- Poster presentation
- Open Access
Cine acquisition strategies for visualizing atrial septal defects by CMR
© Natarajan et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Cardiovascular Magnetic Resonance
- Atrial Septal Defect
- Cardiovascular Magnetic Resonance Study
- Short Axis Cine
- Ostium Secundum
Atrial septal defects (ASDs) may escape detection before adulthood, particularly those in unusual locations, which may elude echocardiographic visualisation. CMR is established for the quantification of shunt flow and, if appropriately acquired, can provide clear visualisation of ASDs and adjacent structures to inform decisions regarding intervention. Our objective is to recommend cardiovascular magnetic resonance (CMR) cine acquisition strategies suitable for the visualisation of the less common as well as the common types of ASD.
In the CMR Unit of a tertiary referral centre for adults with congenital heart disease we retrospectively reviewed the CMRs of patients with unoperated ASDs over a 3 year period to assess the suitability of cine acquisition strategies for the visualisation of different types of ASD and any associated anomalies of pulmonary venous connection.
157 patients with unoperated ASDs had CMR studies in 3 years. If already suspected, we had routinely acquired an ‘atrial stack' of cines, meaning a contiguous stack, 5mm thick, parallel to the routine ventricular short axis (SA) stack, stepping backward from the basal ventricular plane until the superior vena cava was identifiable. This orientation visualized ostium secundum ASDs well (n=117), and was also good for inferior sinus venosus defects (n=2) and unroofed coronary sinus (n=3). In superior sinus venosus defects (n=21), a transaxial cine stack was found to give clearer visualisation of both the defect and any associated anomalous pulmonary vein connection(s) (n=20, plus 4 anomalous connections identified with secundum ASDs). The transaxial cine orientation was also the more suitable one for atrio-ventricular septal defects (AVSD, n=15) as it depicted insertions of the A-V valve leaflets adjacent to the defect(s).
Cine orientations for visualizing atrial septal defects and anomalous pulmonary veins.
Atrial short axis stack
Additional oblique planes
Ostium secundum defect
Superior sinus venosus defect
Atrioventricular septal defect
Unroofed coronary sinus
Consider whether the coronary sinus roof is visible in all long axis cines
Inferior sinus venosus defect
Oblique sagittal cine
Anomalous pulmonary veins
Oblique coronal cine
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.