Prospective comparison of echocardiography versus cardiac magnetic resonance imaging in patients with Ebstein’s anomaly

Abstract

Ebstein's anomaly (EA) is primarily diagnosed by echocardiography. The purpose of this study was to compare echocardiography and magnetic resonance imaging (MRI) in EA. Data from cardiac MRI and echocardiography were prospectively collected from 16 patients with EA. Imaging data also were compared with intraoperative findings. Information provided by MRI and echocardiography were comparable for left ventricular size and function, tricuspid valve repairability, qualitative assessment of right-sided cavities, and visibility of septal and anterior tricuspid valve leaflets. The posterior tricuspid valve leaflet and tricuspid valve fenestrations were better visualized with MRI; associated heart defects were equally recognized, apart from small shunts that tended to be more readily diagnosed with echocardiography. Quantification of right-cavity size and right ventricular ejection fraction was possible only with cardiac MRI. The degree of tricuspid valve regurgitation was underestimated by echocardiography (2 patients) and by MRI (4 patients) when compared with intraoperative assessment. When evaluating EA, echocardiography and MRI provide complementary data. For visualization of the posterior tricuspid valve leaflet and quantitative assessment of right ventricular size and function, MRI is preferable. For appropriate risk stratification in EA, both MRI and echocardiography should be performed before cardiac surgery.

A Young Man With Cardiomegaly and Edema

“…Ebstein anomaly is traditionally evaluated by echocardiogram, but CMR imaging provides complementary images if there are structures difficult to assess. Cardiac magnetic resonance imaging is similar to an echocardiogram for qualitative assessments of the RA and RV and for visualizing the septal and anterior leaflets . However, CMR imaging provides enhanced quantitative measures of the RA and RV as well as visualization of the posterior leaflet.…”

Ebstein anomaly in the adult: focus on pregnancy

“…In addition, MRI is more sensitive for identification of adhesions of the anterior valve and for the assessment of RV function, an important feature in the decision making for surgery as well as for for surgical planning [32] (Figure 3).…”

2014 Korean Guidelines for Appropriate Utilization of Cardiovascular Magnetic Resonance Imaging: A Joint Report of the Korean Society of Cardiology and the Korean Society of Radiology

“…Another important disease for which CMR can make great contributions to assessment is the Ebstein anomaly and the associated tricuspid regurgitation. 161) Obtaining a stack of transaxial cines is recommended, as well as horizontal four-chamber cines for complete visualization of the relationship between the right atrium and RV in patients with the Ebstein anomaly. A combination of these cine images is necessary for accurate and reproducible volume measurements of the functional RV in these patients, which is not easy to perform using short-axis cines.…”