Magnetic resonance imaging is the diagnostic tool of choice in the preoperative evaluation of patients with partial anomalous pulmonary venous return.
BACKGROUND
Diagnosis of partial anomalous pulmonary venous return is usually suspected by echocardiography and often confirmed by cardiac catheterization. Magnetic resonance imaging is a powerful non-invasive diagnostic tool that can give accurate insight on systemic and pulmonary veins, cardiac anatomy and physiopathology.


OBJECTIVE
To test the diagnostic accuracy of magnetic resonance in patient with suspected partial anomalous pulmonary venous return.


METHODS
Twenty consecutive patients (10 male, mean age: 27+/-20 years) with suspected partial anomalous pulmonary venous return underwent a magnetic resonance study comprehensive of Gadolinium-enhanced three-dimensional magnetic resonance angiography and phase-velocity-contrast in order to evaluate pulmonary and systemic venous anatomy and QP/QS. In 14 of them a cardiac catheterization was also performed. Anatomy findings and QP/QS result of both exams were compared. Sixteen patients underwent surgical correction. In the other four patients with QP/QS<1.5, surgical correction was not indicated according to the literature (1). Among patients who had both magnetic resonance and cardiac catheterization (14 patients) anatomical findings were concordant in 12 of them. In all operated patients, surgical findings were concordant with MRI report. There was a good correlation between magnetic resonance and cardiac catheterization QP/QS evaluation (mean value 2.23 and 2.4, respectively).


CONCLUSIONS
In patients with suspected anomalous pulmonary venous return, magnetic resonance provides a comprehensive evaluation of pulmonary venous return and the amount of shunt, overcoming most of the limitations of echocardiography. Therefore magnetic resonance is a powerful diagnostic tool for indicating therapeutic management and surgical strategies for this group of patients, and can be considered a non-invasive alternative to cardiac catheterization.
Pediatric Cardiology, and Cardiac Surgery, Osp. G.Pasquinucci, Massa CNR, Via Aurelia Sud, Massa, Italy. gigifesta@ifc.cnr.it
Pierluigi
P
Festa
Lamia
L
Ait-Ali
Alfredo Giuseppe
AG
Cerillo
Daniele
D
De Marchi
Bruno
B
Murzi
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D017352:Echo-Planar Imaging; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000503:physiopathology; D006571:Heterocyclic Compounds; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000503:physiopathology
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium; D019786:Gadolinium DTPA