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Number 07-13. Cine Artefact

Case from: 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

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:
Normal global LV function
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

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