version 1 cardiac imaging st. francis state-of-the-art...state-of-the-art cardiac magnetic resonance...

State-of-the-art Cardiac Magnetic Resonance Imaging

St. Francis Cardiac ImagingUnmatchable expertise powered by state-of-the-art technology

St. Francis Hospital, The Heart Center® has one of the largest

cardiac MRI programs in the country, performing over 1,200

studies per year. Our mission is three-fold:

• To provide state-of-the-art clinical imaging for our

referring physicians

• To push the envelope of imaging techniques through research

• To train future generations of cardiac imagers

Patients are scanned at one of three facilities: outpatients at the

DeMatteis Research Center or at 2200 Northern Blvd., a short distance

away, and inpatients at St. Francis Hospital. The three magnets are

state-of-the-art utilizing two 1.5T and one 3.0 T magnets. The imaging

group at St. Francis utilizes the latest technology. Clinical studies are

read the same day as performed and results are communicated back

to the clinician the same day. Three cardiologists specifically trained

for cardiac MRI imaging provide the interpretations. Each of them con-

ducts research protocols, which are available for patient enrollment.

Jane Cao, M.D., Lab Director

Level 3 fellowship in Cardiac MRI,

National Institutes of Health

Madhavi Kadiyala, M.D.

Level 3 fellowship, St Francis Hospital/

DeMatteis Cardiac Research Center

Timothy Christian, M.D.

Level 3 fellowship in Cardiac MRI,

National Institutes of Health

We have an active fellowship program in cardiac imaging

where physicians can obtain level 3 training cardiac MRI.

Clinical Indications for Cardiac MRI

There are many uses of MRI in the care of patients with cardiac disease.

Below is a list of the major categories for the most common referrals for a

cardiac MRI exam.

Coronary artery disease: Cardiac MRI is a powerful and comprehensive imaging modality in patients with known or suspected CAD. MRI can define left ventricular wall motion and systolic function with high accuracy. It can measure infarct size, detect acute events, and diagnose CAD with stress

perfusion testing.

Cardiac masses: Physical properties inherent to MRI allow for the charac-terization of most cardiac masses with high accuracy.

Cardiomyopathies: In many instances, MRI can provide an etiology of ventricular dysfunction in patients with CHF. Infiltrative diseases such as amyloidosis and sarcoidosis can be detected on post-contrast images. T1 mapping allows for further delineation of the extra-cellular space.

Late enhancement in patients with hypertrophic cardiomyopathy is prognos-

tically important.

A patient with acute MI showing early edema (left), infarct size (middle) and persistent perfusion defect (right).

Rare apical masses: (left) a large thrombus at the ventricular apex in a patient with prior MI. (Mid-dle and right): a rare cardiac myxoma in the LV apex distigiushed by T2 and T1 weighted imaging.

A patient with advanced cardiac amyloidosis

Event free survival at 5yrs

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After Surgery

Myocarditis/pericardial disease: Myocarditis can be detected, quan-tified, and staged in terms of chronicity with MRI. Pericardial thickening, effusions, and constriction can also be evaluated.

The pericardium is well seen on MRI, as well as pericardial effusions.

Right ventricular dysplasia: While rare, CMRI is a valuable test in

terms of RV function and fat characterization.

Valvular heart disease: CMR can anatomically define valve structure such as the bicuspid aortic valve (right). However, its strongest use is in the quantitation of regurgitation and shunts (left). This is a rapidly

growing field in CMR.

Ventricular Noncompaction: This congenital defect is often unrecog-

nized, but readily identified by CMR. Note the extensive web of noncom-

pacted myocardium toward the apex.

A patient with chronic myocarditis with epicardial enhancement. The degree can be quantified (right).

Frequently Asked Questions

How long is the exam?Most studies can be performed within 45 minutes.

Can patients with coronary stents be imaged safely?Yes, cardiac stents pose no increased risk.

Can patients with artificial valves be imaged?Yes, in most instances imaging can be done safely with the exception of

some very old mechanical valves. It is valuable to provide us with informa-

tion on the type of valve.

What about patients with metal implants?Most implants are safe with some exceptions such as neural stimulators

and cochlear implants. It is important to provide us with information on

the type of implant. An X-ray of the implant or foreign body is very helpful

if available.

Does my patient need contrast?The majority of studies are significantly enhanced by the use of contrast

so unless there is a contraindication such as history of allergy or low GFR,

it is best to order with contrast. The exception is in patients with questions

purely regarding valvular disease.

Is the contrast the same as iodine based-CT scans?No, MRI uses Gadolinium which does not have the toxicities associated

with iodinated contrast. However, in rare instances patients can have an

allergic reaction. Also, patients with renal dysfunction (a creatinine clear-

ance of less than 40 cc/min) are at risk for complications.

How do you handle claustrophobic patients?Our staff is very experienced and has a number of methods to

reduce claustrophobic anxiety in the magnet. We are able to image over

90% of referred patients, but occasionally there are patients too anxious

to enter the magnet.

How do I schedule an appointment and what is the wait time? Appointments are generally made through SFH’s Central Scheduling

Department at (516) 629-2028. The wait time is usually a week or less.

Long Island Expressway (495)

Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39

Nassau County Museum of Art

2200Northern

Blvd.


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Exit 36 Exit 39

The DeMatteisCenter


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39

St.FrancisHospital

NYIT College


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39


2200Northern

Blvd.


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Exit 36 Exit 39

The DeMatteisCenter


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39

St.FrancisHospital

NYIT College


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39


2200Northern

Blvd.


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Exit 36 Exit 39

The DeMatteisCenter


Northern Blvd.

Port Washington B

lvd.

Glen Cove Rd.

Route 107

Exit 36 Exit 39

St.FrancisHospital

NYIT College

St. Francis Cardiac Imaging

at 101 Northern Blvd. in Greenvale.

St. Francis Ambulatory Center

at 22000 Northern Blvd. in East Hills

St. Francis Hospital

at 100 Port Washington Blvd. in Roslyn

100 Port Washington Blvd. Roslyn, NY 11576Phone: (516) 629-2028stfrancisheartcenter.chsli.org

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version 1 cardiac imaging st. francis state-of-the-art...state-of-the-art cardiac magnetic resonance...

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