Cardiac MRI examination: An overview

Abstract

Congenital heart disease is the most common birth defect occurring in 4.8/1,000 births (Ferencz et al. (1993) Epidemiology of congenital heart disease: the Baltimore Washington Infant Study 1981-1989. Futura Publishing, Mount Kisco). Previously, many patients with complex congenital heart disease did not survive to adulthood, confining the field of congenital heart disease to pediatric specialists. With improved medical, diagnostic, and interventional techniques, many patients with congenital heart disease are surviving to adulthood (Marelli et al., Circulation 115:163-172, 2007; Williams et al., J Am Coll Cardiol 47:701-707, 2006). This has created a need for adult providers who are familiar with congenital heart disease and therapies. The increase in the number of congenital heart disease patients has also highlighted a need for further investigation and research with a goal of improved mortality and quality of life. The first imaging modality used in the imaging of congenital heart disease patients was radiography (Taussig (1947) Congenital malformations of the heart. The Commonwealth Fund, New York). Taussig used radiography and fluoroscopy to image the thorax of patients and compared her finding to the clinical presentation and physical examination. As a result, she characterized the radiographic appearance of the thorax to particular congenital heart defects (Taussig (1947) Congenital malformations of the heart. The Commonwealth Fund, New York). The field of angiography and cardiac catheterization arose from this technology and experience. Angiography was the mainstay of congenital heart disease imaging until the late 1970s and early 1980s. The emergence of echocardiography in the late 1980s led to its replacement of cardiac catheterization as the leading diagnostic modality. Echocardiography's ability to provide morphologic, hemodynamic, and functional assessment in a safe and noninvasive manner was the primary reason. However, echocardiography has limitations, particularly in patients with adult congenital heart disease (ACHD).