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Review of new techniques in echocardiography and magnetic resonance imaging as applied to patients with congenital heart disease
  1. D J Sahna,
  2. G W Vick IIIb
  1. aOregon Health and Science University, Clinical Care Center for Congenital Heart Disease, 3181 SW Sam Jackson Park Road, Portland, Oregon 97201–3098, USA, bTexas Children's Hospital, Division of Pediatric Cardiology, 6621 Fannin, Z-2280, Houston, Texas 77030-2303, USA
  1. Dr Sahnsahnd{at}ohsu.edu

https://doi.org/10.1136/heart.86.suppl_2.ii41

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    Echocardiography and magnetic resonance imaging (MRI) have sometimes been contrasted with each other in an attempt to define which method provides overall superiority for imaging and functional evaluation. We believe that the important question is not whether echocardiography or MRI is the globally superior technique for imaging and/or functional analysis. Rather the relevant question for any given patient is how to best utilise non-invasive imaging technology to provide optimal benefit in specific clinical situations. In our experience, patients with congenital heart disease will be better served by an imaging strategy that extensively uses both MRI and echocardiography, as opposed to a strategy that relies on either technique in isolation. Both echocardiography and MRI are developing at an exceedingly rapid pace. This review highlights some of the new developments in each field that apply to patients with congenital heart disease.

    Echocardiography

    Echocardiography has major advantages in that it is inexpensive, portable, and gives immediate feedback on structure, function, and flow in one exam.

    HIGHER RESOLUTION FOR TRANSTHORACIC ECHOCARDIOGRAPHY

    For babies, the definition and resolution provided by echocardiography is better than MRI, and for the rapid heart rates and continuous windows, little else is needed for diagnostic management.

    HIGHER RESOLUTION FOR TRANSOESOPHAGEAL ECHOCARDIOGRAPHY

    Transoesophageal echocardiography (TOE) provides the windows needed for detailed diagnosis in older postoperative or adult congenital heart disease, and can be used for monitoring surgery and catheter interventions1 (fig 1).

    Figure 1

    7.5 MHz high resolution intraoperative transoesophageal echocardiography (TOE) images of a subaortic ventricular septal defect with aortic valve prolapse using an 8 mm micromultiplane TOE probe developed with National Institutes of Health funding from grant 1R01 HL 36472–01.1

    HARMONICS

    Harmonics have improved signal to noise for prenatal diagnosis, and resolution for tough patients with poor windows. They can also be used in conjunction with transpulmonary echo contrast agents to delineate cardiac perfusion.

    NEW ARRAYS FOR MICRO USES

    New types of array technologies for …

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