title: The optimal timing for magnetic resonance imaging in long-term follow-up of patients after a complete correction of the Tetralogy of Fallot.
abstract: OBJECTIVE
  Long-term pulmonary regurgitation (PR) leads to right ventricular (RV) dilatation and dysfunction. In patients after a complete correction of the tetralogy of Fallot (TOF) it represents the most frequent and high risk late complication. Magnetic resonance imaging (MRI) is an objective possibility for RV measurements; on the other hand MRI is complicated and not always accessible method.
  
  
  BACKGROUND
  We analyzed echocardiography (ECHO) and MRI parameters regarding RV dilatation and function and the correlation between these two methods with the aim to define optimal ECHO parameters indicating a necessity for further investigations.
  
  
  METHODS
  In 50 patients with TOF > 10 years, after a complete surgical correction, ECHO and MRI were performed.
  
  
  RESULTS
  ECHO finding of end-diastolic diameter (EDD) of RV > 30mm was detected in 13 patients (26%) and in 30 patients (60%) RV EDD above 4 standard deviations (SD) their normal values was present. MRI finding of end-diastolic volume (EDV) > 160 ml/m2 was present in 14 patients (28%) and end-systolic volume (ESV) > 85 ml/m2 in 17 patients (34%). Significant correlations between ECHO and MRI RV diastolic measurements were found (p=0.0001, r=0.34, resp. p=0.001, r=0.39). PR was significantly affecting diastolic RV dilatation (p=0.0001), on the other hand. RV dysfunction resulted in systolic RV dilatation (p=0.007). PR did not correlate with RV function (p=0.56).
  
  
  CONCLUSIONS
  MRI is a golden standard for exact RV measurements and for the indication of pulmonary valve replacement, but ECHO still can be used during long-term follow-up, defining the point for further and more exact RV measurements (Tab. 2, Fig. 11, Ref. 17). Full Text in free PDF www.bmj.sk.
authors.affiliation: National Institute of Cardiovascular Diseases, Children's Cardiac Centre, Bratislava, Slovakia. kantorova@dke-sr.sk
authors.forename: A
authors.initials: A
authors.lastname: Kantorova
authors.forename: M
authors.initials: M
authors.lastname: Kaldararova
authors.forename: V
authors.initials: V
authors.lastname: Neuschl
authors.forename: M
authors.initials: M
authors.lastname: Nosal
authors.forename: J
authors.initials: J
authors.lastname: Masura
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D055815:Young Adult