Magnetic resonance (MR) images of a variety of cardiac malformations in 19 patients aged 1 week to 33 years were obtained using pulse plethysmographic- or ECG-gated spin echo pulse sequences. Coronal, axial, and sagittal images displaying intracardiac structures with excellent spatial and contrast resolution were acquired during systole or diastole. It is concluded that MR will be a valuable noninvasive method of diagnosing congenital heart disease.

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Two cases of lipoblastomatosis in infants are described. Radiography, ultrasonography, and computerized tomography showed well-defined soft-tissue densities embedded within large masses of adipose tissue. This appearance, which may be specific for lipoblastomatosis, correlated precisely with the pathologic appearance of lobules of immature adipose tissue surrounding masses of myxoid tissue.

Eleven patients with a total of 17 palliative systemic-pulmonary artery shunts underwent evaluation by electrocardiogram-gated magnetic resonance imaging (GMRI). GMRI CONGENITAL heart defects characterized by cyanosis and decreased pulmonary blood flow are often palliated by creation of systemic-pulmonary artery shunts. All of the operations that have been devised increase pulmonary blood flow and differ primarily in terms of which specific vessels are anastomosed. The evaluation of patients who have previously undergone palliative shunt procedures frequently includes imaging of the shunt and pulmonary arterial anatomy. This generally requires invasive angiographic studies, either during cardiac catheterization or, more recently, with digital subtraction techniques.Noninvasive imaging of systemic-pulmonary artery shunts has been unsatisfactory. Ultrasonography is limited by the poor echographic accessibility of these structures, which are extracardiac and enveloped by lung tissue. We have previously reported our experience with electrocardiogram-gated magnetic resonance imaging (GMRI) in patients with congenital heart defects.1 2 Included in our early work were two patients in whom palliative systemic-pulmonary artery From Patients and methodsEleven patients with cyanotic congenital heart disease in whom 17 palliative systemic-pulmonary artery shunts were present underwent evaluation by GMRI. Five patients had pulmonic atresia: two with intact ventricular septum, two with large ventricular septal defects, and one in association with a univentricular heart. Three patients had tricuspid atresia and the remaining three had atrioventricular septal defects, with severe pulmonic stenosis in two and a tight pulmonary arterial band in the other. Six patients had two shunts. There were nine BlalockTaussig shunts, six Glenn shunts, one Waterston shunt, and one Potts shunt. Patients ranged in age from 1 to 21 years (mean 13). Only one patient was under 2 years of age. This patient was sedated with 2 mg/kg meperidine. 1 mg/kg promethazine, and 1 mg/kg chlorpromazine. Informed consent was obtained in all cases from the patient or the patient's guardian.Images were obtained with a superconducting magnet operating at 0.3 T (Technicare; Solon, OH). At this field strength the resonant frequency for protons is 12.85 MHz. Infants were placed within a smaller 29 cm head-coil radio antenna inserted into the 100 cm magnet bore to improve signal-to-noise ratio. A 90 degree saturation-recovery pulse was followed in 15 msec by a 180 degree pulse, resulting in a peak ''read-echo 30 msec after the 90 degree pulse. Image acquisition was gated to systole by initiating the 90 degree saturation-recovery pulse at a prede-CIRCULATION