Multicenter review: role of cardiovascular magnetic resonance in diagnostic evaluation, pre-procedural planning and follow-up for patients with congenital heart disease.

ABSTRACT

The number of patients with congenital heart disease (CHD) is rapidly increasing in the adult population, mainly due to the improved long-term survival. Serial follow-up with cardiac magnetic resonance imaging (CMR) is very appealing due to its non-invasive nature. CMR exam is able to provide specific information about cardiac function, hemodynamics, anatomy and tissue characterization unlikely achievable by other diagnostic techniques. CMR in CHD plays a role both in early diagnosis and in post-operative follow-up. Black Blood T1 weighted sequences are used to acquire morphological information. Cine Steady State Free Precession sequences are mainly used to provide data about cardiac function and kinesis. Hemodynamic assessment is routinely performed using phase contrast sequences, which provide reliable information concerning vessel flow pattern, cardiac output and intracardiac shunts. Magnetic Resonance Angiography (MRA) and 3D coronary MRA of the whole thorax can provide detailed morphological information regarding great vessels and proximal coronary arteries. Presence of late gadolinium enhancement suggesting myocardial macroscopic fibrosis seems to play a prognostic and diagnostic role even in this field.