HeartScore: MRI Screening

As our "Heart Score" series continues this week, doctors are using magnetic resonance imaging, commonly known as MRI, to look at our arteries and tell us in a few moments whether we are headed down the road toward heart disease. Dr. Emily Senay is here with a closer look.

Atherosclerosis is hardening of the arteries and a leading cause of heart disease and stroke. Diagnosis usually involves an invasive catheter procedure. But now the noninvasive MRI is giving doctors a clearer picture and providing a way to spot cardiovascular problems before they become critical.

Louisa Haigler is like many Americans at risk for heart disease. She has high cholesterol and other factors that put her at risk. "My family history is we have heart trouble, diabetes, and stroke," says Haigler. "As I began to get older, I became concerned about those things in my own life."

So Haigler joined a study at Mount Sinai School of Medicine where doctors are beginning to use high-resolution MRI to look at the cardiovascular system.

"This dark area here is where the fat accumulated, and this is where the cholesterol is building up inside the wall," says Dr. Zahi Fayed. Even though Haigler has no symptoms of heart disease, Fayed can see potential trouble for her down the road.

"I can tell you that this plaque on this side seems fine but on this side seems dangerous," says Fayed. "The one that's dangerous is the one that's full of fat. It's gooey." Fayed says that not only can this can tell him that there's something there--it can also indicate to him what it's made of and how dangerous it is.

Haigler is taking steps to avoid heart disease by lowering her cholesterol, but MRI is also being used to diagnose people who are already sick.

With the aid of MRI, cardiologist Dr. Valentin Fuster can also pinpoint problem areas in patients who require urgent treatment.

"This is a patient who had three strokes and nobody understood where the strokes came from. We looked at the MRI, and we saw the blood clots," says Fuster. "We were able to see that the blood clots were in the main artery. The technology not only is providing us with better knowledge of what is going on with the patient, but I think it's already beginning to guide us in general to be much more aggressive about how we treat such people."

With a promise of early intervention and early treatment, MRI will hopefully lead to more aggressive and therefore more effective treatment for heart disease. There are a number of studies underway to determine exactly how MRI will be most useful in diagnosing heart disease, but so far it looks like a promising way to check out problems without the need for an invasive catheter procedure.

MRI screening for heart disease will not become part of a general physical checkup until this diagnostic technique becomes routine in a few more years. But the hope is that one day it might be used along with other noninvasive screening techniques like CT (computed tomograhy) scanning or ultrasound to provide a more complete picture for doctors to use to diagnose and treat heart disease.
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