MR-IMAGING OF SURGICAL COMPLICATIONS OF SYSTEMIC-TO-PULMONARY ARTERY SHUNTS

Patients with a systemic-to-pulmonary artery shunt and positive findin gs on traditional imaging modalities such as chest X-ray, echocardiogr aphy, or cardiac angiography often can benefit from additional noninva sive imaging with magnetic resonance imaging (MRI). Diagnostic dilemma s encountered include: pseudoaneurysms, contained fluid collection (se roma) surrounding a shunt, and stenosis of the shunt anastomoses. MRI studies using traditional cardiac-triggered spin-echo (SE) imaging and the newer breathhold MRI studies with k-space segmented gradient-reca lled echo (GRE) imaging can greatly help resolve diagnostic dilemmas, By combining different MR imaging techniques it becomes possible to cl early distinguish between pseudoaneurysms and seroma, to exclude an ac tive leak and to sometimes visualize the distal anastomosis with more precision than conventional angiography, MRI is often able to add info rmation needed for clinical decision making prior to surgical repair. Copyright (C) 1996 Elsevier Science Inc.