- Technologist presentation
- Open Access
Pediatric CMR evaluation of double outlet right ventricle using a hybrid suite
© Thind et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Congenital Heart Disease
- Double Outlet Right Ventricle
- Atrial Septostomy
- Additional Diagnostic Information
- Balloon Atrial Septostomy
A one month old female with an echocardiographic diagnosis of double outlet right ventricle was brought into the MRI for a morphological assessment of the heart. There was possibly a small remote inlet ventricular septal defect, whilst the left atrium appeared hypertensive.
To use a combined conventional fluoroscopic cardiac catheterization and magnetic resonance imaging (XMR) suite to further delineate the cardiac morphology in a patient with a double outlet right ventricle with a small remote inlet ventricular septal defect.
Following balloon atrial septostomy in the catheterization lab, the anesthetized patient was transferred into the Siemens 1.5T Avanto MR scanner on a moveable tabletop. Three plain localizer images were obtained using an ECG gated static TrueFISP technique. Next, cine images of the heart were acquired in the two-chamber, four-chamber, short axis, and right ventricular outflow tract views with a TrueFISP technique. A non-gated contrast-enhanced MR angiogram was performed in the sagittal plane using 0.3 mMol/kg of dilute gadolinium. The angiographic 3-D data-set was then used to create a life size plastic model which allowed the cardiovascular surgeon to inspect the relationship of the ventricles, interventricular communication and great arteries.
This case demonstrates the evolving use of a XMR system for percutaneous intervention and advanced diagnostic techniques in congenital heart disease. From the balloon septostomy in the cath lab to the intra-cardiac anatomy provided by the MRI study, one anesthetic could provide additional diagnostic information without any additional risk to the patient. The cardiac surgical team has found the opportunity to view the structures in the form of a life size plastic model helpful for planning their interventions. MRI anatomical information showing complex spatial relationships of cardiac structures can be used to guide interventional procedures and open new avenues for future research that combines x-ray angiography and MRI.
This article is published under license to BioMed Central Ltd.