Abstract
Cardiovascular magnetic resonance (CMR) has expanded its role in the diagnosis and management of congenital heart disease (CHD) and acquired heart disease in pediatric patients. Ongoing technological advancements in both data acquisition and data presentation have enabled CMR to be integrated into clinical practice with increasing understanding of the advantages and limitations of the technique by pediatric cardiologists and congenital heart surgeons. Importantly, the combination of exquisite 3D anatomy with physiological data enables CMR to provide a unique perspective for the management of many patients with CHD. Imaging small children with CHD is challenging, and in this article we will review the technical adjustments, imaging protocols and application of CMR in the pediatric population.
Highlights
Congenital heart disease (CHD) has an incidence of 6-8 per 1000 at birth [1,2]
The survival of CHD patients has increased because of improvements in early diagnosis and treatment, which have led to more patients surviving into adulthood [1,2,3]
Data acquisition is accelerated for any Cardiovascular magnetic resonance (CMR) pulse sequence with the use of parallel imaging
Summary
Congenital heart disease (CHD) has an incidence of 6-8 per 1000 at birth [1,2]. The survival of CHD patients has increased because of improvements in early diagnosis (including fetal echocardiography) and treatment, which have led to more patients surviving into adulthood [1,2,3]. Some patients benefits from a combined approach using a hybrid CMR/cardiac catheterization laboratory, in which patients can be transferred, under the same general anesthetic, from imaging to interventional procedures and vice versa This guides the intervention procedure, and gives potential to immediately assess the hemodynamic results of intervention with assessment of flow and ventricular function [28,29] (see section 6). Beats per minute) requiring a high temporal resolution for accurate ventricular volume and flow measurements; small-sized heart and blood vessels requiring greater spatial resolution;[56,57] and potential arrhythmias as complications surgical procedure or the congenital anomaly itself. These will render CMR difficult, and will require adjustments to normal CMR imaging protocols. It is crucial that these data incorporate, or at least attempt to unify, the multitude of different imaging and post-processing conventions that have evolved in the international centers developing pediatric CMR
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