Update on non-invasive imaging for congenital heart disease: an additional dimension

In the past three decades, technical advances in cardiovascular imaging have created a better balance in the requisite trade-off between spatial versus temporal resolution that is inherent to all dynamic imaging modalities. This update focuses on two techniques in which the advances in computer and engineering technologies have allowed for an additional dimension of imaging for patients with congenital heart disease (CHD). The development of matrix array probes has propelled three-dimensional (3D) echocardiography into a routinely available tool for the assessment of valvular dysfunction, structural abnormalities, and ventricular size and function. Recent advances in time-resolved 3D velocity mapping, widely known as four-dimensional flow cardiac magnetic resonance, have significantly improved our ability to assess the hemodynamic abnormalities associated with CHD. These advances have allowed for significantly increased amounts of data to be collected, with further improvements expected. Their current applications in patients with CHD are reviewed. Future studies will help to define the roles of these advanced technologies in routine clinical care.