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Cardiac MR Imaging and MR Angiography for Assessment of Complex Tetralogy of Fallot and Pulmonary Atresia¹

¹ From the Department of Radiological Sciences (M.I.B., O.R., P.L.W., A.S.G.), Department of Pediatrics (V.A.), and Division of Cardiology (J.S.C.), University of California at Los Angeles, David Geffen School of Medicine, 650 Charles E. Young Dr S, Box 951721, Los Angeles CA 90095-1721. Recipient of Certificate of Merit and Excellence in Design awards for an education exhibit at the 2002 RSNA Annual Meeting. Received March 24, 2004; revision requested June 3 and received April 4, 2005; accepted April 18. All authors have no financial relationships to disclose. Address correspondence to M.I.B. (e-mail: iboechat{at}mednet.ucla.edu).

Breath-hold electrocardiographically gated cardiac magnetic resonance (MR) imaging and contrast material–enhanced MR angiography are emerging as ideal techniques for the evaluation of complex congenital heart disease. Tetralogy of Fallot is the most common cause of cyanotic congenital heart disease and, in its classic form, is associated with varying degrees of hypoplasia of the central and peripheral pulmonary arteries, with valvar pulmonary atresia and collateral aortopulmonary vessels occupying the extreme end of the spectrum. Accurate assessment of the size and anatomy of the pulmonary arteries is often difficult with echocardiography and conventional cineangiography. Compared with echocardiography in particular, cardiac MR imaging with three-dimensional reconstruction has distinct advantages for pre- or postoperative assessment of pulmonary anatomy in patients with tetralogy of Fallot and pulmonary atresia. MR imaging enables the clear and complete depiction of anatomy and thus can provide additional information about pulmonary artery abnormalities that are difficult to evaluate with conventional cardiac imaging techniques.

© RSNA, 2005

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