Congenital heart disease. Evaluation of anatomy and function by MRI

With the increasing number of patients surviving after therapeutic interven tion for congenital heart disease (CHD), accurate and frequent follow-up of their morphologic and functional cardiovascular status is required, prefer ably with a noninvasive imaging technique. Echocardiography, either transthoracic or transesophageal, has been the fir st choice for this purpose, and will probably keep that status, at least in a large segment of the CHD spectrum. Magnetic resonance imaging (MRI) is a n established method for high-resolution visualization of cardiovascular mo rphology. In the past decade, newer MRI techniques have been developed that allow functional evaluation of CHD patients. Particularly the introduction of breath-hold imaging, contrast-enhanced MRA and user-friendly computer s oftware for image analysis may move functional MRI of CHD from the science laboratory to clinical use. It is already evident that MRI is superior to e chocardiography in certain areas of limited echocardiographic access, such as the pulmonary artery branches and the aortic arch in adult patients. But MRI has also a unique potential for accurate volumetric analysis of ventri cular function and cardiovascular blood flow, without any geometric assumpt ions. If supported by increased cooperation between cardiologists and radio logists, MRI will grow into a useful noninvasive imaging tool that, togethe r with echocardiography, will obviate the need for invasive catheter studie s for diagnostic purposes.