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Sixteen cine magnetic resonance imaging (MRI) studies were performed in 14 patients aged 1 week to 17 years (mean age, 46 months), who had coarctation of the aorta confirmed at angiography or surgery. Conventional echocardiographic-gated MRI was first performed in axial and rotated sagittal views and was used to identify the slice locations for cine MRI. Cine MRI was performed by gradient-recalled acquisition in steady state with a 300 flip angle, 12-msec echo time, 22-msec pulse repetition time, and a 128 x 256 acquisition matrix. Coarctation anatomy was extremely well defined in all but one patient who had vascular clips at the coarctation repair site. The smallest descending aortic flow diameter on cine MRI showed excellent agreement with angiography (r = 0.90). Lucent jets of high-velocity flow through the site of coarctation were imaged in eight patients, and jet length correlated well with the angiographic severity of coarctation (r= -0.81). Two patients were restudied after surgery, and they exhibited excellent repair and normal flow patterns. Cine MRI provides highresolution imaging of coarctation anatomy with a dynamic spatial and temporal visualization of flow and with excellent detail of vascular anatomy and flow both proximal and distal to the coarctation. (Circulation 1988;78:142-148) It is well recognized that two-dimensional echocardiography can diagnose and estimate the severity of coarctation of the aorta. -3 Adequate imaging of the coarctation site is usually possible in neonates, but difficulties can be encountered in older patients or in patients after surgery in whom the distance between the ultrasound transducer and the descending aorta is greater and in whom the image resolution is poorer. Doppler ultrasound has further enhanced the noninvasive assessment of these patients,4,5 and favorable results in predicting pressure gradients across the coarctation have been reported.5-7 However, the pressure gradient measured across a coarctation will not necessarily reflect the degree of obstruction since it is dependent on a number of other factors including From the

A 30-year-old male had a headache for one month and was evaluated with both computed tomography (CT) and magnetic resonance (MR). These scans demonstrated an obstructing pineal cyst containing layered acute and subacute blood products by MR criteria. The concurrent scans allowed correlation between CT and MR findings in this rare complication of an unusual entity, explained his headache (and the development of later upward gaze paresis), provided a precise surgical/anatomic approach, and gave a good final clinical result. The report illustrates appropriate CT and MR images and pathological specimen.

Cine magnetic resonance imaging (MRI) was used for postoperative evaluation of eight patients who underwent intra-atrial baffle procedure for surgical repair of D-transposition of the great arteries (D-TGA SYSTEMIC OR PULMONARY venous pathway obstruction is the most common anatomic complication of the intra-atrial baffle procedure by either Mustard or Senning procedure for D-transposition of the great arteries (D-TGA). 1,2 Several investigators have reported the value of electrocardiographically gated magnetic resonance imaging (MRI) for evaluation of congenital heart disease.3-0 Recently, rapid MRI techniques (cine MRI) using low flip angles, gradient-refocused echoes, and short repetition time have provided dynamic visualization of blood flow. 1 -3 This new cine MRI technique allows us to appreciate the complex anatomic/ flow relationships of congenital cardiac defects as moving rather than stationary images.From the Departments of Pediatrics (Cardiology) and Radiology,

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