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Computed tomography and magnetic resonance imaging findings in congenital cardiovascular anomalies
Mustafa Koplay1, Nusret Seher1
1Selçuk University Faculty of Medicine, Department of Radiology, Konya, Türkiye.
Insights
Advanced imaging techniques like cardiac MRI and CT are crucial for diagnosing and monitoring congenital heart disease (CHD) in patients of all ages. These methods offer detailed anatomical and functional insights, complementing traditional echocardiography in postoperative care.
Area of Science:
- Cardiology
- Medical Imaging
- Pediatric Cardiology
Background:
- Congenital heart disease (CHD) incidence is 6-7 per 1,000 newborns, with increasing survival rates.
- Advanced diagnostic, medical, and surgical methods improve CHD survival, leading to a growing population living with the condition.
- Evolving imaging technologies like cardiac MRI (CMR) and cardiac CT/CTA are becoming vital for congenital cardiac imaging, especially in postoperative follow-up.
Purpose of the Study:
- To review the diagnostic value and relative advantages of CMR and cardiac CT/CTA.
- To evaluate the role of these advanced imaging modalities in the diagnosis and postoperative follow-up of CHD.
- To provide an overview of current literature on CMR and cardiac CT in congenital cardiac imaging.
Main Methods:
- Literature review focusing on diagnostic value, advantages, and evaluation of CMR and cardiac CT/CTA.
- Analysis of imaging techniques including spin echo MRI, cine MRI, phase contrast CMR, MR angiography, myocardial perfusion, fibrosis imaging, and CT angiography.
- Comparison of information obtained from echocardiography, invasive cardiac catheterization, CMR, and cardiac CT/CTA.
Main Results:
- CMR provides detailed anatomical and functional data, including flow quantification and assessment of myocardial tissue characteristics.
- Cardiac CT and CTA excel in newborns due to high resolution and fast acquisition, minimizing artifacts.
- 3D imaging with contrast-enhanced CMR/CT/CTA offers excellent visualization of complex vascular structures in CHD.
- CT imaging facilitates easier viewing of coronary anatomy.
Conclusions:
- CMR and cardiac CT/CTA are indispensable tools for diagnosing and managing congenital heart disease, offering complementary information to echocardiography and catheterization.
- These advanced imaging modalities are particularly valuable for the increasing population of adults and children with CHD requiring long-term follow-up.
- The choice between CMR and CT depends on specific clinical questions, patient age, and imaging requirements, with both offering significant advantages in congenital cardiac imaging.
Abstract:
The incidence of congenital heart disease (CHD) is approximately 6-7 per 1,000 newborns. With advanced diagnostic, medical, and surgical methods, survival of CHD is increasing, as is the number of people living with CHD. Echocardiography is a useful modality in non-invasive imaging, whereas magnetic resonance imaging (MRI), cardiac MR (CMR), cardiac computed tomography (CT), and CT angiography (CTA) are increasingly gaining ground in congenital cardiac imaging with developing technology. Considering the limited postoperative use of echocardiography, these techniques have assumed vital roles with the increasing population of CHD in children and adults. CMR and cardiac CT can complement the information obtained with echocardiography and invasive cardiac catheterization and can sometimes provide more detail. In postoperative imaging of CHD, CMR allows an evaluation of anatomy, especially with spin echo MRI techniques, whereas cine MRI, created in gradient echo sequences, allows functional data to be obtained. Phase contrast CMR data provides information on flow direction and flow rate, allowing accurate measurement of regurgitation and shunt volume. In addition, in post-gadolinium imaging, data such as on MR angiography, myocardial perfusion, and fibrosis can be obtained with CMR. Cardiac CT and CTA provide great advantages, especially in newborns, by almost completely reducing movement and respiratory artifacts through capabilities such as high spatial and temporal resolution, fast acquisition, and short acquisition time. Three-dimensional reformatted images with contrast-enhanced CMR or cardiac CT/CTA provide excellent visualization of vascular structures in complex CHDs. Coronary imaging can be viewed more easily with CT imaging. This article reviews the literature to provide an overview of the diagnostic value, relative advantages, and overall evaluation of CMR and cardiac CT examinations in the diagnosis and postoperative follow-up of CHD.
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