Key result
Gadolinium-enhanced MR angiography correctly identified thoracic vasculature in 100% of cases and accurately assessed pathology in 95.7% of preoperative and 93.3% of postoperative pediatric patients.
Why the study?
The utility of dynamic contrast MR angiography under sedation for assessing congenital cardiovascular disease in infants and small children before and after cardiac surgery was evaluated.
Does gadolinium-enhanced dynamic MR angiography under sedation accurately evaluate thoracic vasculature in infants and small children with congenital cardiovascular disease pre- and postoperatively?
Observational (n=38)
Does gadolinium-enhanced dynamic MR angiography under sedation accurately evaluate thoracic vasculature in infants and small children with congenital cardiovascular disease pre- and postoperatively?
Gadolinium-enhanced dynamic MR angiography under sedation is a highly accurate imaging modality for evaluating thoracic vasculature in infants and children with congenital heart disease before and after surgery.
Supports gadolinium-enhanced MR angiography for thoracic assessment in sedated pediatric congenital heart disease; leaves open prospective validation against alternatives.
The purpose of this study was to evaluate the utility of dynamic contrast magnetic resonance (MR) angiography under sedation for assessing congenital cardiovascular disease in infants and small children before and after cardiac surgery. In 38 patients with cardiovascular abnormalities, thoracic vasculatures were evaluated in either the preoperative (group 1; 23 patients, median age 9 months old) or the postoperative (group 2; 15 patients median age 1. 3 years old) state using gadolinium-enhanced dynamic MR angiography. Acquired data were processed with a multiprojection volume reconstruction. Image quality (grades 1-5, undiagnostic to excellent), presence or absence of the extracardiac vasculature, its pathology (group 1), and the patency of the postsurgical shunt or reconstructed vasculature (group 2) were evaluated. All images were of diagnostic image quality (mean grade 4.4-3.2). Recognition of the thoracic vasculature was correctly made in all cases (38/38, 100%). In group 1, anomalies and pathologic changes were correctly identified in 22 of 23 cases (95.7%). In one patient with dextrocardia and the cardiac type of total anomalous pulmonary venous return, the abnormality was not recognized. In group 2, the patency of the shunt flow after Glenn (n = 6), modified Fontan (n = 4), Rastelli (n = 1), and Blalock-Taussig (n = 3) operations was well demonstrated in each case. The reconstructed pulmonary artery (n = 1), veins (n = 2), and aorta (n = 1) were correctly visualized. In one case, stenosis of the reconstructed left pulmonary vein was missed by MR angiography. In 14 of 15 cases in group 2 (93.3%), MR angiography correctly gave information on the operated areas. In conclusion, dynamic contrast MR angiography under sedation is useful for evaluation of the thoracic vasculature of infants and small children in the pre- and postoperative states. J. Magn. Reson. Imaging 2000;12:1034-1042.
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Masui et al. (2000) conducted an observational in Congenital cardiovascular disease (n=38). Gadolinium-enhanced dynamic MR angiography under sedation was evaluated on Correct recognition of the thoracic vasculature and its pathology or postsurgical shunt patency. Gadolinium-enhanced MR angiography correctly identified thoracic vasculature in 100% of cases and accurately assessed pathology in 95.7% of preoperative and 93.3% of postoperative pediatric patients.
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