Cardiac magnetic resonance: impact on diagnosis and management of patients with congenital cardiovascular disease

Clin Radiol. 2011 Aug;66(8):720-5. doi: 10.1016/j.crad.2011.03.007. Epub 2011 May 12.

Abstract

Aim: To estimate the clinical impact of cardiac magnetic resonance (CMR) in patients with congenital cardiovascular disease (CCD).

Materials and methods: Since 2003, 1.5T CMR was used at our university hospital to evaluate morphology, cardiac kinetics, aortic and pulmonary flow, and vascular anatomy in patients with CCD. The present study considered a consecutive series of these patients from 2003 to 2006. A paediatric cardiologist judged our reports as expected or unexpected and, secondarily, as not reliable (level 0), describing findings already known (level 1), not changing therapy/suggested lifestyle (level 2), changing therapy/suggested lifestyle (level 3) or changing diagnosis (level 4).

Results: CMR reports were judged to be expected in 187/214 (87%) and unexpected in 27/214 (13%). Less than 2% of CMRs were judged as levels 0 or 1, 66% as level 2, and 5% as level 4. During 2005-2006 the clinical impact improved toward higher impact levels (p<0.001, chi-square test).

Conclusions: In patients with CCD, more than one in 10 CMR reports were unexpected to cardiologists and over seven in 10 prompted a change of diagnosis or therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / congenital
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / surgery
  • Child
  • Child, Preschool
  • Coronary Circulation / physiology*
  • Female
  • Heart Ventricles / abnormalities
  • Heart Ventricles / surgery
  • Humans
  • Infant
  • Magnetic Resonance Angiography / methods*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult