Division of Pediatric Cardiology, UCSF Benioff Children's Hospitals, University of California, San Francisco, San Francisco, CA, USA.
Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Curr Cardiol Rep. 2022 Apr;24(4):419-429. doi: 10.1007/s11886-022-01659-8. Epub 2022 Feb 2.
Cardiac magnetic resonance imaging provides radiation-free, 3-dimensional soft tissue visualization with adjunct hemodynamic data, making it a promising candidate for image-guided transcatheter interventions. This review focuses on the benefits and background of real-time magnetic resonance imaging (MRI)-guided cardiac catheterization, guidance on starting a clinical program, and recent research developments.
Interventional cardiac magnetic resonance (iCMR) has an established track record with the first entirely MRI-guided cardiac catheterization for congenital heart disease reported nearly 20 years ago. Since then, many centers have embarked upon clinical iCMR programs primarily performing diagnostic MRI-guided cardiac catheterization. There have also been limited reports of successful real-time MRI-guided transcatheter interventions. Growing experience in performing cardiac catheterization in the magnetic resonance environment has facilitated practical workflows appropriate for efficiency-focused cardiac catheterization laboratories. Most exciting developments in imaging technology, MRI-compatible equipment and MRI-guided novel transcatheter interventions have been limited to preclinical research. Many of these research developments are ready for clinical translation. With increasing iCMR clinical experience and translation of preclinical research innovations, the time to make the leap to radiation-free procedures is now.
心脏磁共振成像提供了无辐射的三维软组织可视化，并附有辅助血流动力学数据，使其成为图像引导经导管介入治疗的有前途的候选方法。本综述重点介绍实时磁共振成像（MRI）引导的心脏导管术的优势和背景、启动临床项目的指导以及最近的研究进展。
介入性心脏磁共振（iCMR）已有成熟的应用记录，早在近 20 年前就有首例完全 MRI 引导的先天性心脏病心脏导管术的报道。此后，许多中心已经开展了临床 iCMR 项目，主要进行诊断性 MRI 引导的心脏导管术。也有一些关于成功实施实时 MRI 引导的经导管介入治疗的有限报告。在磁共振环境中进行心脏导管术的经验不断增加，为注重效率的心脏导管术实验室制定了实用的工作流程。成像技术、MRI 兼容设备和 MRI 引导的新型经导管介入治疗方面的大多数令人兴奋的发展仅限于临床前研究。其中许多研究进展已准备好进行临床转化。随着 iCMR 临床经验的增加和临床前研究创新的转化，现在是迈向无辐射手术的时机。
