Postoperative evaluation of congenital heart disease by magnetic resonanceimaging

In the last four decades the survival of patients with corrected or palliat ed congenital heart disease has increased dramatically, However, post-opera tive abnormalities frequently occur and therefore a noninvasive imaging too l is mandatory for the timely detection of morphological as well as functio nal abnormalities. Magnetic resonance imaging (MRI) is ideally suited for t he noninvasive diagnosis and post-operative follow-up of congenital heart d isease, Spin-echo MRI is able to visualize structures that may be difficult to assess with other noninvasive image modalities and is sensitive in the detection of postinterventional stenoses or aneurysms. Because the function of the ventricles may deteriorate over time after correction or palliation of a congenital cardiac malformation, the use of gradient-echo MRI is esse ntial in the follow-up after correction or palliation, as no other conventi onal technique allows such detailed evaluation of ventricular function, wit hout geometrical assumptions. Phase-contrast MRI is well suited to assess v alvular function, allowing accurate measurement of regurgitation or stenosi s. Shunt quantification is another application of phase-contrast MRI. (C) 1 999 Wiley-Liss, Inc.