Impaired continuity of flow in congenital heart disease with single ventricle physiology.
We report the comprehensive evaluation of cardiac morphology, valve function, and three-dimensional (3D) blood flow in a pediatric patient with congenital heart disease. 3D visualization of cardiovascular flow paths and quantitative flow analysis based on flow-sensitive 4D magnetic resonance imaging (MRI) provided detailed insight into hemodynamic changes associated with valve insufficiency and the complex single ventricle physiology. Despite only moderate atrio-ventricular regurgitation (fraction=28%) a marked redirection of atrial flow and pronounced vortex flow in the entire atrium was observed. Disturbed retrograde flow was even found upstream within the left pulmonary veins (regurgitant fraction=27%) indicating interrupted continuity of flow directed through the single atrium and ventricle. Such findings indicate the potential of flow-sensitive 4D MRI to detect and quantify complex 3D flow alterations.
Department of Radiology, Medical Physics, University Hospital Freiburg, Breisacher Str. 60a, 79106 Freiburg, Germany. michael.markl@uniklinik-freiburg.de
Michael
M
Markl
Julia
J
Geiger
Brigitte
B
Stiller
Raoul
R
Arnold
D002675:Child, Preschool; D006351:Heart Valves / Q000002:abnormalities / Q000503:physiopathology; D006352:Heart Ventricles / Q000002:abnormalities / Q000503:physiopathology* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods; D058327:Norwood Procedures; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000503:physiopathology; D012039:Regional Blood Flow; D016896:Treatment Outcome