DIAGNOSTIC METHODS CONGENITAL HEART DISEASE Magnetic resonance imaging in patients with congenital heart disease

Magnetic resonance imaging (MRI) was conducted with use of the spin-echo technique (0.35 Tesla) in 22 patients with a variety of congenital and cardiovascular anomalies and in 16 normal volunteers. Electrocardiographic (ECG) synchronization of the data acquisition produced transverse, parasagittal, and coronal tomograms that were used to define size and relationship of the great vessels and internal cardiac structures. MRI findings were corroborated by angiography and sector-scan echocardiography. In most patients the diagnosis had been established before the MRI study. MRI detected all of 11 abnormalities at the level of the great vessels, all of six atrial septal abnormalities, and 10 of 11 ventricular septal defects. Images of poor quality resulting from patient motion were obtained in the one instance in which a small ventricular septal defect was not imaged. Of two patients with Ebstein's anomaly, the displacement of the tricuspid leaflets was shown in one patient but was not evident in another. Complex anomalies such as double-outlet right ventricle, uncorrected L-transposition, single atrioventricular valve, single ventricle, and common ventricle were clearly shown by MRI. Initial experience with MRI has indicated the effectiveness of this technique for defining great vessel and internal cardiac anatomy in patients with congenital heart disease. This is accomplished without the use of contrast media and is thus a completely noninvasive technique for cardiovascular diagnosis. Circulation 70, No. 5, 851-860, 1984. GATED magnetic resonance imaging (MRI) is a completely noninvasive technique for evaluating cardiovascular anatomy.)` A recent study has reported its use for defining congenital heart disease.4 In our early experience, we have used gated MRI to examine the central cardiovascular structures from the great vessel level to the liver in patients with congenital heart disease. Segmental anatomy was described by these multiple tomographic images and the results were corroborated by those of cardiac angiography and twodimensional echocardiography.