(Circulation. 1995;92:3473-3480.)
© 1995 American Heart Association, Inc.
Articles |
Imaging and Sizing of Atrial Septal Defects by Magnetic Resonance
Presented in part at the 40th Annual Scientific Session, American College of Cardiology, Atlanta, Ga, March 3-7, 1991, and published in abstract form in J Am Coll Cardiol (1991;17:326A).
From the Cardiac Unit (G.H., I.F.P., R.R.L., P.C.B., B.B., H.L.K.), the Department of Radiology (G.H., R.E.D., S.W.M., T.J.B.), and the Department of Surgery (G.J.V.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass.
Correspondence and reprint requests to Godtfred Holmvang, MD, Boston Heart Foundation, 139 Main St, Cambridge, MA 02142.
Background Development of techniques for percutaneous closure of atrial septal defects (ASDs) makes accurate noninvasive sizing of ASDs important for appropriate patient selection.
Methods and Results Magnetic resonance (MR) images of ASDs were obtained in 30 patients (mean age, 41±16 years) by both spin-echo and phase-contrast cine MR imaging. Spin-echo images were obtained in two orthogonal views (short-axis and four-chamber) perpendicular to the plane of the ASD. Spin-echo major and minor diameters were measured, and spin-echo defect area was calculated. Phase-contrast cine MR images were obtained in the plane of the ASD, and cine major diameter and defect area were measured from the region of signal enhancement or phase change due to shunt flow across the defect. MR measurements were compared with templates cut during surgery to match the defect or with ASD diameter determined by balloon sizing at catheterization. ASD size measured from cine MR images (y) agreed closely with catheterization and template standards (x). For major diameter, y=0.78x+5.7, r=.93, and SEE=3.4 mm. On average, spin-echo measurements overestimated major diameter and area of secundum ASDs by 48% and 125%, respectively.
Conclusions Phase-contrast cine MR images acquired in the plane of an ASD define the defect shape by the cross section of the shunt flow stream and allow noninvasive determination of defect size with sufficient accuracy to permit stratification of patients to closure of the defect by catheter-based techniques versus surgery. Spin-echo images, on the other hand, are not adequate for defining ASD size, because septal thinning adjacent to a secundum ASD may appear to be part of the defect.
Key Words: heart defects, congenital • magnetic resonance imaging • shunts • transcatheter closure
This article has been cited by other articles:
 |
|
 |
|
  L. E.J. Thomson, A. L. Crowley, J. F. Heitner, P. J. Cawley, J. W. Weinsaft, H. W. Kim, M. Parker, R. M. Judd, J. K. Harrison, and R. J. Kim Direct En Face Imaging of Secundum Atrial Septal Defects by Velocity-Encoded Cardiovascular Magnetic Resonance in Patients Evaluated for Possible Transcatheter Closure Circ Cardiovasc Imaging, July 1, 2008; 1(1): 31 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. K. Mohrs, S. E. Petersen, D. Erkapic, C. Rubel, R. Schrader, B. Nowak, W. A. Fach, H.-U. Kauczor, and T. Voigtlaender Diagnosis of Patent Foramen Ovale Using Contrast-Enhanced Dynamic MRI: A Pilot Study Am. J. Roentgenol., January 1, 2005; 184(1): 234 - 240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Zanchetta, E. Onorato, G. Rigatelli, L. Pedon, M. Zennaro, A. Carrozza, and P. Maiolino Intracardiac echocardiography-guided transcatheter closure of secundum atrial septal defect: A new efficient device selection method J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1677 - 1682. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lapierre, M.-J. Raboisson, J. Miro, N. Dahdah, and R. Guerin Evaluation of a Large Atrial Septal Occluder with Cardiac MR Imaging RadioGraphics, October 1, 2003; 23(90001): S51 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. J. Wang, G. P. Reddy, M. B. Gotway, B. M. Yeh, and C. B. Higgins Cardiovascular Shunts: MR Imaging Evaluation RadioGraphics, October 1, 2003; 23(90001): S181 - 194. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Beerbaum, H. Korperich, H. Esdorn, U. Blanz, P. Barth, J. Hartmann, J. Gieseke, and H. Meyer Atrial Septal Defects in Pediatric Patients: Noninvasive Sizing with Cardiovascular MR Imaging Radiology, August 1, 2003; 228(2): 361 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rickers, M. Jerosch-Herold, X. Hu, N. Murthy, X. Wang, H. Kong, R. T. Seethamraju, J. Weil, and N. M. Wilke Magnetic Resonance Image-Guided Transcatheter Closure of Atrial Septal Defects Circulation, January 7, 2003; 107(1): 132 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. A. Ferrari, C. H. Scott, G. A. Holland, L. Axel, and M. St. John Sutton Ultrafast three-dimensional contrast-enhanced magnetic resonance angiography and imaging in the diagnosis of partial anomalous pulmonary venous drainage J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1120 - 1128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ewert, F. Berger, I. Daehnert, J. van Wees, M. Gittermann, H. Abdul-Khaliq, and P. E. Lange Transcatheter Closure of Atrial Septal Defects Without Fluoroscopy : Feasibility of a New Method Circulation, February 29, 2000; 101(8): 847 - 849. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Lange, M. Walayat, C. M Turnbull, P. Palka, P. Mankad, G. R Sutherland, and M. J Godman Assessment of atrial septal defect morphology by transthoracic three dimensional echocardiography using standard grey scale and Doppler myocardial imaging techniques: comparison with magnetic resonance imaging and intraoperative findings Heart, October 1, 1997; 78(4): 382 - 389. [Abstract] [Full Text] [PDF]
|
|