Comparison of magnetic resonance imaging with transthoracic echocardiography in the diagnosis of ventricular septal defect-associated coronary cusp prolapse.

ABSTRACT

PURPOSE: To compare magnetic resonance imaging (MRI) with transthoracic echocardiography (TTE) in the diagnosis of coronary cusp prolapse (CCP) as a complication of ventricular septal defect (VSD). MATERIALS AND METHODS: Twenty-three patients (10 males, 13 females, mean age 9 years) with clinically suspected CCP were included in a retrospective study. Long and short axis cine images and electrocardiogram (ECG)-gated axial T1-weighted image MRI images were evaluated for deformity and protrusion of right and noncoronary cusps. We compared MRI and TTE results. We compared the agreement between MRI and TTE in outlet VSD and membranous VSD. RESULTS: On MRI, 19 patients had right coronary cusp prolapse (RCCP), three had noncoronary cusp prolapse (NCCP), and one patient had RCCP and NCCP on MRI. Twenty-two patients had RCCP on TTE and none had NCCP. Seventeen patients had outlet defects and six patients had a membranous defect at operation. All patients with an outlet VSD had RCCP on both MRI and TTE. The agreement between MRI and TTE in outlet VSD was better than in membranous VSD. CONCLUSION: MRI results corresponded with TTE results in patients with outlet VSDs, but discordant results were observed in patients with membranous VSDs.