title: Preoperative evaluation of pulmonary artery morphology and pulmonary circulation in neonates with pulmonary atresia--usefulness of MR angiography in clinical routine.
abstract: BACKGROUND
  To explore the role of contrast-enhanced magnetic resonance angiography (CE-MRA) in clinical routine for evaluating neonates with pulmonary atresia (PA) and to describe their pulmonary artery morphology and blood supply.CE-MRA studies of 15 neonates with PA (12 female; median weight: 2900 g) were retrospectively evaluated by two radiologists in consensus. Each study was judged to be either diagnostic or non-diagnostic depending on the potential to evaluate pulmonary artery morphology and pulmonary blood supply. In those cases where surgery or conventional angiocardiography was performed results were compared.
  
  
  RESULTS
  CE-MRA was considered diagnostic in 87%. Pulmonary artery morphology was classified as "confluent with (n = 1) and without (n = 1) main pulmonary artery", "non-confluent" (n = 6) or "absent" (n = 7). Source of pulmonary blood supply was "a persistent arterial duct" (n = 12), "a direct" (n = 22) or "indirect (n = 9) aortopulmonary collateral artery (APCA)" or "an APCA from the ascending aorta" (n = 2). In no patient were there any additional findings at surgery or conventional angiocardiography which would have changed the therapeutic or surgical approach.
  
  
  CONCLUSIONS
  CE-MRA is a useful diagnostic tool for the preoperative evaluation of the morphology of pulmonary arteries and blood supply in neonates with PA. In most cases diagnostic cardiac catheterization can be avoided.
authors.affiliation: Department of Diagnostic Imaging, University Children's Hospital Zurich, Zurich, Switzerland. nadine.kawel@gmx.de
authors.forename: Nadine
authors.initials: N
authors.lastname: Kawel
authors.forename: Emanuela
authors.initials: E
authors.lastname: Valsangiacomo-Buechel
authors.forename: Ricarda
authors.initials: R
authors.lastname: Hoop
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Kellenberger
mesh_terms: D000790:Angiocardiography; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007231:Infant, Newborn; D018810:Magnetic Resonance Angiography; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011651:Pulmonary Artery / Q000002:abnormalities / Q000473:pathology* / Q000503:physiopathology; D018633:Pulmonary Atresia / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011652:Pulmonary Circulation; D012189:Retrospective Studies; D013557:Switzerland
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA