Diagnosis of congenital obstructive aortic arch anomalies in Chinese children by contrast-enhanced magnetic resonance angiography.
OBJECTIVE
The purpose of this study was to evaluate the accuracy of contrast-enhanced magnetic resonance angiography for the diagnosis of congenital obstructive aortic arch anomalies in children and compare it with transthoracic echocardiography and other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging).


METHODS
Contrast-enhanced magnetic resonance angiography, ECG gated T1-weighted spin-echo imaging, and gradient-echo cine imaging were performed for the diagnosis of congenital obstructive aortic arch anomalies in 416 patients from April 1999 to March 2005 (age range, 3 days to 12 years; mean age, 2.4 years) using a GE 1.5T MR scanner. Transthoracic echocardiography was performed in all patients prior to MR examination. Surgery and/or conventional X-ray angiocardiography were done in all patients to determine the final diagnosis.


RESULTS
The population consisted of 416 patients. Congenital obstructive aortic arch anomalies were diagnosed in 213 patients and ruled out in 203 patients by operation and/or conventional X-ray angiocardiography. Among the 213 patients with anomalies, coarctation of aorta was diagnosed in 174, interruption of aortic arch was diagnosed in 35, and persistent fifth aortic arch with fourth aortic arch interruption was diagnosed in 4 patients. Among the 35 patients with interruption of aortic arch, 21 were of type A, and 14 were of type B. The diagnostic sensitivity, specificity and accuracy of contrast-enhanced magnetic resonance angiography for congenital obstructive aortic arch anomalies were 98% (208/213), 99% (201/203) and 98% (409/416), respectively. The diagnostic sensitivity, specificity and accuracy of transthoracic echocardiography were 88% (187/213), 92% (186/203) and 90% (373/416), respectively. The diagnostic sensitivity, specificity and accuracy of other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging) were 89% (189/213), 84% (170/203) and 86% (359/416), respectively.


CONCLUSIONS
Contrast-enhanced magnetic resonance angiography is a reliable, noninvasive imaging technique for the diagnosis of congenital obstructive aortic arch anomalies in children. Occasionally, even more information can be obtained from this technique than from conventional X-ray angiocardiography. Contrast-enhanced magnetic resonance angiography is superior to transthoracic echocardiography and other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging) for diagnosis of congenital obstructive aortic arch anomalies in children.
Ming
Zhu
Z
Department of Radiology, Shanghai Children's Medical Center, Affiliated Xinhua Hospital of Shanghai Second Medical University, Shanghai, PR China. zhuming58@uip.sina.com
Yumin
Zhong
Z
Yuhua
Li
L
Biao
Jin
J
Aimin
Sun
S
Qian
Wang
W
D001013:Aorta, Thoracic / Q000002:abnormalities*; D001018:Aortic Diseases / Q000151:congenital* / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D001157:Arterial Occlusive Diseases / Q000151:congenital* / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003287:Contrast Media / Q000008:administration & dosage*; D017352:Echo-Planar Imaging; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D007223:Infant; D007231:Infant, Newborn; D018810:Magnetic Resonance Angiography / Q000379:methods; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D012680:Sensitivity and Specificity
D003287:Contrast Media