Postoperative evaluation of congenital heart disease by magnetic resonance imaging

In the last four decades the survival of patients with corrected or palliated congenital heart disease has increased dramatically. However, post-operative abnormalities frequently occur and therefore a noninvasive imaging tool is mandatory for the timely detection of morphological as well as functional abnormalities. Magnetic resonance imaging (MRI) is ideally suited for the noninvasive diagnosis and post-operative follow-up of congenital heart disease. Spin-echo MRI is able to visualize structures that may be difficult to assess with other noninvasive image modalities and is sensitive in the detection of post-interventional stenoses or aneurysms. Because the function of the ventricles may deteriorate over time after correction or palliation of a congenital cardiac malformation, the use of gradient-echo MRI is essential in the follow-up after correction or palliation, as no other conventional technique allows such detailed evaluation of ventricular function, without geometrical assumptions. Phase-contrast MRI is well suited to assess valvular function, allowing accurate measurement of regurgitation or stenosis. Shunt quantification is another application of phase-contrast MRI. J. Magn. Reson. Imaging 1999;10:656-666.