Written by Dr. Aphrodite Tzifa, Pediatric Cardiologist – Adult Congenital Heart Disease Cardiologist, Director of the Pediatric Cardiology and Adult Congenital Heart Disease Clinic MITERA, Asst. Associate HYGEIA and LITO Dimitra Logitsi, Radiologist Deputy Director of MITERA Imaging Departments
Cardiac MRI offers imaging of cardiac anatomy and physiology with very high resolution, as well as accurate assessment of cardiac function and hemodynamic status in congenital heart disease and other cardiomyopathies.
From birth are the so-called congenital heart diseases which are noticed, either during pregnancy or after birth, in newborn, infant, child, adolescent and even adult life. The most common are related to insufficiency of the atrial and interventricular septum, anomalies in the outlet of the pulmonary veins, in the construction of the aortic arch, such as narrowing of the isthmus, anomalies of the heart valves, but also more complex anomalies, such as Tetralogy of Fallot, Transposition of great vessels, Single Abdominal etc. In addition to congenital heart diseases, however, frequent referrals for MRI in children and adolescents are inflammations of the myocardium and pericardium (myopericarditis), as well as the investigation of arrhythmias.
The images in the Magnetic Tomography are taken without the use of X-rays and in general any ionizing radiation. Therefore, the examination can be done as many times as needed during life, since there is no radiation burden on the examinee. The images we take offer us information about the anatomy of the heart and the vessels of the chest, the connections between them, the function of the heart valves in case of stenosis or insufficiency, but also the composition of the myocardium in case of inflammation from viral or other infections. Most of the time, the examination is completed with the intravenous administration of a substance called a contrast agent, which is based on gadolinium, in order to obtain either three-dimensional images useful for assessing the anatomy, or images that will help us assess whether there are foci of inflammation of the myocardial or more chronic fibrosis lesions. In all heart MRI examinations, we make quantitative measurements of the parameters, which are necessary for the pediatric cardiologist and pediatric cardiologist to manage each pathology.
The peculiarity of cardiac MRI in children is that each examination is individualized, that is, it aims to answer specific clinical questions arising from the clinical examination and the imaging test that has preceded it, most commonly the heart triplex. Our goal is for the examination to be as short as possible, based on each child’s pathology and degree of cooperation, without however lacking in information. In young children and newborns undergoing cardiac magnetic resonance, the examination is performed under general anesthesia, which applies to all special
Pediatric cardiology/ Pediatric cardiac surgery centers internationally. This is necessary because during the taking of the images, the child’s chest must be completely still, without any respiratory movement. The procedure is completely controlled and safe, as any general anesthesia and the safety regulations that must be observed for any anesthesia are applied: continuous presence of an anesthesiologist in the room, continuous monitoring of vital functions with special monitors, suitable for the environment of the magnet.
Cardiac MRI in children is a comprehensive examination, which has not only significantly reduced diagnostic catheterizations in the hemodynamic laboratory, but offers much additional information beyond anatomy.
Source :Skai
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