Magnetic resonance imaging examinations of congenital heart disease

Since 1987 the authors have examined 219 patients with a variety of congeni tal and acquired heart diseases by means of EGG-gated magnetic resonance im aging (MRI). Different imaging techniques (spin-echo, flowrephased 2-D-grad ient-echo, flowrephased 3-D-gradient-echo and flowrephased spin-echo-REFRES H) have been used interactively to demonstrate the pathologic cardiovascula r morphology and function. The patients' ages ranged from 2 days to 20 year s (mean age, 4.14 years). The results were compared to echocardiographic an d angiocardiographic data in each patient. The cardiac anatomy was correctl y classified by MRI with a sensitivity of 93-100% and a specificity of 94-1 00%. MRI proved to be superior to echocardiography and, in part, to angioca rdiography for identifying the vascular status in pulmonary atresia and in anomalous pulmonary venous drainage, as well as in systemic arterial malfor mations. MRI is particularly helpful in patients with cardiac malposition o r complex congenital heart disease. The diagnosis of cardiac tumors and car diomyopathy is also facilitated. With the continued improvement of all magn etic resonance components (hardware and software), the current problems of the technique, such as its long examination time and the need for sedation in small children, will be solved. (C) 1998 Elsevier Science Ireland Ltd. A ll rights reserved.