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Ciancarella P, Ciliberti P, Santangelo TP, Secchi F, Stagnaro N, Secinaro A. Noninvasive imaging of congenital cardiovascular defects. Radiol Med 2020; 125:1167-1185. [PMID: 32955650 DOI: 10.1007/s11547-020-01284-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022]
Abstract
Advances in the treatment have drastically increased the survival rate of congenital heart disease (CHD) patients. Therefore, the prevalence of these patients is growing. Imaging plays a crucial role in the diagnosis and management of this population as a key component of patient care at all stages, especially in those patients who survived into adulthood. Over the last decades, noninvasive imaging techniques, such as cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT), progressively increased their clinical relevance, reaching stronger levels of accuracy and indications in the clinical surveillance of CHD. The current review highlights the main technical aspects and clinical applications of CMR and CCT in the setting of congenital cardiovascular abnormalities, aiming to address a state-of-the-art guidance to every physician and cardiac imager not routinely involved in the field.
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Affiliation(s)
- Paolo Ciancarella
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Paolo Ciliberti
- Pediatric Cardiology and Pediatric Cardiac Surgery Department, Bambino Gesù Children's Hospital IRCSS, Rome, Italy
| | - Teresa Pia Santangelo
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Francesco Secchi
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, San Donato Milanese, Italy
| | - Nicola Stagnaro
- Radiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Aurelio Secinaro
- Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
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Muscogiuri G, Suranyi P, Eid M, Varga-Szemes A, Griffith L, Pontone G, Schoepf UJ, De Cecco CN. Pediatric Cardiac MR Imaging:: Practical Preoperative Assessment. Magn Reson Imaging Clin N Am 2019; 27:243-262. [PMID: 30910096 DOI: 10.1016/j.mric.2019.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prevalence of patients with congenital heart disease (CHD) is rapidly increasing due to continuous advancements in diagnostic techniques and medical or surgical treatment approaches. Along with cardiac computed tomography angiography, cardiac magnetic resonance (CMR) serves as a fundamental imaging modality for pre-surgical planning in patients with CHD, as CMR allows for the evaluation of cardiac and great vessel anatomy, biventricular function, flow dynamics, and tissue characterization. This information is essential for risk-assessment and optimal timing of surgical interventions. This article discusses the current role of pediatric cardiac MR imaging as a practical preoperative assessment tool in the pediatric population.
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Affiliation(s)
- Giuseppe Muscogiuri
- Centro Cardiologico Monzino, IRCCS, Via Centro Cardiologico Monzino, Via Carlo Parea, 4, 20138 Milano MI, Italy; Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Rome, Italy
| | - Pal Suranyi
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Marwen Eid
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Akos Varga-Szemes
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Lewis Griffith
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Via Centro Cardiologico Monzino, Via Carlo Parea, 4, 20138 Milano MI, Italy
| | - Uwe Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc., 1364 Clifton Road Northeast, Atlanta, GA 30322, USA.
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Schicchi N, Secinaro A, Muscogiuri G, Ciliberti P, Leonardi B, Santangelo T, Napolitano C, Agliata G, Basile MC, Guidi F, Tomà P, Giovagnoni A. Multicenter review: role of cardiovascular magnetic resonance in diagnostic evaluation, pre-procedural planning and follow-up for patients with congenital heart disease. Radiol Med 2015; 121:342-51. [DOI: 10.1007/s11547-015-0608-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 11/16/2015] [Indexed: 01/21/2023]
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Babar JL, Jones RG, Hudsmith L, Steeds R, Guest P. Application of MR imaging in assessment and follow-up of congenital heart disease in adults. Radiographics 2010; 30:1145. [PMID: 20442335 DOI: 10.1148/rg.e40] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Judith L Babar
- Department of Radiology, University Hospital Birmingham, Queen Elizabeth Medical Centre, Edgbaston, Birmingham B15 2TH, United Kingdom
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Navallas M, Orenes P, Sánchez Nistal MA, Jiménez López Guarch C. [Congenital heart disease in adults: the contribution of multidetector CT]. RADIOLOGIA 2010; 52:288-300; quiz 376-7. [PMID: 20416911 DOI: 10.1016/j.rx.2010.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 01/09/2010] [Accepted: 01/12/2010] [Indexed: 11/17/2022]
Abstract
Congenital heart disease is relatively common among adults. Patients' conditions have generally been diagnosed previously and imaging tests are requested for follow-up or for complications of the anomaly or of its surgical correction. Classically, these patients were studied with echocardiography and cardiac catheterization, but multidetector CT and magnetic resonance imaging have changed the approach because these techniques show the anatomy of heart defects and their correction very clearly. We emphasize the importance of multidetector CT as a complementary technique for the study of congenital heart disease that is newly discovered in adults or for the follow-up of congenital heart disease that was surgically corrected during childhood. When vascular anomalies are present outside the heart or after palliative surgery, multidetector CT shows anatomical details that are difficult or impossible to see with echocardiography. We also emphasize the frequent association between pulmonary hypertension and congenital heart disease that can debut in adults.
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Affiliation(s)
- M Navallas
- Departamento de Radiología, Hospital Universitario 12 de Octubre, Madrid, España.
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Navallas M, Orenes P, Sánchez Nistal M, Jiménez López Guarch C. Congenital heart disease in adults: The contribution of multidetector CT. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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7
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Bastarrika Alemañ G, Gavira Gómez J, Zudaire Díaz-Tejeiro B, Castaño Rodríguez S, Romero Ibarra C, Sáenz De Buruaga J. Resonancia magnética cardíaca de las cardiopatías congénitas en el adulto. RADIOLOGIA 2007; 49:397-405. [DOI: 10.1016/s0033-8338(07)73810-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
There has been tremendous progress for MR imaging depiction of cardiac morphology and function. Further advances toward achieving faster acquisition with real-time imaging, higher resolution for plaque imaging, and quantitative analysis are taking place at a rapid pace.
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Affiliation(s)
- Ernesto Castillo
- The Russell H. Morgan Department of Radiology and Radiological Sciences, MRI Division, The Johns Hopkins University School of Medicine, MRI-143 Nelson Basement, 600 North Wolfe Street, Baltimore, MD 21287, USA
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Abstract
Echocardiography and catheterization angiography suffer certain limitations in the evaluation of congenital heart diseases in adults, though these are overcome by MRI, in which a wide field-of view, unlimited multiplanar imaging capability and three-dimensional contrast-enhanced MR angiography techniques are used. In adults, recently introduced fast imaging techniques provide cardiac MR images of sufficient quality and with less artifacts. Ventricular volume, ejection fraction, and vascular flow measurements, including pressure gradients and pulmonary-to-systemic flow ratio, can be calculated or obtained using fast cine MRI, phase-contrast MR flow-velocity mapping, and semiautomatic analysis software. MRI is superior to echocardiography in diagnosing partial anomalous pulmonary venous connection, unroofed coronary sinus, anomalies of the pulmonary arteries, aorta and systemic veins, complex heart diseases, and postsurgical sequelae. Biventricular function is reliably evaluated with cine MRI after repair of tetralogy of Fallot, and Senning's and Mustard's operations. MRI has an important and growing role in the morphologic and functional assessment of congenital heart diseases in adolescents and adults.
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Affiliation(s)
- Y H Choe
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Ko SF, Wan YL, Ng SH, Lee TY, Cheng YF, Wong HF, Hsieh MJ. MRI of thoracic vascular lesions with emphasis on two-dimensional time-of-flight MR angiography. Br J Radiol 1999; 72:613-20. [PMID: 10560347 DOI: 10.1259/bjr.72.858.10560347] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
MRI is a valuable method for evaluating thoracic vascular lesions by virtue of its non-invasiveness and multiplanar capability. In addition, ionizing radiation and iodinated contrast medium are not required. Electrocardiographically gated T1 weighted spin echo MRI remains the principal technique for demonstrating the anatomy and morphology of thoracic vascular diseases. Cine MRI allows dynamic evaluation of vascular flow, whereas MR angiography is particularly useful in the two-dimensional (2D) or three-dimensional (3D) display of vascular anatomy. This pictorial review illustrates the use of 2D time-of-flight MR angiography in the assessment of various thoracic vascular conditions including aortic arch and great vessel anomalies, heterotaxic syndromes, aortic dissection, aortic or arch vessel aneurysms, pulmonary embolism, pulmonary sequestration, axillofemoral bypass and tumour/vessel relationships.
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Affiliation(s)
- S F Ko
- Department of Radiology, Chang Gung University, Chang Gung Memorial Hospital at Kaohsiung, Taiwan, Republic of China
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Abstract
TTE with color flow imaging remains the most appropriate initial method for imaging CHD in adults. In many patients with minor abnormalities, this will be the only imaging required. For complicated intracardiac anomalies not well shown by TTE, TEE or MRI are usually adequate with the choice of technique being dependent on the availability of appropriate equipment and expertise. For great vessel abnormalities, further evaluation with MRI and MRA is most appropriate. In patients suspected of having significant systemic or pulmonary venous abnormalities or abnormalities of the aortic arch, MRI and MRA should be regarded as the definitive imaging technique. MRI and MRA are robust methods for evaluating intracardiac disease and can provide accurate information on cardiac chamber anatomy relationships, valvar lesions, and shunts. However, in most patients, this information is provided more rapidly and cost effectively by color Doppler echocardiography.
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Affiliation(s)
- G G Hartnell
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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