Ultrafast three-dimensional contrast-enhanced magnetic resonance angiography and imaging in the diagnosis of partial anomalous pulmonary venous drainage

OBJECTIVES The purpose of our study was to evaluate patients with suspected anomalous pulmonary veins (APVs) and atrial septal defects (ASDs) using fa st cine magnetic resonance imaging (MRI) and ultrafast three-dimensional ma gnetic resonance angiography (MRA). BACKGROUND Precise anatomic definition of anomalous pulmonary and systemic veins, and the atrial septum art: prerequisites for surgical correction of ASDs. Cardiac catheterization and transesophageal echocardiography (TEE) ar e currently used to diagnose APVs, but did not provide complete information in our patients. METHODS Twenty consecutive patients with suspected APVs were studied by MRA after inconclusive assessment by catheterization, TEE or both. The MRI ima ges were acquired with a fast cine sequence and a novel ultrafast three-dim ensional sequence before and after contrast injection. RESULTS Partial anomalous pulmonary venous drainage was demonstrated in 16 of 20 patients and was excluded in four patients. Magnetic resonance imagin g correctly diagnosed APVs and ASDs in all patients (100%) who underwent su rgery. For the diagnosis of APVs, the MRI and catheterization results agree d in 74% of patients and the MRI and TEE agreed in 75% of patients. For ASD s, MRI agreed with catheterization and TEE in 53% and 83% of patients, resp ectively. CONCLUSIONS Fast cine MRI with three-dimensional contrast-enhanced MRA prov ides rapid and comprehensive anatomic definition of APVs and ASDs in patien ts with adult congenital heart disease in a single examination. (J Am Coll Cardiol 2001;37:1120-8) (C) 2001 by the American College of Cardiology.