In the last few years, magnetic resonance imaging (MRI) has gained a role of primary importance in the diagnosis of numerous diseases, thanks to its high diagnostic accuracy and the almost total absence of side effects, due to the absence of ionizing radiations. 1 However, the presence of a strong magnetic field poses safety problems in patients with metallic implants, such as non-conditional implantable cardiovascular devices, pacemakers, and mechanical prostheses.2 Metallic heart prostheses such as heart valve prosthesis and annuloplasty rings in the patient body...

A systematic review of the literature was performed on March 2017 using MEDLINE and EMBASE for original articles published in English on the safety of MRI in patients carrying a heart valve prosthesis or annuloplasty ring. Articles evaluating the effect of MRI on such prosthesis in vitro were also included. Keywords included MRI, heart prosthesis, valve, safety, in vitro, and adverse events. Two independent readers reviewed all abstracts for eligibility. The full text of papers deemed eligible was retrieved. References of the retrieved papers were...

Database search retrieved 631 studies, 13 being analysed for a total of 226 prosthesis (128 in vivo and 98 in vitro). Raw data were not provided in some articles; thus, it was not possible to back-calculate the number of patients. All studies had a prospective design: 6 articles evaluated prosthesis in vivo only (122 prosthesis), 6 articles evaluated prosthesis in vitro only (93 prosthesis), 1 was mixed (6 prosthesis in vivo and 5 in vitro). In vivo, 16 valves were tested at 0.2 T, 9...

The evidence on the use of MRI in patients carrying a heart valve prosthesis or annuloplasty ring is still insufficient. However, data support the hypothesis of a low or negligible interaction with MRI. If confirmed by other larger studies, patients carrying a metallic heart prosthesis may safely undergo MRI under controlled conditions.

Post Graduation School in Radiodiagnostic Università degli Studi di Milano Policlinico San Donato - San Donato Milanese (MI) [email protected]

1.Levine G.N., «Safety of magnetic resonance imaging in patients with cardiovascular devices...,» Circulation, pp. 11;116(24):2878-91, 2007 2.Di Leo G., «Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis.,» European Radiology, pp. 26(10):3706-18, 2016 Oct. 3.Shellock F.G., «MR Imaging of Metallic Implants and Materials: A Compilation of the Literature,» American Journal of Roentgenology, pp. 151:811-814, 1988. 4.Randall P.A., «Magnetic resonance imaging of prosthetic cardiac valves in vitro and in vivo,» The American Journal of cardiology, pp. 1;62(13):973-6, 1988....