Heart MRI to screen for calcium/plaque build-up. How reliable are the results?

Per the recommendation of my doctor and based on my family history of heart disease, I had a heart MRI to check for signs of plaque in my coronary arteries. It came up "zero/normal" which my doctor explained means there is no evidence of calcium and therfore no plaque build-up in my arteries.

This test is highly touted by many imaging centers as being useful and accurate and my doctor highly recommended it. It was only 0, but not covered by insurance.

So… question:

Why don't insurance companies require this test for 0 before consenting to pay for a lifetime of Lipitor treatment for someone? Or at least, why aren't they willing to pay for it?

Thoughts?

One Response to “Heart MRI to screen for calcium/plaque build-up. How reliable are the results?”

  1. SpiN Says:

    The use of cardiac fast MRI for flow, patency, and plaque in the coronary arteries is still considered "experimental" by many physicians and in the medical literature. More often, calcium is detected using cine-CT, a superfast CT scan (CAT scan – computer aided tomography), and there is a greater amount of medical literature published for superfast CT than for fast-acquisition MRI.

    MRI tends to show anatomy incredibly well, but it's not quite up to par with cine-CT/superfast CT. I am surprised that this MRI was only $100. Even limited MRI exams in the United States will begin around $400 and can go over $2000 or more in extensive circumstances. Do you live in the US, or in a socialised medicine State?

    Insurance actuaries and underwriters want rock solid cost to benefit ratios, showing that the cost of an examination is outweighed by benefits that are provided by the information from that exam. They are also behind the curve … that is, there can be clear medical consensus established in the literature, but the insurance companies will drag their feet until it becomes so overwhelmingly commonplace that the costs to benefit ratio is strongly in their favour. After all, they have to keep their stockholders happy, showing ever-increasing profits year after year.

    In summary, cine-MRI is not yet at a consensus point in the medical literature for evaluation of coronary artery calcification, patency, flow, anatomy, and structure because the resources that have these ultrfast-MRI machines are few and far between … usually only at major teaching hospitals, however, some are popping up in these MRI/CT-in-a-box mall radiology joints. oomph. Have a full body CT or MRI while you are waiting for your eyeglasses to be made next door and your kids are at the food court slurping down Orange Julius beverages. 🙂