Atrial septal defect MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]

Overview

Magneic resonance imaging (MRI) is a noninvasive imaging modality that can be used as a diagnostic tool in identifying an atrial septal defect. MRI aids in direct visualization of the atrial septal defect and pulmonary veins. It can assist in quantifying ventricular volume and function as well as shunt size. Velocity-encoded, phase difference MRI have been found to assess the magnitude of left-to-right shunting as reliably as is done by cardiac catheterization. Also it has the additional advantage of being a non-invasive tool compared to the invasive cardiac catheterization.

Magnest Resonance Imaging (MRI)

• Non-invasive imaging method
• Effective tool for when echocardiographic results are inconclusive.
• Provides better visualization of heart vasculture

Indications

• Effective in measuring:

• Flow measurements from the aorta and main pulmonary vein
• Shunt flow
• Heart volumes
• Blood flows
• Ventricular wall thickness
• Size of the septum defect

• Provides identification of additional associated anomalies

Advantages

• Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).
• Quantifies ventricular volume and function and shunt size
• Provides an assessment of the pressure gradient across the valves and atria
• Can provide morphologic image of the heart in neonates
• Provides multiple images of the heart per cardiac cycle

Disadvantages

• Certain physiologic formations can be misidentified, such as a thin fossa ovalis, and mistaken for an ostium secundum defect.
• Imaging, specifically static images, can provide a skewed perception of the thickness of the septum.
• Lacks large study backing, needs more clinical trial investigation to further evaluate the potential indications and limitations of the technique.
• In pediatrics, it may require general anesthesia. This may be less desirable as echocardiography does not.