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Clinical role, accuracy, and technical aspects of cardiovascular magnetic resonance imaging in infants

  • Beverly Tsai-Goodman
    Affiliations
    Department of Cardiology, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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  • Tal Geva
    Affiliations
    Department of Cardiology, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Radiology, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

    Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
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  • Kirsten C Odegard
    Affiliations
    Department of Anesthesia, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
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  • Laureen M Sena
    Affiliations
    Department of Radiology, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
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  • Andrew J Powell
    Correspondence
    Address for reprints: Andrew J. Powell, MD, Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, Massachusetts 02115, USA.
    Affiliations
    Department of Cardiology, Children's Hospital BostonBoston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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      Abstract

      Cardiovascular magnetic resonance imaging (CMRI) has been shown to be an important alternative to echocardiography and catheterization for diagnostic imaging in older patients with congenital heart disease. However, little information is available on its clinical role, accuracy, and technical aspects in infants. We retrospectively identified all patients <1 year of age who underwent a CMRI examination at our institution over a 4-year period (from 1999 to 2002) and reviewed their medical records. Ninety-nine CMRI examinations were performed in 91 patients (median weight 4.9 kg; range 1.2 to 16.3) at a median age of 102 days (range 1 to 358). Technical modifications were used to improve signal-to-noise ratio and temporal resolution, and specialized personnel and equipment were employed. All CMRI studies were performed under general anesthesia without any complications, and all outpatients (n = 44) were discharged the same day. The primary referral questions for CMRI were delineation of the thoracic vasculature (n = 54), assessment of possible airway compression (n = 25), evaluation of cardiac tumor (n = 6), and other (n = 14). For the thoracic vasculature group, findings at surgery (n = 37) and catheterization (n = 16) were concordant with the CMRI diagnoses. In the airway compression group, findings at surgery (n = 16) were also in agreement with CMRI findings. Tumor types by CMRI in the 3 patients with preoperative studies were confirmed by histologic results. Thus, CMRI has a limited but important diagnostic role in infants with cardiovascular disease. It is an accurate and safe method to delineate the thoracic vasculature, evaluate possible airway compression, and characterize cardiac tumors. CMRI may obviate cardiac catheterization and bronchoscopy in selected cases.
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      References

        • Rhodes J.F
        • Asnes J.D
        • Blaufox A.D
        • Sommer R.J
        Impact of low body weight on frequency of pediatric cardiac catheterization complications.
        Am J Cardiol. 2000; 86: 1275-1278
        • Vitiello R
        • McCrindle B.W
        • Nykanen D
        • Freedom R.M
        • Benson L.N
        Complications associated with pediatric cardiac catheterization.
        J Am Coll Cardiol. 1998; 32: 1433-1440
        • Geva T
        • Sahn D.J
        • Powell A.J
        Magnetic resonance imaging of congenital heart disease in adults.
        Prog Pediatr Cardiol. 2003; 17: 21-39
        • Therrien J
        • Thorne S.A
        • Wright A
        • Kilner P.J
        • Somerville J
        Repaired coarctation.
        J Am Coll Cardiol. 2000; 35: 997-1002
        • Holmvang G
        • Palacios I.F
        • Vlahakes G.J
        • Dinsmore R.E
        • Miller S.W
        • Liberthson R.R
        • Block P.C
        • Ballen B
        • Brady T.J
        • Kantor H.L
        Imaging and sizing of atrial septal defects by magnetic resonance.
        Circulation. 1995; 92: 3473-3480
        • Hirsch R
        • Kilner P.J
        • Connelly M.S
        • Redington A.N
        • St John S
        • Somerville J
        Diagnosis in adolescents and adults with congenital heart disease. Prospective assessment of individual and combined roles of magnetic resonance imaging and transesophageal echocardiography.
        Circulation. 1994; 90: 2937-2951
        • Vliegen H.W
        • van Straten A
        • de Roos A
        • Roest A.A
        • Schoof P.H
        • Zwinderman A.H
        • Ottenkamp J
        • van der Wall E.E
        • Hazekamp M.G
        Magnetic resonance imaging to assess the hemodynamic effects of pulmonary valve replacement in adults late after repair of tetralogy of Fallot.
        Circulation. 2002; 106: 1703-1707
        • Geva T
        • Vick III, G.W
        • Wendt R.E
        • Rokey R
        Role of spin echo and cine magnetic resonance imaging in presurgical planning of heterotaxy syndrome. Comparison with echocardiography and catheterization.
        Circulation. 1994; 90: 348-356
        • Simpson I.A
        • Chung K.J
        • Glass R.F
        • Sahn D.J
        • Sherman F.S
        • Hesselink J
        Cine magnetic resonance imaging for evaluation of anatomy and flow relations in infants and children with coarctation of the aorta.
        Circulation. 1988; 78: 142-148
        • Simpson I.A
        • Valdes-Cruz L.M
        • Berthoty D.P
        • Powell J.B
        • Hesselink J.R
        • Chung K.J
        • Sahn D.J
        Cine magnetic resonance imaging and color Doppler flow mapping in infants and children with pulmonary artery bands.
        Am J Cardiol. 1993; 71: 1419-1426
        • Holmqvist C
        • Larsson E.-M
        • Stahlberg F
        • Laurin S
        Contrast-enhanced thoracic 3D-MR angiography in infants and children.
        Acta Radiol. 2001; 42: 50-58
        • Holmqvist C
        • Hochbergs P
        • Bjorkhem G
        • Brockstedt S
        • Laurin S
        Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect.
        Acta Radiol. 2001; 42: 63-69
        • Masui T
        • Katayama M
        • Kobayashi S
        • Ito T
        • Seguchi M
        • Koide M
        • Nozaki A
        • Sakahara H
        Gadolinium-enhanced MR angiography in the evaluation of congenital cardiovascular disease pre- and postoperative states in infants and children.
        J Magn Reson Imaging. 2000; 12: 1034-1042
        • Fogel M.A
        • Weinberg P.M
        • Hubbard A
        • Haselgrove J
        Diastolic biomechanics in normal infants utilizing MRI tissue tagging.
        Circulation. 2000; 102: 218-224
        • Niwa K
        • Uchishiba M
        • Aotsuka H
        • Tateno S
        • Tashima K
        • Fujiwara T
        • Matsuo K
        Magnetic resonance imaging of heterotaxia in infants.
        J Am Coll Cardiol. 1994; 23: 177-183
        • Boxer R.A
        • LaCorte M.A
        • Singh S
        • Shapiro J
        • Schiller M
        • Goldman M
        • Stein H.L
        Diagnosis of cardiac tumors in infants by magnetic resonance imaging.
        Am J Cardiol. 1985; 56: 831-832
        • Geva T
        • Greil G.F
        • Marshall A.C
        • Landzberg M
        • Powell A.J
        Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia.
        Circulation. 2002; 106: 473-478
        • Greil G.F
        • Powell A.J
        • Gildein H.P
        • Geva T
        Gadolinium-enhanced three-dimensional magnetic resonance angiography of pulmonary and systemic venous anomalies.
        J Am Coll Cardiol. 2002; 39: 335-341
        • Powell A.J
        • Geva T
        Blood flow measurement by magnetic resonance imaging in congenital heart disease.
        Pediatr Cardiol. 2000; 21: 47-58
        • Chung T
        Assessment of cardiovascular anatomy in patients with congenital heart disease by magnetic resonance imaging.
        Pediatr Cardiol. 2000; 21: 18-26
        • Prince M.R
        Contrast-enhanced MR angiography.
        Magn Reson Imaging Clin N Am. 1998; 6: 257-267
        • Kiaffas M.G
        • Powell A.J
        • Geva T
        Magnetic resonance imaging evaluation of cardiac tumor characteristics in infants and children.
        Am J Cardiol. 2002; 89: 1229-1233
        • Sallee D
        • Spector M.L
        • van Heeckeren D.W
        • Patel C.R
        Primary pediatric cardiac tumors.
        Cardiol Young. 1999; 9: 155-162
        • Beghetti M
        • Gow R.M
        • Haney I
        • Mawson J
        • Williams W.G
        • Freedom R.M
        Pediatric primary benign cardiac tumors.
        Am Heart J. 1997; 134: 1107-1114
        • Hoffmann U
        • Globits S
        • Frank H
        Cardiac and paracardiac masses. Current opinion on diagnostic evaluation by magnetic resonance imaging.
        Eur Heart J. 1998; 19: 553-563
        • Grebenc M.L
        • Rosado de Christenson M.L
        • Burke A.P
        • Green C.E
        • Galvin J.R
        Primary cardiac and pericardial neoplasms.
        Radiographics. 2000; 20: 1073-1103
        • Beekman R.P
        • Hoorntje T.M
        • Beek F.J
        • Kuijten R.H
        Sedation for children undergoing magnetic resonance imaging.
        Eur J Pediatr. 1996; 155: 820-822
        • Didier D
        • Ratib O
        • Beghetti M
        • Oberhaensli I
        • Friedli B
        Morphologic and functional evaluation of congenital heart disease by magnetic resonance imaging.
        J Magn Reson Imaging. 1999; 10: 639-655
        • Schlesinger A.E
        • Hernandez R.J
        Magnetic resonance imaging in congenital heart disease in children.
        Tex Heart Inst J. 1996; 23: 128-143
        • Baker E
        What's new in magnetic resonance imaging?.
        Cardiol Young. 2001; 11: 445-452