5 Apr, 2017

Breast Implant Screening

It has been reported that over 40,000 British women have had PIP Breast implants which may have an increased risk of rupture or silicone leak.

Safe MRI Breast Screening
National MRI Scan Ltd can now arrange an effective MRI scan for those women that have had breast implants, not just PIP. This scan has been specifically designed to identify ruptures, tears and silicone leaks.  

Breast MRI Scan Information
All reporting is undertaken by Consultant Breast Radiologists with results available within two working days. The MRI scan takes approximately 30 minutes.

MRI spares some patients invasive cardiac studies
Invasive catheter cardiac angiography is a powerful diagnostic tool but is far from risk free, particularly in some groups of patients. In those presenting with new-onset heart failure of uncertain etiology, the role of catheter coronary angiography (CCA) is unclear. Although conventionally performed to differentiate underlying coronary artery disease from dilated cardiomyopathy, CCA is associated with a significant risk of complications and may not in the end detect an ischemic cause. As in so many medical fields MRI is providing a viable, safe, non-invasive alternative.

In a recent study carried out at the Brompton Hospital in London (1) the diagnostic accuracy of cardiovascular magnetic resonance imaging (CMR) with late gadolinium contrast enhancement (LGE) as a noninvasive "gatekeeper" to CCA in determining the etiology of heart failure in this subset of patients was assessed.

120 consecutive patients underwent GE-CMR and CCA. The etiology was ascribed by a consensus panel that used the results of the CMR scans; similarly, a separate consensus group ascribed an underlying cause by using the results of CCA. The diagnostic accuracy of both strategies was compared against a gold-standard panel that made a definitive judgment by reviewing all data. The study was powered to show noninferiority between the 2 techniques. The sensitivity of 100%, specificity of 96%, and diagnostic accuracy of 97% for GE-CMR were equivalent to CCA (sensitivity, 93%; specificity, 96%; and diagnostic accuracy, 95%). As a "gatekeeper" to CCA, GE-CMR was also found to be a cheaper diagnostic strategy in a decision tree model when UK-based costs were assumed. The economic merits of this model would change, depending on the relative costs of GE-CMR and CCA in another healthcare system.

In summary, the study showed that GE-CMR is a safe, clinically effective, and potentially economical "gatekeeper" to invasive CCA in patients presenting with heart failure of uncertain etiology. This would be a boon for many of these patients.

Reference: 1. Assomull RG, Shakespeare C, Kalra PR, Lloyd G, Gulati A, Strange J, Bradlow WM, Lyne J, Keegan J, Poole-Wilson P, Cowie MR, Pennell DJ, Prasad SK. Role of Cardiovascular Magnetic Resonance as a Gatekeeper to Invasive Coronary Angiography in Patients Presenting With Heart Failure of Unknown Etiology. Circulation. 2011 Sep 6.

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