Transcript Case of the week – 06-02 - Society for Cardiovascular

Case of the week 07-13: Cine artefact
Clinical:. A 55 y.o. male admitted with new heart failure. No acute coronary syndrome.
Past medical history includes type I Diabetes, hypertension, chronic renal insufficiency
and anaemia of chronic disease. After stabilization, transthoracic echo showed an EF of
40%, no significant valvular disease. CMR was requested.
CMR findings:
1.Normal global LV function
2.Large signal artefact arising from below the diaphragm
Interpretation:
Unknown to operators, the patient had taken iron sulfate (FeSO4) supplement pills
(325mg, 20% elemental iron) <2 hours prior to scanning causing this large signal
artifact. Iron transit in the stomach and small intestine can be variable (2 to 24 hours).
Patients undergoing CMR should be asked to abstain from iron pills/vitamins with iron at
least 24 hours prior to CMR.
Scanner: Siemens 1.5T Symphony
References:
1. Cook SC et al, JMRI 2006:24:1148-1150
2. Shellock FG, AJR 1988:151:811-814
Authors: John D. Vu, MD, Leslie Weiss, RT(MR), Jigar Patel, DO, David Lee, MD PhD, Robert
Russo, MD PhD. Scripps Clinic Green Hospital, La Jolla, CA, USA