Evaluation of Magnetic Resonance Imaging in Coarctation of the Aorta: The Importance of Multiple Imaging Planes

Abstract

Coarctation of the aorta can be evaluated reliably and noninvasively by magnetic resonance imaging. However, the value of different imaging planes in the evaluation of restenosis or aneurysm has not previously been studied. Our purpose was to study the relative sensitivity for oblique coronal and oblique parasagittal magnetic resonance imaging to detect restenosis or aneurysm formation in children following surgical repair or balloon angioplasty of coarctation of the aorta. The study included magnetic resonance imaging studies in 27 children. Each exam included ECG gated, spin-echo imaging in oblique coronal and oblique parasagittal planes. Recoarctation was defined as a greater than 50% narrowing of the aorta. Aneurysms were defined as focal dilatation of the aorta in the region of coarctation 20% or greater than the adjacent aortic diameter. Recoarctation was detected in 11 children, but in both views in only five children. Aneurysms were detected in 15 children, but in both views in only three children. Recoarctation and aneurysm detection were both statistically more likely to be detected if oblique coronal and oblique parasagittal views were obtained, indicating that multiple imaging planes are necessary to completely evaluate magnetic resonance imaging of coarctation.

Coarctation of the aorta: pre and postoperative evaluation with MRI and MR angiography; correlation with echocardiography and surgery

“…In theses cases, only the coronal or oblique coronal plane encompassing the origin of the descending aorta permits the demonstration of the narrowing. The importance of multiple imaging planes has been mentioned previously [24], indicating that these two latter planes are complementary and more sensitive for the depiction of the anomaly.…”

Postoperative evaluation of congenital heart disease by magnetic resonance imaging

“…1A) (13)(14)(15) and is therefore sensitive in the detection and follow-up of aneurysms and recoarctation after balloon angioplasty (18) or surgical intervention (13)(14)(15). Oblique spin-echo images also allow visualization of additional pathology of the aorta, such as displacement of the left subclavian artery and aneurysmal dilatation of the ascending aorta (14).…”

“…Frequent post-surgical follow-up of these patients is necessary because of the considerable incidence of aneurysm formation (13)(14)(15) and recoarctation, which varies from 8 to 67% depending on age at operation and surgical technique (9,16,17).…”

Long-Term Results of Balloon Angioplasty for Native Coarctation of the Aorta in the Surgical Specialty Teaching Hospital/Cardiac Center/Hawler

“…Bicuspid aortic valve disease is a big contributor to cardiac failure, which in turn makes up roughly 20% of late deaths to coarctation patients [7]. The diagnosis of COA in older children and adult usually follows a routine medical examination, where the murmur is discovered; weak femoral pulse, or unexplained systemic hypertension is found; headache, nosebleeds, cold feet or calf pain on exercise is often experienced.…”

“…COA occurs as of other congenital heart defects such as bicuspid aortic valve (as many as 85% of patients with COA have bicuspid aortic valve), transposition of great arteries, double outlet right ventricle (taussing being anomaly), discordant ventriculoarterial connection, common arterial trunk, ventricular septal defect (defects are more frequently perimembranous and associated with postero-inferior overriding of the aortic valve), interruption of the aortic arch which can be found with an aortopulmonary window rather than VSD, and mitral valve abnormalities (a supravalvular mitral ring or parachute mitral valve, and subaortic stenosis are potential associated lesion, when this group of left-sided obstructive lesions occurs together, they are referred to as the shone complex) [1]- [3] [7]. Bicuspid aortic valve disease is a big contributor to cardiac failure, which in turn makes up roughly 20% of late deaths to coarctation patients [7].…”