Gadolinium-Enhanced Three-Dimensional Magnetic Resonance Angiographic Assessment of the Pulmonary Artery Anatomy in Cyanotic Congenital Heart Disease With Pulmonary Stenosis or Atresia: Comparison With Cineangiography

Srinivas, B.; Patnaik, A.N.; Rao, Dinesh

doi:10.1007/s00246-011-9958-z

Cited by 10 publications

(4 citation statements)

References 11 publications

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“…These results agree with pervious reports that compared contrast enhanced MRA with cardiac catheterization for assessment of the pulmonary artery anatomy and the pulmonary blood supply in Tetralogy of Fallot patients and PA patients. 9–11 However, the median age in these studies was 28 years, 9 4.7 years, 11 and a range of 3–30 years, 10 respectively. Our patients were much younger and median age was 2.5 years (range 6 months-13 years).…”

Section: Discussionmentioning

confidence: 79%

Comparison of Contrast Enhanced Magnetic Resonance Angiography with Invasive Cardiac Catheterization for Evaluation of Children with Pulmonary Atresia

Romeih

Al-Sheshtawy

Salama

et al. 2012

Heart International

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Complete assessment of the source of pulmonary blood supply and delineation of the anatomy of pulmonary arteries are essential for the management and prognostic evaluation of pulmonary atresia (PA) patients. Invasive cardiac catheterization is considered the gold standard imaging modality to achieve this. We investigated the role of contrast enhanced magnetic resonance angiography (MRA) to evaluate the pulmonary blood supply and the anatomy of the pulmonary arteries and compared this with cardiac catheterization in children with PA. We studied 20 children with PA. Median age was 2.5 years (range 6 months–13 years). All patients were examined with cardiac catheterization and contrast enhanced MRA, and the results of both modalities were compared. There was a complete agreement between both modalities in the detection of the main pulmonary artery morphology and determination of the confluence state of the central pulmonary arteries. There was an 88% agreement for patency of the ductus arteriosus and 66% for patency of the surgically placed shunt. There was a complete agreement between both techniques on determining the presence of collaterals more than 2.5 mm. Twenty-eight collaterals of less than 2.5 mm were detected only by contrast enhanced MRA. There was a strong correlation between both modalities in measuring the pulmonary arteries and collaterals diameter (P<0.001). Contrast enhanced MRA is a safe and accurate non-invasive technique to evaluate the pulmonary artery morphology and the sources of pulmonary blood supply in children with PA.

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Section: Discussionmentioning

confidence: 79%

Comparison of Contrast Enhanced Magnetic Resonance Angiography with Invasive Cardiac Catheterization for Evaluation of Children with Pulmonary Atresia

Romeih

Al-Sheshtawy

Salama

et al. 2012

Heart International

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“…The sum of the mean cross-sectional area of the left and right PAs was divided by BSA for calculation of CMR-derived Nakata index (mm 2 /m 2 ) 11. CMR-derived Nakata index has been validated and used previously as an accurate non-invasive alternative to fluoroscopy-angiography 9 12–14…”

Section: Methodsmentioning

confidence: 99%

Pulmonary artery size is associated with functional clinical status in the Fontan circulation

Ridderbos

Bonenkamp²,

Eshuis³

et al. 2019

Heart

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ObjectiveIn the Fontan circulation, non-pulsatile pulmonary blood flow is suggested to negatively affect pulmonary artery growth. The pulmonary vasculature is regarded a key determinant of outcome after Fontan completion. We hypothesised that in Fontan patients pulmonary artery size correlates with follow-up and functional clinical status.MethodsThis is a single-centre, cross-sectional cohort study. Thirty-nine paediatric and adult Fontan patients with a concomitant cardiac magnetic resonance (CMR) scan and a cardiopulmonary exercise test between 2012 and 2013 were included. CMR-derived left and right pulmonary artery cross-sectional areas were expressed as Nakata index. Functional status was defined as peak oxygen consumption (pVO2) indexed for weight, as percentage of predicted (pred) and as New York Heart Association Functional Class (NYHA-FC).ResultsAge at CMR was 18±7.2 years. Time since Fontan completion was 11.9±7.4 years. Nakata index was lower versus the reference values (238.6±78.5 vs 330±30 mm2/m2, p<0.001). Nakata index correlated negatively with age at CMR (r=−0.393, p=0.013) and time since Fontan completion (r=−0.341, p=0.034). pVO2 was 27.9±8.9 mL/min/kg and pVO2pred was 58.1%±14.1%. Nakata index correlated positively with pVO2 (r=0.468, p=0.003) and pVO2pred (r=0.353, p=0.028). Nakata index correlated negatively with NYHA-FC (r=−0.450, p=0.004). Nakata index was an independent predictor (β=0.359, p=0.007) for pVO2 (adjusted R2=0.442, with maximum heart rate and oxygen pulse at peak exercise).ConclusionsPulmonary artery size expressed as Nakata index is a novel independent predictor for functional clinical status. Nakata index negatively correlated with follow-up duration, suggesting that chronic abnormal non-pulsatile pulmonary blood flow plays a role in lagging pulmonary arterial growth in the Fontan circulation.

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“…Cardiac magnetic resonance (CMR) has expanded its role in the diagnosis and management of congenital and acquired heart disease in children and young adults for the past 20 years [4][5][6][7]. It provides high quality images that help outline complex thoracic vasculature, cardiac anatomy, coronary arteries (including vessel wall), cardiac function and viability assessment, as well as cardiac perfusion, with the bene t of obviating the risks from invasive catheterization, iodinated contrast agent use and ionizing radiation exposure [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Evaluation of Coronary Anatomy, First-Pass Myocardial Perfusion and Late Gadolinium Enhancement in children and Young Adults with Acquired and Congenital Heart Disease

Adebo¹,

Brownlee

Alba

et al. 2021

Preprint

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IntroductionCardiac magnetic resonance (CMR) has expanded its role in the diagnosis and management of congenital heart disease and acquired heart disease in children. However, there are few studies evaluating the role of cardiac magnetic resonance delineating the anatomy of coronary arteries along with assessment of first pass myocardial perfusion in children. The purpose of this study is to evaluate the extensive use of CMR for delineating coronary anatomy, evaluating first pass myocardial perfusion and late gadolinium enhancement in children with acquired and congenital heart disease.MethodsA retrospective review of 81 consecutive CMR Whole Heart T2 Prep coronary angiography studies of patients with congenital and acquired heart disease that were performed from December 2013 to May 2015. Results of first pass myocardial perfusion study (at rest and with adenosine stress) and Late Gadolinium enhancement imaging findings were also reviewed.ResultsThe median age at the time of CMR was 14 years with range of 2 months to 35 years of age with 46 male and 35 female subjects. Tetralogy of Fallot was the most common pre CMR diagnosis with almost 30% (24/81) of all subjects, followed by suspected coronary artery anomaly in 18.5% (15/81) of all subjects. First pass myocardial perfusion defects were identified in 2.5% (2/81) of subjects. Delayed myocardial enhancement study was performed in 83% (67/81) of all patients, with an abnormal result identified in 28.3% (19/67) of these subjects. The left coronary origin, proximal course and proximal branches were visualized in 94% (76/81) of the subjects. The right coronary origin and proximal course was visualized in about 89% (72/81) of subjects. We found good diagnostic quality images in 90% (73/81) of the subjects. Abnormal coronary artery origin was observed in about 9% of all subjects (7/81). Coronary aneurysmal malformations were identified in 6% of all subjects (5/81). We were unable to visualize either one of the coronary arteries in about 9% of subjects (7/81) either due to patient movement during the study, metallic artifacts or extremely fast heart rate. ConclusionsCardiac magnetic resonance imaging can reliably evaluate the coronary anatomy, first pass myocardial perfusion defect and myocardial scar in a diverse group of patients with acquired and congenital heart diseases.

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Gadolinium-Enhanced Three-Dimensional Magnetic Resonance Angiographic Assessment of the Pulmonary Artery Anatomy in Cyanotic Congenital Heart Disease With Pulmonary Stenosis or Atresia: Comparison With Cineangiography

Cited by 10 publications

References 11 publications

Comparison of Contrast Enhanced Magnetic Resonance Angiography with Invasive Cardiac Catheterization for Evaluation of Children with Pulmonary Atresia

Comparison of Contrast Enhanced Magnetic Resonance Angiography with Invasive Cardiac Catheterization for Evaluation of Children with Pulmonary Atresia

Pulmonary artery size is associated with functional clinical status in the Fontan circulation

Magnetic Resonance Evaluation of Coronary Anatomy, First-Pass Myocardial Perfusion and Late Gadolinium Enhancement in children and Young Adults with Acquired and Congenital Heart Disease

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