Please send your request to the following email address in order to receive a schedule for a cardiac MR exam: atoth(at)atoth(dot)sote(dot)hu .
Please specify the following data in the email: patient's Hungarian insurance ID (optional), patient's name, patient's birth date, patient's phone number. The address of the patient can be also handy. The phone number of the patient will be used to reschedule the exam in case of a technical difficulty to avoid unnecessary jurneys. Please indicate the underlying conditions and the specific reason for the MR examination. This is particularly important to select the proper protocol and to plan the estimated length of the exam.
Before exams requiring contrast administration an actual (in a week) GFR of the patient must be known in case there have been renal insufficiency or recent renal injury in the medical history. Creatinin is not adequate to decide in this case. According to the European guidelines, gadolinium based contrast materials should not be injected below a given limit.
There are no restrictions regarding fluid intake and meals before an examination without contrast administration. Otherwise a 2-hour food restriction must be applied as a security precaution in case of a rare event of nausea. Adenosine perfusion studies imply further dietary restrictions.
The patient must present a referring opinion and identification documents at the reception desk before the examination. It is advised for the patients to carry prior medical test results relevant to their cardiac problem.
Emergency referrals may cause even 1-2 hours of unwanted delay to the actual schedule.
If anesthesia is necessary, the team must be provided by the referring institution. Cardiac exams require episodes of apnoe. That means total narcosis with intubation and relaxation. Simple sedation is not enough contrary to a head MR exam. Our unit has MR-conditional SpO2, non-invasive RR, respiratory, ETCO2 and ECG monitoring capabilities. An MR-compatible ventilation system is also available for the team.
In case of an official Hungarian medical transportation the examination cannot be guaranteed if the patient is late for more than 1-2 hours. The way of transport must be reconsidered in case of possible inaccuracies. Seriously ill patients must be accompanied by a medical person for observational purposes. Monitoring equipment will be provided.
Sternal wires are not a problem. Necessary time to wait after stent deployment differ for each vendor. Please consult the manual supplied with the stent for clarification. Some intracranial aneurysm clips are not MR safe. The exact type of the implanted material must be checked in order to avoid life-threatening complications. There are cochlear implants, which can be introduced to an MR system, but the required preparations are so strict, that it is often not possible to carry out a cardiac MR scan. Pacemakers are not totally contraindicated, and there are some new models, which permit an MR scan. However special procedures must be applied, so further discussion is necessary.
The location of the building: 1122 Budapest, Határőr út 18. Using public transport it takes 3 stops (Temes utca) for buses 128 or 129; 2 or 3 stops (Szent János Kórház) for buses 155, 156, 22, 22A or 222 to reach the diagnostic unit from Széll Kálmán tér (formerly Moszkva tér). The second/red subway (M2) can be used to reach Széll Kálmán tér from Keleti pályaudvar (railway station). Trams number 4 and 6 provide the simplest way to get to Széll Kálmán tér form the Nyugati pályaudvar. Starting from Déli pályaudvar, M2 can be taken for a single stop to get to Széll Kálmán tér, however trams 56, 59 or 61 touch Szent János Kórház in 4 stops. These three trams can also be taken from Széll Kálmán tér, however only three stops necessary in that case - all trams use the same stop. Starting from Temes utca, the patient should climb up the Acsády Ignác street and turn to the right. After passing by the light blue building at the corner the next facility will be the diagnostic building. From Szent János Kórház bus/tram stop Határőr út can be approached through Városmajor utca. The name of the street suddenly switches to Pethényi köz for a short distance, which can be very confusing.
Cardiac MR studies are perfomed according to the Hungarian reimbursement by default for patients covered by the OEP. Apart from OEP reimbursed exams, there are three slots registered for private studies every Saturday: from 5pm till 8pm. Please contact the institution or me for exam fees. The amount depends on the protocol - most importantly on contrast material administration. Fees follow changes of Hungarian reimbursement and determined by the University. Stress agent (Adenosine) consumed during the exam are not reimbursed by OEP - needs special discussion and preparations.
Upon any further questions please use the following mobile number: (20)825-8057. Ask for 0*8057 when calling from within or using the main phone line of the University. I cannot answer the phone all the time. Therefore I would prefer texting or email.
Cardiac MR examinations are hosted by the Heart and Vascular Center of the Semmelweis University. Private studies can be conducted on Saturday afternoons.
Regards:
Attila Tóth MD, radiologist, cardiac MR specialist
Some helpful examples for possible types of cardiac MR studies:
- viability
- prior infarct, CTO
- left ventricle is the primary focus
- implies contrast administration
- 45 - 60 minutes
- ARVD
- right ventricle is the primary focus
- contrast administration is necessary
- 60 minutes
- myocarditis
- left ventricle is the primary focus
- contrast material administration is a must
- 60 minutes
- post-COVID symptoms (including MIS-C/PMIS)
- constrast administration
- mapping techniques
- 60 minutes
- stress function
- Dobutamin pharmacological stress
- requires further actions to arrange
- 60 - 75 minutes
- stress prerfusion
- Adenosinose pharmacological stress
- additional restrictions are necessary for the patient
- requires further planning
- the stress agent must be provided by the referral, it takes ~10 vials of Adenosine for an average weight (currently a box costs ~27.500 HUF)
- 60 - 75 minutes
- athlete with complains
- viability, myocarditis or ARVD protocol
- constrast administration
- 60 minutes
- athlete without complains
- function and MRCA
- no contrast material
- 45 - 60 minutes
- PFO
- contrast administration
- 60 minutes
- shunt
- contrast injection depends on the specific case
- 60 minutes
- tumor
- requires contrast material
- 45 - 60 minutes
- prior CRT implantation
- contrast administration study
- 60 minutes
- prior ICD implantation
- contrast administration necessary
- can be similar to an ARVD or a viability scan
- 60 minutes
- left atrial MRA
- contrast material administration
- 15 minutes
- MR coronarography
- function and MRCA without contrast material administration
- 60 minutes
- Coarctation
- thoracic MRA using ECG
- without contrast material injection
- 60 minutes
- doesn't include TOF MRA of the brain
- Coarctation + TOF MRA
- thoracic MRA and brain MRA
- no contrast administration
- 75-90 minutes
- Congential heart disease
- various conditions
- Fallot tetralogy
- pulmonary atresia with or without VSD
- DORV
- truncus arteriosus communis
- after Ross procedure
- Taussig-Bing anomaly
- after Rastelli surgery
- l-TGA
- d-TGA
- after Senning procedure
- after Mustard surgery
- after arterial switch (Jatene)
- univentricular heart
- tricuspidal atresia
- hypoplastic left ventricle (HLHS)
- after Fontan/TCPC surgery - possbile Kreutzer, Sano or Björk modifications
- fenestrated conduit
- bidirectional Glenn shunt
- Kawashima procedure
- situs ambiguus
- Ivemark syndrome
- Williams sy, Turner sy, Marfan sy... etc.
- no administration of contrast material without specific question
- 60 - 90 minutes
- various conditions
- patient with a pacemaker
- requires additional planning
- exam time depends on the body part and the protocol used
