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A comparison of magnetic resonance angiography with conventional angiography in the diagnosis of tetralogy of Fallot

Published online by Cambridge University Press:  26 May 2006

Renata Junqueira Moll Bernardes ,
Edson Marchiori ,
Paulo Manuel de Barros Bernardes ,
Maria Beatriz Albano Monzo Gonzaga  and
Luiz Carlos Simões
Renata Junqueira Moll Bernardes
Affiliation:
Department of Pediatric Cardiology, Laranjeiras National Institute of Cardiology, Rio de Janeiro, Brazil
Edson Marchiori
Affiliation:
Department of Radiology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Paulo Manuel de Barros Bernardes
Affiliation:
Department of Radiology, Copa D'Or Hospital, Rio de Janeiro, Brazil
Maria Beatriz Albano Monzo Gonzaga
Affiliation:
Department of Anesthesiology, Copa D'Or Hospital, Rio de Janeiro, Brazil
Luiz Carlos Simões
Affiliation:
Department of Pediatric Cardiology, Laranjeiras National Institute of Cardiology, Rio de Janeiro, Brazil
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Abstract

Aims: Our purpose was to assess the value of magnetic resonance angiography as a non-invasive alternative to catheterization in the evaluation of patients with tetralogy of Fallot, including those with pulmonary atresia. Methods and results: We evaluated prospectively, using magnetic resonance angiography, 30 patients, aged from 1 to 18 years, 15 with tetralogy of Fallot and pulmonary stenosis, and 15 with pulmonary atresia. The studies obtained using magnetic resonance provided adequate visualization of the aorta, and provided excellent imaging of the pulmonary trunk and its right and left branches. Compared with catheterization, magnetic resonance had 100 percent sensitivity, specificity and accuracy for defining the presence or absence of the pulmonary arteries. Magnetic resonance also had 93.9 percent sensitivity, 98.2 percent specificity, and 96.7 percent accuracy for detection of stenosis or hypoplasia of the pulmonary arteries. We detected 25 major aortopulmonary collateral arteries with magnetic resonance, but only 22 with conventional angiography. There was complete agreement between the two methods in detecting patency of the arterial duct in 6 patients, and of Blalock-Taussig shunts in 12 patients. Conclusion: Magnetic resonance angiography is a useful tool in the evaluation of patients with tetralogy of Fallot. It can be considered a non-invasive alternative to cardiac catheterization in the evaluation of the pulmonary vascular anatomy.

Keywords

Heart defectscongenitalcyanotic heart diseasetomographic imagingpulmonary atresia
Type
Original Article
Information
Cardiology in the Young , Volume 16 , Issue 3 , June 2006 , pp. 281 - 288
Copyright
© 2006 Cambridge University Press

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References

Doyle TP, Kavanaugh-McHugh A, Graham TP. Tetralogy of Fallot and pulmonary atresia with ventricular septal defect. In: Moller JH, Hoffman JIE (eds). Pediatric cardiovascular medicine. 1st edn. Churchill Livingstone, Philadelphia, 2000, pp 391–408.
Greenberg SB, Crisci KL, Koenig P, Anisman P, Russo P. Magnetic resonance imaging compared with echocardiography in the evaluation of pulmonary artery abnormalities in children with tetralogy of Fallot following palliative and corrective surgery. Pediatr Radiol 1997; 27: 932–935.Google Scholar
Gupta D, Saxena A, Kothari SS, et al. Detection of coronary artery anomalies in tetralogy of Fallot using a specific angiographic protocol. Am J Cardiol 2001; 87: 241–244.Google Scholar
Holmqvist C, Hochbergs P, Björkhem G, Brockstedt S, Laurin S. Pre-operative evaluation with MR in tetralogy of Fallot and pulmonary atresia with ventricular septal defect. Acta Radiologica 2001; 42: 63–69.Google Scholar
Need LR, Powell AJ, Nido P, Geva T. Coronary echocardiography in tetralogy of Fallot: diagnostic accuracy, resource utilization and surgical implications over 13 years. JACC 2000; 36: 1371–1377.Google Scholar
Beekman RP, Beek FJA, Meijboom EJ. Usefulness of MRI for the pre-operative evaluation of the pulmonary arteries in tetralogy of Fallot. Magn Reson Imaging 1997; 15: 1005–1015.Google Scholar
Edelman RR. Contrast-enhanced MR imaging of the heart: overview of the literature. Radiology 2004; 232: 653–668.Google Scholar
Haramati LB, Glickstein JS, Issenberg HJ, Haramati N, Crooke GA. MR imaging and CT of vascular anomalies and connections in patients with congenital heart disease: significance in surgical planning. RadioGraphics 2002; 22: 337–349.Google Scholar
Vick GW III, Rokey R, Huhta JC, Mulvagh SL, Johnston DL. Nuclear magnetic resonance imaging of the pulmonary arteries, subpulmonary region, and aorticopulmonary shunts: a comparative study with two-dimensional echocardiography and angiography. Am Heart J 1990; 119: 1103–1110.Google Scholar
Canter CE, Gutierrez FR, Mirowitz AS, Martin TC, Hartmann AF Jr. Evaluation of pulmonary arterial morphology in cyanotic congenital heart disease by magnetic resonance imaging. Am Heart J 1989; 118: 347–354.Google Scholar
Kondo C, Takada K, Yokoyama U, Nakajima Y, Momma K, Sakai F. Comparison of three-dimensional contrast-enhanced magnetic resonance angiography and axial radiographic angiography for diagnosing congenital stenoses in small pulmonary arteries. Am J Cardiol 2001; 87: 420–424.Google Scholar
Bernardes RJM, Marchiori E, Bernardes PMB, Gonzaga MBAM, Simões LC. Magnetic resonance imaging pré- and postoperative evaluation of tetralogy of Fallot. Radiol Bras 2004; 37: 251–260.Google Scholar
Geva T, Greil GF, Marshall AC, Landzberg M, Powell AJ. Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia. Comparison with X-ray angiography. Circulation 2002; 106: 473–478.Google Scholar
Roche KJ, Rivera R, Argilla M, et al. Assessment of vasculature using combined MRI and MR angiography. AJR 2004; 182: 861–866.Google Scholar
Snider AR, Enderlein MA, Teitel DF, Juster RP. Two-dimensional echocardiographic determination of aortic and pulmonary artery sizes from infancy to adulthood in normal subjects. Am J Cardiol 1984; 53: 218–224.Google Scholar
Lorenz CH. The range of normal values of cardiovascular structures in infants, children and adolescents measured by magnetic resonance imaging. Pediatr Cardiol 2000; 21: 37–46.Google Scholar
Ichida F, Aubert A, Denef B, Dumoulin M, Hauwaert LGVD. Cross sectional echocardiographic assessment of great artery diameters in infants and children. Br Heart J 1987; 58: 627–634.Google Scholar
Tatli S, Yucel EK, Lipton MJ. CT and MR imaging of the thoracic aorta: current techniques and clinical applications. Radiol Clin North Am 2004; 42: 565–585.Google Scholar
Niwa K, Siu SC, Webb GD, Gatzoulis MA. Progressive aortic root dilatation in adults late after repair of tetralogy of Fallot. Circulation 2002; 106: 1374–1378.Google Scholar
Strouse PJ, Hernandez RJ, Beekman III RH. Assessment of central pulmonary arteries in patients with obstructive lesions of the right ventricle: comparison of MR imaging and cineangiography. Am J Roentgenol 1996; 167: 1175–1183.Google Scholar
Prasad SK, Soukias N, Hornung T, et al. Role of magnetic resonance angiography in the diagnosis of major aortopulmonary collateral arteries and partial anomalous pulmonary venous drainage. Circulation 2004; 109: 207–214.Google Scholar