Congenital heart disease MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor-In-Chief: Keri Shafer, M.D. [2],Atif Mohammad, M.D., Priyamvada Singh, MBBS

Overview

Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.

MRI

Magnetic resonance imaging (MRI) can be used as a diagnostic modality in congenital heart diseases.

Advantages

• It can be used in cases where echocardiographic results are inconclusive.
• Helps in measuring heart volumes, blood flow and ventricular wall thickness.
• The magnetic resonance angiography helps in better visualization of heart vasculature
• Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).

Disadvantage

For successful MRI procedure breath holding is required, which is sometimes difficult to achieve with small kids. Due to this, the procedure is done under general anesthesia in children.

2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Recommendations for Cardiovascular Magnetic Resonance Imaging

Class I

1.In patients with ACHD who have or who are at risk of developing RV enlargement and dysfunction, serial CMR is recommended for quantitative assessment of RV size and function (Level of Evidence: B-NR)

Class IIa

1.CMR can be useful in the initial evaluation and serial assessment of selected patients with CHD based on anatomic complexity and clinical status. (Level of Evidence: C-LD)

ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

“

CMR may be used for assessing cardiac structure and function, blood flow, and cardiac and extracardiac conduits in individuals with simple and complex congenital heart disease. Specifically, CMR can be used to identify and characterize congenital heart disease, to assess the magnitude or quantify the severity of intracardiac shunts or extracardiac conduit blood flow, to evaluate the aorta, and to assess the pathological and physiologic consequences of congenital heart disease on left and right atrial and ventricular function and anatomy.

”