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Updated: Apr 28, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
What every radiologist should know about paediatric echocardiography
Erich Sorantin1, Bernd Heinzl2
1Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz, Austria.
Insights
Echocardiography is a key tool for diagnosing congenital heart defects (CHD) in children, offering bedside assessments. However, its effectiveness diminishes in adults with CHD due to limitations, necessitating complementary imaging like cardiac MRI and CT.
Area of Science:
- Cardiology
- Radiology
- Pediatric Imaging
Background:
- Congenital heart defects (CHD) affect a small percentage of newborns.
- Echocardiography is the primary imaging modality for assessing CHD morphology and function.
- Bedside echocardiography is reliable for diagnosing various CHD types in childhood.
Purpose of the Study:
- To provide a systematic approach for echocardiographic assessment of CHD.
- To highlight typical echocardiographic findings in common CHD.
- To discuss the strengths and limitations of echocardiography in CHD follow-up, especially in adults.
Main Methods:
- Systematic review of echocardiography in congenital heart defect assessment.
- Presentation of representative echocardiographic images.
- Discussion of limitations in older patients and comparison with other imaging modalities.
Main Results:
- Echocardiography is effective for childhood CHD diagnosis and follow-up.
- Limitations in adults with CHD include skeletal and pulmonary issues, impacting right ventricular assessment.
- Cardiac MRI and CT are valuable adjuncts when echocardiography is limited.
Conclusions:
- Echocardiography is crucial for pediatric CHD, but its utility decreases in grown-up congenital heart disease (GUCH).
- Radiologists must understand echocardiography's limitations and when to utilize advanced imaging like cMRI and cCT.
- A comprehensive imaging strategy is essential for lifelong CHD management.
Abstract:
Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations - partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized.
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