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Flow-sensitive four-dimensional magnetic resonance imaging facilitates and improves the accurate diagnosis of partial anomalous pulmonary venous drainage

Published online by Cambridge University Press:  19 April 2011

Sarah Nordmeyer ,
Felix Berger ,
Titus Kuehne  and
Eugénie Riesenkampff
Sarah Nordmeyer*
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Felix Berger
Affiliation:
Department of Paediatric Cardiology, Charité Universitaetsmedizin Berlin, Berlin, Germany
Titus Kuehne
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany Department of Paediatric Cardiology, Charité Universitaetsmedizin Berlin, Berlin, Germany
Eugénie Riesenkampff
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
*
Correspondence to: Dr med. S. Nordmeyer, Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: +49 30 4593 2800; Fax: +49 30 45932900; E-mail: snordmeyer@dhzb.de
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Abstract

Objectives

To assess if flow-sensitive four-dimensional velocity-encoded cine magnetic resonance imaging adds value in diagnosing patients with suspected partial anomalous pulmonary venous drainage.

Methods

In six patients with echocardiographically suspected partial anomalous pulmonary venous drainage, anatomy was evaluated using standard magnetic resonance imaging including angiography. Functional analysis included shunt calculations from flow measurements. We used four-dimensional velocity-encoded cine magnetic resonance imaging for visualisation of maldraining pulmonary veins and quantification of flow via the maldraining veins and interatrial communications, if present.

Results

In all patients, the diagnosis of partial anomalous pulmonary venous drainage was confirmed by standard magnetic resonance imaging. Shunt volumes ranged from 1.4:1 to 4.7:1. Drainage sites were the superior caval vein (n = 5) or the vertical vein (n = 1). Multiple maldraining pulmonary veins were found in three patients. Pulmonary arteries and veins could be clearly distinguished by selective visualisation using four-dimensional velocity-encoded cine magnetic resonance imaging. Flow measured individually in maldraining pulmonary veins in six patients and across the interatrial communication in three patients revealed a percentage of the overall shunt volume of 30–100% and 58–70%, respectively.

Conclusion

Selective visualisation of individual vessels and their flow characteristics by four-dimensional velocity-encoded cine magnetic resonance imaging facilitates in distinguishing adjacent pulmonary arteries and veins and thus improves the accurate diagnosis of maldraining pulmonary veins. By detailed quantification of shunt volumes, additional information for planning of treatment strategies is provided. This method adds clinical value and might replace contrast-enhanced magnetic resonance angiography in these patients in the future.

Keywords

Partial anomalous pulmonary venous drainageflow-sensitive four-dimensional velocity-encoded cine magnetic resonance imagingblood flow visualisation
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 5 , 09 September 2011 , pp. 528 - 535
Copyright
Copyright © Cambridge University Press 2011

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