title: Cardiac magnetic resonance: impact on diagnosis and management of patients with congenital cardiovascular disease.
abstract: OBJECTIVE
  To estimate the clinical impact of cardiac magnetic resonance (CMR) in patients with congenital cardiovascular disease (CCD).
  
  
  METHODS
  Since 2003, 1.5T CMR was used at our university hospital to evaluate morphology, cardiac kinetics, aortic and pulmonary flow, and vascular anatomy in patients with CCD. The present study considered a consecutive series of these patients from 2003 to 2006. A paediatric cardiologist judged our reports as expected or unexpected and, secondarily, as not reliable (level 0), describing findings already known (level 1), not changing therapy/suggested lifestyle (level 2), changing therapy/suggested lifestyle (level 3) or changing diagnosis (level 4).
  
  
  RESULTS
  CMR reports were judged to be expected in 187/214 (87%) and unexpected in 27/214 (13%). Less than 2% of CMRs were judged as levels 0 or 1, 66% as level 2, and 5% as level 4. During 2005-2006 the clinical impact improved toward higher impact levels (p<0.001, chi-square test).
  
  
  CONCLUSIONS
  In patients with CCD, more than one in 10 CMR reports were unexpected to cardiologists and over seven in 10 prompted a change of diagnosis or therapy.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy. francescosecchimd@gmail.com
authors.forename: F
authors.initials: F
authors.lastname: Secchi
authors.forename: G
authors.initials: G
authors.lastname: Di Leo
authors.forename: G D E
authors.initials: GD
authors.lastname: Papini
authors.forename: V G
authors.initials: VG
authors.lastname: Nardella
authors.forename: D
authors.initials: D
authors.lastname: Negura
authors.forename: M
authors.initials: M
authors.lastname: Carminati
authors.forename: F
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult