Atrial Septal Defects in Pediatric Patients: Noninvasive Sizing with Cardiovascular MR Imaging

Abstract

In children with ASD and inconclusive TTE results, MR imaging can enable determination of defect size, rim distances to adjacent structures, and venous connections.

Sizing of Atrial Septal Defects in Adults

“…Other noninvasive methods have also been studied; Durongpisitkul et al [8] suggested using MRI for accurate sizing [9], whereas Zhu et al[ 10] suggested using 3-dimensional measurement giving excellent correlation. Intracardiac echo provides accurate measurement as well and allows the procedure to be carried out without anesthesia [11].…”

The Role of Cardiovascular Magnetic Resonance in Congenital Heart Disease

“…Cardiac output, pulmonaryto-systemic fl ow ratio and quantifi cation of gradients across stenoses and valvar regurgitation can all be accurately determined using this technique. Volume blood fl ow measured using this technique has been shown to be accurate when compared to both invasive oximetry (10) and fl ow-phantom experiments. (10) In the case of stenoses interrogation, excellent comparative data exists with Doppler echocardiography and catheter data.…”

“…Volume blood fl ow measured using this technique has been shown to be accurate when compared to both invasive oximetry (10) and fl ow-phantom experiments. (10) In the case of stenoses interrogation, excellent comparative data exists with Doppler echocardiography and catheter data. (11) The quantifi cation of regurgitant volume using this technique has been demonstrated to be superior to echocardiography.…”

“…Also, evaluation of the hemodynamic status of ASDs can be performed with cardiovascular MR. Quantifi cation of left-toright shunts using velocity-encoded phase-contrast MR compares well with invasive catheterization derived data. (10) Multi-slice SSFP short-axis imaging accurately quantifi es the degree of ventricular overload, information that is critical in determining the timing of invasive intervention. (9,58) …”

“…Velocity-encoded phase-contrast MR compares well with traditional invasive catheterization methods. (10) Added to this there is preliminary evidence to suggest that in certain situations combining phase-contrast MR and invasive pressure measurements is more accurate than traditional methods alone, which rely on the Fick principle. (59) Cardiovascular MR provides accurate 2D and 3D images of the defect.…”