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cardiovascular imaging

Cardiac MRI – the heart in all its functional aspects

Cardiac MRI provides detailed images of the heart muscle, heart function and tissue structure – without the use of X-rays. It is a particularly important procedure for diagnosing inflammation of the heart muscle (myocarditis) and heart muscle disorders (cardiomyopathies).

Unfortunately, it is not currently possible to book this examination online.

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Basics

What is a cardiac MRI?

Cardiac MRI (magnetic resonance imaging of the heart) is a non-invasive examination that can visualise the heart gently and without exposure to radiation. It enables a comprehensive assessment of heart function, the heart muscle, the heart chambers, the heart valves and tissue structures. Important functional parameters, such as the heart’s pumping function and regional wall motion abnormalities, can be measured precisely.

A particular advantage of cardiac MRI is the assessment of heart muscle tissue. Inflammation of the heart muscle (myocarditis), scar tissue following a heart attack, and changes associated with heart muscle diseases can be reliably detected and assessed.

Cardiac stress MRI can be used to investigate impaired blood flow to the heart muscle in cases where coronary heart disease (CHD) is suspected.

Cardiac MRI provides important information for treatment planning and, in suitable patients, can help to ensure that invasive procedures such as cardiac catheterisation are used more selectively or, in certain cases, avoided altogether.

Heart functions

What can a cardiac MRI show?

Cardiac MRI provides answers to questions that other techniques are often unable to answer.

Heart function
  • Precise measurement of the ejection fraction, stroke volume, cardiac output and regional wall motion abnormalities.
Myocarditis
  • Detection of active myocarditis using T1/T2 mapping and late gadolinium enhancement (LGE).
Heart attack scars
  • Precise localisation and extent of cardiac scar tissue following a myocardial infarction – for the assessment of viability.
Cardiomyopathies
  • Differentiation between HCM, DCM, ARVC and other structural heart muscle disorders.
Heart valves
  • Dynamic assessment of heart valves, regurgitation and stenosis – without exposure to radiation.
Congenital heart defects
  • 3D anatomical visualisation of congenital heart defects, before and after surgery.

In comparison

Cardiac CT vs. cardiac MRI: When to use which?

Cardiac CT and cardiac MRI are two modern imaging techniques that complement one another in their applications. Which method is more suitable depends on the specific clinical issue.

Cardiac CT is particularly effective at visualising the coronary arteries and is regarded as the best method for this purpose. It is also very effective at detecting calcium deposits as part of calcium scoring. Furthermore, the technique is suitable for assessing bypass grafts and stents, as well as for visualising the aorta and pulmonary vessels. Another advantage is the very short examination time of around 15 minutes.

Cardiac MRI, on the other hand, offers particular advantages in the examination of heart muscle tissue and in cases of inflammation, and is regarded as the best method in this area. Scar tissue can also be visualised precisely using a technique known as late gadolinium enhancement. The examination is completely radiation-free and is also well suited to the assessment of heart valves and congenital heart defects.

Indications

When is a cardiac MRI used?

A cardiac MRI is suitable for investigating various issues relating to the heart’s blood vessels and anatomy.

Myocarditis
  • Diagnosis and monitoring of myocarditis following infections or autoimmune diseases.
Cardiomyopathy
  • Differential diagnosis and monitoring of HCM (hypertrophic), DCM (dilated) and other heart muscle diseases.
Heart failure
  • Precise measurement of pumping function and wall motion abnormalities in heart failure.
After a heart attack
  • Assessment of the extent of the infarct and viable cardiac muscle tissue (viability assessment) prior to revascularisation.
Congenital heart defects
  • Anatomical diagnosis and follow-up of congenital heart disease.
Heart valve defects
  • Dynamic assessment of valve function and the severity of regurgitation or stenosis.

Preparation

What you need to bear in mind before a cardiac CT scan

Important note: You must not take any phosphodiesterase-5 inhibitors (sildenafil/Viagra, tadalafil/Cialis, vardenafil/Levitra, etc.) for 72 hours prior to the cardiac CT scan. When taken in combination with the nitro spray used during the examination, these can lead to a dangerous drop in blood pressure. Please inform us in good time if you are taking any such medication.

???? Please bring the following with you
  • Referral form from the cardiologist or GP
  • Latest doctor’s report (including ECG results and, where applicable, echocardiogram findings)
  • Current medication plan
  • Blood tests: creatinine and TSH (in cases of kidney or thyroid disease)
  • Pre-operative report for a bypass assessment
⚠️ Preparation
  • No caffeine: no coffee, black tea, cola, energy drinks or chocolate
  • No smoking
  • No heavy breakfast – a light meal is fine
  • Make sure you drink plenty of fluids (including after the examination)
  • Arrange for someone to accompany you or use public transport – don’t drive yourself

Costs

Who pays for a cardiac MRI scan?

For privately insured patients, cardiac MRI is covered by private health insurance for all indications. Unfortunately, however, the costs of a cardiac MRI are not currently covered by statutory health insurance.

The examination can be offered to patients with statutory health insurance at a special rate as part of the Individual Health Management (IGeL) scheme for self-paying patients. Good to know: The German Scale of Fees for Doctors (GOÄ) sets out the estimated costs for a cardiac MRI, meaning that those with statutory health insurance need not expect to pay more than €535.

In addition, there are the so-called ‘selective contracts’ that some health insurance providers have entered into, which enable their insured members to undergo a cardiac CT scan and cardiac MRI if coronary heart disease is suspected (though currently only for this condition!). Our practice is a member of the selective agreements with GWQ and DAK. If you are insured with any of the following health insurance providers, you can participate in such a selective agreement, meaning you will not incur any out-of-pocket costs.

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FAQ

Questions about cardiac MRI

Cardiac MRI is a specialised MRI scan of the heart. It does not use X-rays but instead utilises magnetic fields to produce detailed images of the heart muscle, heart function and heart structure.

It is a particularly important procedure for the diagnosis and monitoring of heart muscle diseases such as myocarditis (inflammation of the heart muscle) or cardiomyopathies (diseases of the heart muscle), and enables an accurate assessment of tissue changes, scarring and functional impairments.