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ECHO 2013 / Cardiac Magnetic Resonance Imaging in the Adult Congenital Patient

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CMR RV Contours - Diastole

CMR RV Contours - Systole

Repeatability of CMR RV Size and

Function in Congenital Heart Disease

Walsh Pediatr Radiol 2011

 

Interobserver

Intraobserver

 

Comparisons

Comparisons

 

 

 

RV EDV Difference (ml/m2)

-1.4 + 7.7

-1.2 + 6.8

 

 

 

RV EDV Coefficient of

3.3%

3.2%

Variability

 

 

RV EDV Repeatability

14.9%

13.2%

Coefficient

 

 

RV EDV Threshold Values

20.2

15.1

(ml/m2)

 

 

RV EF Repeated Coefficient

6.0%

5.0%

 

 

 

RV EF Threshold Values (%)

3.0

2.6

 

 

 

CMR in Adult CHD

•Program Description

•CMR Technique

•Reproducibility

•Other Strengths and Limitations

•Cases

Other Strengths of CMR

•Window independent

•3D assessment

•Tissue characterization

•Myocardial viability

•Flow ratios

•Extracardiac structures

•Safety (no radiation exposure)

Limitations of CMR

•Load dependent

•Size limitation

•Sedation sometimes required

•Metallic artifacts

•Pacemaker incompatibility

•Not available in the OR or cath lab

CMR in Adult CHD

•Program Description

•CMR Technique

•Reproducibility

•Other Strengths and Limitations

•Cases

QUESTION

Cardiac MRI sequence(s) that can be used to measure stroke volumes for the assessment of valvular regurgitation:

1.Bright blood (cine) imaging

2.Black blood imaging

3.Phase contrast

4.Both 1 and 3

Case

•21 yr-old with tetralogy of Fallot with pulmonary atresia, s/p repair with takedown of Blalock-Taussig shunt and subsequent replacement of RV-to-PA conduit

•Indication: RV size/function, RVOT, and pulmonary regurgitation (PR)