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Author Spotlight: Improved Imaging for Neovascular Development in Congenital Heart Disease Research
Published on: April 26, 2024
Cardiovascular imaging trends in congenital heart disease: a single center experience
B Kelly Han1, Andrew M Lesser2, Marko Vezmar3
1The Children's Heart Clinic at The Children's Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA; The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA.
Insights
Diagnostic imaging for congenital heart disease (CHD) shows increasing use of cardiac MRI and CT. This trend is associated with a decrease in diagnostic cardiac catheterization procedures for pediatric patients.
Area of Science:
- Cardiovascular Imaging
- Pediatric Cardiology
- Diagnostic Modalities
Background:
- Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are increasingly available in pediatric cardiac centers.
- Understanding current diagnostic imaging trends for congenital heart disease (CHD) is essential.
Purpose of the Study:
- To describe contemporary diagnostic imaging trends for the definition of congenital heart disease (CHD).
- To analyze the utilization of echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT in pediatric CHD patients.
Main Methods:
- Retrospective analysis of diagnostic imaging and surgical procedures for CHD patients (2005-2012) at a single institution.
- Poisson regression was used to estimate modality-specific rates and compare trends over time.
- Tabulation of median age, studies in patients aged >17 years, and referral diagnosis for the final year of review.
Main Results:
- Echocardiography remained the predominant imaging modality (95-97% of studies).
- Cardiac MRI and CT use increased significantly over time, while diagnostic catheterization decreased.
- Patients undergoing advanced imaging (MRI, CT) or catheterization were often older and had moderate to complex CHD.
Conclusions:
- Cardiac CT and MRI utilization is increasing for CHD evaluation.
- The rise in cardiac CT and MRI use correlates with a decline in diagnostic cardiac catheterization.
- Advanced imaging modalities are playing a growing role in the assessment of pediatric congenital heart disease.
Background:
Cardiac magnetic resonance imaging (MRI) and CT are available in the recent era at many pediatric cardiac centers.
Objective:
The aim was to provide a contemporary description of diagnostic imaging trends for definition of congenital heart disease (CHD).
Methods:
Echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT use in patients with congenital heart disease at a single institution was retrospectively recorded (2005-2012). Surgical procedures were recorded. Total and modality-specific rates were estimated by Poisson regression and compared. The median age, studies in patients aged >17 years, and referral diagnosis were tabulated for the last year of review.
Results:
An average of 11,940 cardiovascular diagnostic tests was performed annually. The number of total studies, echocardiograms, catheterizations, and surgical procedures, did not change significantly across time. Echocardiography comprised 95% to 97% of all studies performed during each year of review. The use of cardiac MRI (2%) and cardiac CT (1%) increased linearly (P < .001), and the use of diagnostic catheterization decreased (0.7%; P = .0005). The median age was 3 years for echocardiography, 15 years for MRI, 11 years for CT, and 3 years for catheterization. The percentage of patients aged >17 years was 9% for echocardiography, 33% for cardiac MRI, 29% for cardiac CT, and 8% for catheterization. Most patients undergoing CT, MRI, and diagnostic catheterization had moderate or complex CHD.
Conclusion:
Cardiac CT is used increasingly in the recent era for evaluation of CHD. The increased use of both cardiac CT and cardiac MRI are temporally associated with a decrease in diagnostic cardiac catheterization.
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