Double-outlet right ventricle: morphologic demonstration using nuclear magnetic resonance imaging.

Area of Science:

• Cardiology
• Medical Imaging
• Pediatric Cardiology

Background:

• Double outlet right ventricle (DORV) is a complex congenital heart defect.
• Accurate pre-operative imaging is crucial for surgical planning and patient management.

Purpose of the Study:

• To evaluate the diagnostic accuracy and clinical utility of 1.5 tesla nuclear magnetic resonance (NMR) imaging in patients with double outlet right ventricle.
• To compare NMR imaging findings with echocardiography, angiography, surgical, and postmortem data.

Main Methods:

• Sixteen patients with DORV underwent 1.5 tesla NMR imaging and two-dimensional echocardiography.
• Angiography was performed in 13 patients; 9 underwent surgical correction.
• NMR imaging utilized spin-echo sequences with ECG gating and a proton head coil for infants.

Main Results:

• NMR imaging confirmed DORV diagnosis in 15 of 16 patients, correlating well with surgical and postmortem findings.
• NMR excelled in visualizing great artery relationships, outlet septum anatomy, and ventricular septal defects.
• Abnormalities of the mitral valve were identified by NMR in two patients, missed by echocardiography.

Conclusions:

• Nuclear magnetic resonance imaging provides clinically relevant and accurate morphologic information in patients with double outlet right ventricle.
• NMR imaging can reveal details of cardiac anatomy not evident with other modalities, aiding in surgical planning.
• This cardiac MRI technique holds potential for improving the management of complex congenital heart disease like DORV.