You lie on a movable examination table that is slowly moved into the scanner tunnel. Depending on the body region to be examined, you will be positioned head or feet first.

The examination takes twenty minutes to about an hour, depending on the region to be examined and the question. During this time you should lie on your back as still and relaxed as possible. During the examination you will hold an emergency bell in your hand, which you can use to request help if necessary. Depending on the examination, an ECG will be placed on your chest to adapt the recordings to your heartbeat.

In addition, a surface coil is placed on you and loosely fastened with straps. As the MRI machine produces loud knocking noises, you will be given soundproof headphones through which you can listen to music if you wish. It may also be necessary to follow breathing commands during examinations.

Some questions require the administration of contrast medium, which is injected via a vein in the arm at a fixed time during the examination. For this purpose, a so-called indwelling cannula is inserted in advance and connected to the contrast medium pump in the examination room.

The contrast medium used in MRI contains gadolinium and is generally very well tolerated. Very rarely, patients develop an allergic reaction (e.g. with itching, skin rash, nausea). The contrast agent is excreted via the kidneys. Please let us know if you suffer from impaired kidney function.

Due to the magnetic field generated by the unit, no metal parts may enter the examination room. Please remove all metallic objects (e.g. loose dentures, hair clips, keys, jewellery, watches, money) before the MRI examination and follow our instructions regarding patients for whom the examination is not suitable.

Hearing aids, magnetic dental implants, mobile phones, watches, chip and credit cards can be destroyed by the magnetic field and must also not be taken into the examination room. Persons with implanted metallic devices, such as pacemakers, defibrillators (ICDs) or medication pumps, may only enter the magnet room after medical clearance and under very special safety conditions.

Magnetic resonance imaging is not a routine diagnostic procedure for patients with an implanted pacemaker or defibrillator. Only under special safety conditions, such as the reprogramming of the pacemaker and constant monitoring by specialist staff, has it been possible for some time to perform an MRI on patients with certain diagnoses. However, the cost structure will then usually have to be adapted to the very complex procedure, which makes prior clarification by your insurance provider essential. Furthermore, the examination may not be possible for the following patients:

• Patients on dialysis or with renal insufficiency, if contrast medium is required for the examination.
• Patients with an allergy to gadolinium
• Patients with claustrophobia

Most implants used in medicine today are MRI-compatible. Please inform us about possible implants or metal splinters.

For many years, implanted heart valves and stents have been MRI-approved, but this must be verified in each individual case by researching a safety journal.

Stress MRI of the heart can be used to assess the blood flow to the heart muscles at rest and under stress, and to detect any reduced blood supply to the heart muscle.

This involves simulating a strain on the heart by administering a drug that increases blood flow for a short time. This so-called pharmacological stress is usually done using regadenoson or adenosine. Intolerances rarely occur. However, during the approximately three-minute administration of the drug, symptoms similar to physical exertion may occur (palpitations, sweating, increased breathing, feeling hot).

A feeling of pressure or tightness in the chest (angina pectoris) or in the head may also occur. However, these symptoms show a normal reaction of the body to the adenosine and end very quickly after administration of the drug due to the short half-life. In rare cases, a drop in blood pressure or cardiac arrhythmia may occur. During this phase of the examination, you will be monitored by a cardiologist by means of ECG and blood pressure measurement and asked about changes in your condition.

A circulatory disorder of the heart can also become noticeable without angina pectoris symptoms through a reduction in performance. By means of the MRI examination of the heart, it is possible to differentiate between infarct scars and functionally impaired but still living parts of the heart muscle. The latter would benefit, for example, from a cardiac catheter intervention with balloon/stenting or surgical treatment (bypass).

The preparations are the same as for a normal MRI examination. The examination lasts about an hour, during which you lie on your back as quietly and relaxed as possible. During the examination you will hold an emergency bell in your hand, which you can use to request help if necessary.

An ECG is placed on your chest to match the recordings to your heartbeat. In addition, a surface coil is placed on your chest and loosely fastened with straps. As the MRI machine produces loud knocking noises, you will be given soundproof headphones through which you can listen to music if you wish.

During the measurements you will receive breathing commands from the assistants. Stress is simulated by means of the drug adenosine, which is administered via an access in the area of the crook of the arm. Adenosine causes an increase in blood flow to the heart by dilating healthy vessels. In order to be able to assess the blood flow to the heart muscles, you will receive a contrast medium via another access point in the area of the crook of the arm following the administration of adenosine. This may feel a little cool. The contrast medium used contains gadolinium and is generally very well tolerated.

This examination alone takes about an hour for you in the device, and the evaluation including the findings takes the same amount of time again.

In addition to the contraindications already mentioned, stress MRI is suitable for a limited spectrum of questions; the following constellations are not considered:

• Patients with known obstructive airway disease, e.g. chronic obstructive bronchitis or bronchial asthma, should not be tested with adenosine because of the risk of acute airway obstruction.
• Patients after liver transplantation
• Patients with a feeling of pressure or pain in the chest at rest (angina pectoris)
• Patients who have had a heart attack in recent days
• Patients with significant narrowing of a heart valve
• Patients with atrial fibrillation or flutter, or sinus node disease.
• Patients with an allergy to adenosine, regadenoson or gadolinium

There is no need to forgo a light meal before the examination. However, we would like to ask you to avoid drinks and food containing caffeine, theophylline or theobromine (such as coffee, decaffeinated coffee, tea, cola or chocolate) for at least 24 hours before the examination, as otherwise the examination results may be falsified.

If possible, you should also stop taking the following medicines/active substances 24 hours before the examination:

• Nitrates
• Beta-blockers (e.g. metoprolol, Beloc Zok)
• Molsidomine (e.g. Corvaton)

You can take your other medicines as usual. Please contact us if you have any further questions about taking your medication.

For an MRI examination, you should bring current laboratory results with you, which provide information about your kidney function:

• Creatinine value
• Glomerular filtration rate (GFR)

These values should not be older than 4 weeks. The findings of previous examinations (e.g. stress ECG or operation reports) are helpful in the evaluation and assessment of an MRI examination. We would therefore ask you to bring a copy of these findings with you.

Private health insurance companies usually reimburse the costs. The fees for the MRI examination depend on the examination effort and the individual problem. This is determined by the referring doctor and in the preliminary discussion with our radiologist performing the scan. For further information, please contact us by telephone.

The institute does not have outpatient health insurance approval, except for special paediatric cardiological issues, which is why MRI examinations can only be carried out on an outpatient basis by us for privately insured persons or self-pay patients.

The evaluation of an MRI is very time-consuming, so that we cannot always inform you of the final result directly afterwards. After the examination you will receive a DVD with the image data. We will send you or your family doctor the final written findings in the following days.