. Defining structural heart disease in the adult patient: Current scope, inherent challenges and future directions. Eur Heart J Suppl. 2010;12(9):2-9. https://doi.org/10.1093/eurheartj/suq012 DOI: https://doi.org/10.1093/eurheartj/suq012

Lüscher TF. Cardiomyopathies: Definition, diagnosis, causes, and genetics. Eur Heart J. 2016;37(23):1779-82. https://doi.org/10.1093/eurheartj/ehw254 PMid:27317096 DOI: https://doi.org/10.1093/eurheartj/ehw254

Bamalan OA, Soos MP. Anatomy, thorax, heart great vessels. In: Stat Pearls. Treasure Island, FL: Stat Pearls Publishing; 2020.

Laspas F, Pipikos T, Karatzis E, Georgakopoulos N, Prassopoulos V, Andreou J, et al. Cardiac magnetic resonance versus single-photon emission computed tomography for detecting coronary artery disease and myocardial ischemia: Comparison with coronary angiography. Diagnostics (Basel). 2020;10(4):190. https://doi.org/10.3390/diagnostics10040190 PMid:32235380 DOI: https://doi.org/10.3390/diagnostics10040190

Lopez-Mattei JC, Shah DJ. The role of cardiac magnetic resonance in valvular heart disease. Methodist Debakey Cardiovasc J. 2013;9(3):142-8. https://doi.org/10.14797/mdcj-9-3-142 PMid:24066197 DOI: https://doi.org/10.14797/mdcj-9-3-142

Seewöster T, Hilbert S, Spampinato RA, Hahn J, Hindricks G, Bollmann A, et al. Tumor or thrombus? The role of cardiac magnetic resonance imaging in differentiating left atrial mass in a transplanted heart: A case report. J Atr Fibrillation. 2017;10(4):1608. https://doi.org/10.4022/jafib.1608 PMid:29487675 DOI: https://doi.org/10.4022/jafib.1608

Thavendiranathan P, Dickerson JA, Scandling D, Balasubramanian V, Pennell ML, Hinton A, et al. Comparison of treadmill exercise stress cardiac MRI to stress echocardiography in healthy volunteers for adequacy of left ventricular endocardial wall visualization: A pilot study. J Magn Reson Imaging. 2014;39(5):1146-52. https://doi.org/10.1002/jmri.24263 PMid:24123562 DOI: https://doi.org/10.1002/jmri.24263

Hansen MW, Merchant N. MRI of hypertrophic cardiomyopathy: Part I, MRI appearances. AJR Am J Roentgenol. 2007;189(6):1335-43. https://doi.org/10.2214/ajr.07.2286 PMid:18029869 DOI: https://doi.org/10.2214/AJR.07.2286

Sakuma H. Coronary CT versus MR angiography: The role of MR angiography. Radiology. 2011;258(2):340-9. https://doi.org/10.1148/radiol.10100116 PMid:21273518 DOI: https://doi.org/10.1148/radiol.10100116

Weinreb JC, Rodby RA, Yee J, Wang C, Fine D, McDonald R, et al. Use of intravenous gadolinium-based contrast media in patients with kidney disease: Consensus statements from the American college of radiology and the national kidney foundation. Radiology. 2021;298(1):28-35. https://doi.org/10.1148/radiol.2020202903 PMid:33170103 DOI: https://doi.org/10.1148/radiol.2020202903

Shellock FG, Woods TO, Crues JV 3rd. MR labeling information for implants and devices: Explanation of terminology. Radiology. 2009;253(1):26-30. https://doi.org/10.1148/radiol.2531091030 PMid:19789253 DOI: https://doi.org/10.1148/radiol.2531091030

Dziuda Ł, Zieliński P, Baran P, Krej M, Kopka L. A study of the relationship between the level of anxiety declared by MRI patients in the STAI questionnaire and their respiratory rate acquired by a fibre-optic sensor system. Sci Rep. 2019;9(1):4341. https://doi.org/10.1038/s41598-019-40737-w PMid:30867494 DOI: https://doi.org/10.1038/s41598-019-40737-w

Alfudhili K, Masci PG, Delacoste J, Ledoux BJ, Bercheier G, Dunet V, et al. Current artefacts in cardiac and chest magnetic resonance imaging: Tips and tricks. Br J Radiol. 2016;89(1062):20150987. https://doi.org/10.1259/bjr.20150987 PMid:26986460 DOI: https://doi.org/10.1259/bjr.20150987

Ferreira PF, Gatehouse PD, Mohiaddin RH, Firmin D. Cardiovascular magnetic resonance artefacts. J Cardiovasc Magn Reson. 2015;15(1):41. https://doi.org/10.1186/1532-429x-15-41 PMid:23697969 DOI: https://doi.org/10.1186/1532-429X-15-41

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Published

2021-05-14

How to Cite

1.
Trajcheski T, Brovina L, Zafirova B, Trajceska L. Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report. Open Access Maced J Med Sci [Internet]. 2021 May 14 [cited 2024 Mar. 28];9(B):417-25. Available from: https://oamjms.eu/index.php/mjms/article/view/6085

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