Congenital heart disease MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor-In-Chief: Keri Shafer, M.D. [2],Atif Mohammad, M.D., Priyamvada Singh, MBBS

## Overview

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Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive.

## MRI

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Magnetic resonance imaging (MRI) can be used as a diagnostic modality in congenital heart diseases.

#### Advantages

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* It can be used in cases where echocardiographic results are inconclusive.
* Helps in measuring heart volumes, blood flow and ventricular wall thickness.
* The magnetic resonance angiography helps in better visualization of heart vasculature
* Phase velocity mapping helps in measuring the ratio of pulmonary to systemic blood flow (Qp:Qs).

#### Disadvantage

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For successful MRI procedure breath holding is required, which is sometimes difficult to achieve with small kids. Due to this, the procedure is done under general anesthesia in children.

## 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[1]

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### Recommendations for Cardiovascular Magnetic Resonance Imaging

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Class I

1.In patients with ACHD who have or who are at risk of developing RV enlargement and dysfunction, serial CMR is recommended for quantitative assessment of RV size and function (Level of Evidence: B-NR)
Class IIa

1.CMR can be useful in the initial evaluation and serial assessment of selected patients with CHD based on anatomic complexity and clinical status. (Level of Evidence: C-LD)

## ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance[2] (DO NOT EDIT)

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CMR may be used for assessing cardiac structure and function, blood flow, and cardiac and extracardiac conduits in individuals with simple and complex congenital heart disease. Specifically, CMR can be used to identify and characterize congenital heart disease, to assess the magnitude or quantify the severity of intracardiac shunts or extracardiac conduit blood flow, to evaluate the aorta, and to assess the pathological and physiologic consequences of congenital heart disease on left and right atrial and ventricular function and anatomy.

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## References

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1. ↑ Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM; et al. (2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Am Coll Cardiol. 73 (12): 1494–1563. doi:10.1016/j.jacc.2018.08.1028. PMID 30121240.CS1 maint: Multiple names: authors list (link)
2. ↑ American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA; et al. (2010). "ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents". Circulation. 121 (22): 2462–508. doi:10.1161/CIR.0b013e3181d44a8f. PMC 3034132. PMID 20479157.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link) CS1 maint: PMC format (link)

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Congenital malformations and deformations of circulatory system (Q20-Q28, 745-747)

Cardiac chambers and connections|

Persistent truncus arteriosus \- Double outlet right ventricle (Taussig-Bing syndrome) - Transposition of the great vessels (dextro, levo)

Cardiac septa|

Ventricular septal defect \- Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect (Ostium primum) - Tetralogy of Fallot \- Eisenmenger's syndrome

Right: pulmonary and tricuspid valves|

pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, atresia) - Ebstein's anomaly

Left: aortic and mitral valves|

aortic valves (stenosis, insufficiency, bicuspid) - mitral valves (stenosis, regurgitation) - Hypoplastic left heart syndrome

Other congenital malformations
of heart|

Dextrocardia \- Levocardia \- Cor triatriatum

Great arteries|

aorta (Patent ductus arteriosus, Aortic coarctation, Interrupted aortic arch, Overriding aorta, Aneurysm of sinus of Valsalva, Vascular ring) - Pulmonary atresia

Great veins|

Persistent left superior vena cava \- Total anomalous pulmonary venous connection \- Scimitar syndrome

Other|

Arteriovenous malformation (Cerebral arteriovenous malformation)

See also non-congenital conditions (I, 390-459)

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