DIAGNOSTIC METHODS CONGENITAL HEART DISEASE The detection of atrial and ventricular septal defects with electrocardiographically synchronized magnetic resonance imaging

To evaluate the detectability of cardiac septal defects by electrocardiographically synchronized (ECG-gated) magnetic resonance imaging (MRI), 48 subjects were imaged, including 18 normal and 30 abnormal subjects in whom 22 ventricular septal defects (VSDs) and nine atrial septal defects (ASDs) had been diagnosed angiographically. Two radiologists with ECG-gated cardiac MRI experience read the scans in a blinded fashion, and the results were evaluated by receiver operator characteristic curve analysis. The detectability of VSDs appeared greater than that of ASDs, although statistical significance at the .05 level was not achieved. The reported sensitivity and specificity of echocardiography in the detection of VSDs is comparable to MRI, whereas echocardiography probably is superior to MRI for detection of ASDs. Although MRI is potentially valuable in the diagnosis of various complex congenital cardiac defects, echocardiography is probably superior in the detection of VSDs and ASDs. Circulation 73, No. 1, 89-94, 1986. ELECTROCARDIOGRAPHICALLY synchronized (ECG-gated) magnetic resonance imaging (MRI) is a noninvasive technique that has been successfully applied to the heart by various investigators.1`7 MRI of congenital cardiac malformations has been reported in preliminary studies demonstrating the practicality of the technique.8-10 However, images in these studies were read under unblinded conditions, and only one included normal controls. We have employed controlled, blinded readings to explore the detectability of atrial and ventricular septal defects (ASDs and VSDs) by ECG-gated MRI.