...
A good example of an invasive imaging method for the coronary arteries in coronary angiography. In that a catheter is inserted from the groin or radial artery to the coronary artery and meanwhile contract agent is injected to the vein to make the vessels visible. The blood flow in the arteries are observed with x-ray imaging. This exposes the patient to a high radiation dose. However, this procedure is good since the quality of imaging is high-resolution and a possible blockage can be treated right away with a balloon catheter or stent.
...
This technology enables the professionals to see minute structural changes of the heart (eg. inflammatory changes) which aid in the diagnosis. It can be seen if there is an old fibrosis or an ongoing inflammation. In addition to the heart muscle structure the CMRI shows also the condition of heart valves and coronary vessels. As a good image of the heart is seen, the need for an invasive procedure can be re-assessed. However, this machine can be used only in settings which have educated professionals and the machinery is relatively expensive.
Cardiac Magnetic Resonance Imaging (CMRI) is a relatively safe and reliable method of obtaining cardiac structural and functional information, but it does have some particular drawbacks.
...
· Noisy and possible claustrophobia for the patient
...
If iron oxide nanoparticles are added to the equation, then further complications are obvious. Dissanayake et al. (2015) showed in their research that iron oxide nanoparticles exposure could cause mutagenic effects. The results of their work show that DNA alteration was seen post-iron oxide nanoparticle exposure which potentially damages an organism’s (in this case, the patient) development and ability to reproduce. Yarjanli et al. (2017) speculated on the potential for iron oxide nanoparticles to cross the blood-brain barrier and accumulate in the nervous system, causing toxicity and neural damage of the same type as neurodegenerative diseases. Alam et al. (2015) noted that different types of macrophages have different activity levels and may take the iron oxide nanoparticles into the targeted tissue at different rates, causing false positive/negative enhancement and possibility of clinical misjudgment.
...
Future views and prospects
The MRI is based on molecular imaging, where even individual cells or components can be seen. One such cell of interest in cardiac magnetic resonance imaging is the macrophage. Inflammation is found in many cardiovascular conditions such as atherosclerosis, myocardial infarction and heart failure. Macrophages (a type of white blood cell that engulfs and digests anything unrelated to the body in its path) are very important to the inflammatory process, as macrophages both destroy foreign matter in the body and then clear the way for repair work. By imaging macrophages at work, doctors can understand more fully how cardiovascular diseases start, and can also evaluate how severe the condition is in real time. This can aid in diagnostics, prognosis and evaluate efficiency of treatments.
...
In relation to cardiac diagnostics and treatment, nanoparticles have several different prospective uses. With the MRI, a large magnetic field can be created which would use the iron oxide nanoparticles to “pull” medication into the cells, a process known as magnetofection. Magnetic targeting, on the other hand, would use the magnetized nanoparticles to break up thrombi (blood clots). The imaging aspect could also make it possible to “track” magnetized cells in the heart in still non-invasive manner and even evaluate cell grafts and cell based therapies. It is also hoped that the medication, Ferumoxytol, may be used to differentiate between acute myocardial inflammation from old myocardial damage, which opens up the possibilities of observing early stages of heart transplant rejection and cardiac tumors.
References
...
Alam, S.R., Stirrat, C., Richards, J., Mirsadraee, S., Semple, S.I., Tse, G., Henriksen, P., Newby, D.E. 2015. Vascular and plaque imaging with ultrasmall superparamagnetic particles of iron oxide. [Review] Journal of Cardiovascular Magnetic Resonance. 17:83, 2015 Sep 18.
...