Recent Advances and Trends in Pediatric Cardiac Imaging

Cardiac imaging is central to today's pediatric cardiology practice not only to diagnose structural congenital defects and delineate cardiac and extracardiac anatomy but also for determining the hemodynamic impact of the structural defects and acquired pediatric diseases. Not so long ago, clinicians had to heavily rely on angiography as the main cardiac imaging modality to visualize the heart. Particularly, the development of echocardiography in the 1970s and 1980s together with the development of magnetic resonance imaging (MRI) and computed tomography (CT) resulted in a non-invasive diagnostic revolution with diagnostic catheterization becoming obsolete apart for very specific indications. The continuous improvements in non-invasive imaging modalities allow an unprecedented level of understanding of cardiac morphology and function. Over the last few years, the specific roles of the three imaging modalities and their complementary roles in diagnosis and treatment have become well established resulting in a multimodality approach to specific congenital lesions. Recently, multimodality guidelines were published for postoperative tetralogy of Fallot and patients with transposition of the great arteries (Cohen et al. J Am Soc Echocardiogr. 2016;29(7):571-621, Valente et al. J Am Soc Echocardiogr. 2014;27(2):111-41). In this paper, we aim to highlight some of the most significant advances and highlight some emerging trends in pediatric cardiac imaging.