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Magnetic resonance imaging of the great arteries in infants
J M Parsons1, E J Baker, A Hayes
1Department of Paediatric Cardiology, Guy's Hospital, London, U.K.
Insights
Magnetic resonance imaging (MRI) accurately evaluates great arteries in infants with suspected congenital heart disease. This non-invasive technique offers detailed anatomical information, often replacing the need for invasive procedures.
Area of Science:
- Cardiology
- Medical Imaging
- Pediatrics
Background:
- Congenital heart disease (CHD) diagnosis in infants often requires multiple imaging modalities.
- Accurate morphological evaluation of great arteries is crucial for CHD management.
- Non-invasive imaging techniques are preferred to minimize risks in neonates.
Purpose of the Study:
- To assess the utility of 1.5 Tesla magnetic resonance imaging (MRI) for morphological evaluation of great arteries in infants with suspected CHD.
- To compare MRI findings with echocardiography, angiography, and surgical outcomes.
- To determine if MRI can reduce the need for invasive diagnostic procedures.
Main Methods:
- Sixty infants (aged 1-48 weeks) with suspected CHD underwent MRI.
- Standard and oblique imaging planes were used with electrocardiogram gating.
- MRI findings were compared with echocardiography (n=60), angiography (n=33), and surgical data (n=44).
Main Results:
- MRI correctly identified ventriculo-arterial connections in 54 infants and accurately described great artery relationships in all.
- MRI clearly visualized pulmonary arteries, outperforming echocardiography in identifying central pulmonary arteries in cases of pulmonary atresia.
- MRI provided superior information compared to echocardiography for suspected aortic coarctation, accurately demonstrating the thoracic aorta.
Conclusions:
- Magnetic resonance imaging is a valuable non-invasive tool for assessing great arteries in infants with suspected congenital heart disease.
- MRI complements echocardiography and angiography, providing detailed anatomical insights.
- In numerous cases, MRI can obviate the necessity for invasive investigations like angiography.
Abstract:
Sixty infants, aged 1-48 (median 8) weeks, with suspected congenital heart disease underwent a morphological evaluation of the great arteries using magnetic resonance imaging at 1.5 Tesla. Cross-sectional echocardiography was performed in all infants, angiography in 33 and surgery in 44. Multiple sections, 5 mm thick and gated to the patients' electrocardiogram were acquired in standard and oblique imaging planes. Ventriculo-arterial connexions were correctly identified in 54 infants (6 did not have intracardiac imaging performed) and an accurate description of the relationships of the great arteries was made in all. Magnetic resonance imaging clearly demonstrated normal and hypoplastic pulmonary arteries to the level of the first hilar branches and was better than echocardiography at confirming the presence or absence of central intrapericardial pulmonary arteries in 4 infants with pulmonary atresia. All parts of the thoracic aorta were accurately demonstrated and, in 23 infants with clinical suspicion of aortic coarctation, magnetic resonance images provided more information than echocardiography. Magnetic resonance imaging accurately demonstrates great arteries non-invasively supplementing echocardiographic and angiographic findings. In many cases, it replaces the need for invasive investigations.