Cardiac magnetic resonance in the study of neonatal haemodynamics

Circulatory failure plays a key role in the pathogenesis of mortality and key morbidity such as cerebral injury in the preterm infant. However awareness of the pathophysiology of circulatory failure itself is not well understood. Similarly there is significant uncertainty over optimal treatment approaches, particularly for inotropic therapies. Current uncertainties are perpetuated by difficulties with accurately assessing circulatory function. Cardiac magnetic resonance (CMR) imaging has produced significant advances in understanding of adult circulatory function, and acts as a powerful biomarker for interventional studies. Although routine circulatory assessment by CMR in the neonatal population is not currently a realistic goal, it could provide insights into pathophysiology; and act as an outcome measure in clinical trials in small numbers of infants in specialist centres. This review focuses on available CMR techniques, scope for use in the neonatal population, and our initial experience with the technique.