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When to order cardiovascular magnetic resonance in adults with congenital heart disease

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Abstract

Cardiovascular magnetic resonance (CMR), where available, contributes to the informed management of patients with congenital heart disease. In contrast to echocardiography, CMR becomes easier as patients grow. It is versatile and gives unrestricted access to the heart and intrathoracic vessels, providing functional and structural information. Its relative strengths are discussed, and examples are given of congenital conditions in which it provides clinically important information. CMR can prevent the need for diagnostic catheterization or expedite intervention if indicated, enabling planned, directed procedures. In our practice, CMR is used for serial follow-up, investigation of altered symptoms or signs, planning of transcatheter or surgical interventions, and for baseline assessment after surgery. As CMR becomes more widely available, it will contribute increasingly to the lifelong management of patients with congenital heart disease.

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References and Recommended Reading

  1. Therrien J, Dore A, Gersony W, et al.: Canadian Cardiovascular Society Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease (parts 1-3). Can J Cardiol 2001, 17:940–959, 1029-1050, and 1135-1158. Invaluable source of support in the management of adult CHD.

    PubMed  CAS  Google Scholar 

  2. Hirsch R, Kilner PJ, Connelly MS, et al.: Diagnosis in adolescents and adults with congenital heart disease. Prospective assessment of individual and combined roles of magnetic resonance imaging and transesophageal echocardiography. Circulation 1994, 90:2937–2951.

    PubMed  CAS  Google Scholar 

  3. De RoosA, Roest AA: Evaluation of congenital heart disease by magnetic resonance imaging. Eur Radiol 2000, 10:2–6.

    Article  PubMed  Google Scholar 

  4. MRI Safety web site. http://www.mrisafety.com. Accessed January 2003.

  5. University of Pittsburgh Medical Center web site: http:// www.radiology.upmc.edu/MRsafety/. Accessed January 2003.

  6. Mohiaddin RH: Introduction to Cardiovascular MRI. London: Current Medical Literature; 2002.

    Google Scholar 

  7. Manning WJ, Pennell DJ: Cardiovascular Magnetic Resonance. New York: Churchill Livingstone; 2002.

    Google Scholar 

  8. Higgins CB, de Roos A: Cardiovascular MRI and MRA. Philadelphia: Lippincott Williams & Wilkins; 2003.

    Google Scholar 

  9. Lotz J, Meier C, Leppert A, Galanski M: Cardiovascular flow measurement with phase-contrast MR imaging: basic facts and implementation. Radiographics 2002, 22:651–671. Methods, applications, and potential pitfalls of CMR velocity mapping.

    PubMed  Google Scholar 

  10. Vasaprasanthan GA, Araoz PA, Higgins CB, Reddy GP: Quantification of flow dynamics in congenital heart disease: applications of velocity-encoded cine MR imaging. Radiographics 2002, 22:895–905. Methods, applications, and potential pitfalls of CMR velocity mapping.

    Google Scholar 

  11. Tan RS, Mohiaddin RH: Cardiovascular applications of magnetic resonance flow measurement. Rays 2001, 26:71–91.

    PubMed  CAS  Google Scholar 

  12. Masui T, Kattayama M, Kobayashi S, et al.: Gadoliniumenhanced MR angiography in the evaluation of congenital cardiovascular disease pre- and postoperative states in infants and children. J Magn Reson Imaging 2000, 12:1034–1042.

    Article  PubMed  CAS  Google Scholar 

  13. Spuentrup E, Bornert P, Botnar RM, et al.: Navigator-gated freebreathing three-dimensional balanced fast field echo (True-FISP) coronary magnetic resonance angiography. Invest Radiol 2002, 37:637–642.

    Article  PubMed  Google Scholar 

  14. Rebergen SA, Chin JGJ, Ottenkamp J, et al.: Pulmonary regurgitation in the late postoperative follow-up of tetralogy of Fallot — volumetric quantitation by nuclear magnetic resonance velocity mapping. Circulation 1993, 88:2257–2266.

    PubMed  CAS  Google Scholar 

  15. Lorenz CH, Walker ES, Morgan VL, et al.: Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson 1999, 1:7–21.

    PubMed  CAS  Google Scholar 

  16. Lorenz CH, Walker ES, Graham TP Jr., et al.: Right ventricular performance and mass by use of cine MRI late after atrial repair of transposition of the great arteries. Circulation 1995, 92:233–239.

    Google Scholar 

  17. Petersen SE, Voigtlander T, Kreitner KF, et al.: Quantification of shunt volumes in congenital heart diseases using a breathhold MR phase contrast technique--comparison with oximetry. Int J Cardiovasc Imaging 2002, 8:53–60.

    Google Scholar 

  18. Helbeng WA, de RoosA: Clinical applications of cardiac magnetic resonance imaging after repair of tetralogy of Fallot [review]. Pediatr Cardiol 2000, 21:70–79.

    Article  Google Scholar 

  19. Geva T, Greil GF, Marshall AC, et al.: Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia: comparison with x-ray angiography. Circulation 2002, 106:473–478.

    Article  PubMed  Google Scholar 

  20. Vliegen HW, Meier C, Leppert A, Galanski M: Magnetic resonance imaging to assess the hemodynamic effects of pulmonary valve replacement in adults late after repair of tetralogy of Fallot. Circulation 2002, 106:1703–1707.

    Article  PubMed  Google Scholar 

  21. Davlouros PA, Kilner PJ, Hornung TS, et al.: Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 2002, 40:2044–2052. Measurements of RV and LV function and pulmonary regurgitant fraction in a large series of patients late after repair of tetralogy of Fallot.

    Article  PubMed  Google Scholar 

  22. Kilner PJ, Sievers B, Meyer GP, Ho SY: Double-chambered right ventricle or sub-infundibular stenosis assessed by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2002, 4:373–379.

    Article  PubMed  Google Scholar 

  23. Hornung TS, Kilner PJ, Davlouros PA, et al.: Excessive right ventricular hypertrophic response in adults with the mustard procedure for transposition of the great arteries. Am J Cardiol 2002, 90:800–803.

    Article  PubMed  Google Scholar 

  24. Fogel MA, Hubbard A, Weinberg PM: A simplified approach for assessment of intracardiac baffles and extracardiac conduits in congenital heart surgery with two- and threedimensional magnetic resonance imaging. Am Heart J 2001, 142:1028–1036.

    Article  PubMed  CAS  Google Scholar 

  25. Wu KC: Myocardial perfusion imaging by magnetic resonance imaging. Curr Cardiol Rep 2003, 5:63–68.

    Article  PubMed  CAS  Google Scholar 

  26. Kim RJ, Wu E, Rafael A, et al.: The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 2000, 343:1445–1453.

    Article  PubMed  CAS  Google Scholar 

  27. Kim WY, Danias PG, Stuber M, et al.: Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med 2001, 345:1863–1869.

    Article  PubMed  CAS  Google Scholar 

  28. Medis website for image processing software. http://www.medis.nl/ Accessed January 2003. Medis (Leiden, The Netherlands) has been supplying software for the viewing and analysis of CMR for several years. It will run on a PC, but only after installation of software by the company.

  29. CMRtools website for image processing software. Accessible at http://vip.doc.ic.ac.uk/cmrtools/index.php. Accessed January 2003. This software is still in development. It allows viewing of still and cine Digital Imaging and Communications in Medicine (DICOM) images on a PC, with ability to measure areas, volumes, and other parameters. An evaluation version, effective for a limited period, can be downloaded for free trial.

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Babu-Narayan, S.V., Kilner, P.J. & Gatzoulis, M.A. When to order cardiovascular magnetic resonance in adults with congenital heart disease. Curr Cardiol Rep 5, 324–330 (2003). https://doi.org/10.1007/s11886-003-0070-8

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