Case of the week 0713: Cine artefact

1
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
• 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) lt2 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
2006241148-1150 2. Shellock FG, AJR
1988151811-814
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