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VOLUME 1 , ISSUE 1 ( January-March, 2022 ) > List of Articles

REVIEW ARTICLE

Advanced Cardiac Imaging in Neonatology

Bijoy Thattaliyath, Prashob Porayette, Ravi Ashwath

Keywords : Cardiac, Contrast, CT, Imaging, Indications, MRI, Neonate, Radiation, TnEcho

Citation Information : Thattaliyath B, Porayette P, Ashwath R. Advanced Cardiac Imaging in Neonatology. 2022; 1 (1):74-80.

DOI: 10.5005/jp-journals-11002-0020

License: CC BY-NC 4.0

Published Online: 31-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Imaging of congenital heart disease (CHD) starts in the intrauterine period by fetal echocardiography. The anatomy and physiology are confirmed postnatally by transthoracic echocardiogram. However, complex CHDs require further imaging to delineate anatomy for further management and surgical intervention. Cardiac magnetic resonance imaging (MRI) and cardiac chest tomography (CT) complement the role of transthoracic echocardiogram in delineating further details of anatomy and physiology in the neonatal period. This review covers the basic sequences and terminologies used in cardiac MRI and cardiac CT. A brief description of the indications and the ideal modality of imaging is described, including the limitations of each modality of imaging.


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  1. Edler I, Hertz CH. The use of ultrasonic reflectoscope for the continuous recording of the movements of heart walls. Clin Physiol Funct Imaging 2004;24(3):118–136. DOI: 10.1111/j.1475-097X.2004.00539.x.
  2. Wann LS, Weyman AE, Feigenbaum H, et al. Determination of mitral valve area by cross-section echocardiography. Ann Intern Med 1978;88(3):337–341. DOI: 10.7326/0003-4819-88-3-337.
  3. Johnson SL, Baker DW, Lute RA, et al. Doppler echocardiography. The localization of cardiac murmurs. Circulation 1973;48(4):810–822. DOI: 10.1161/01.cir.48.4.810.
  4. Kleinman CS, Hobbins JC, Jaffe CC, et al. Echocardiographic studies of the human fetus: Prenatal diagnosis of congenital heart disease and cardiac dysrhythmias. Obstet Gynecol Surv 1981;36:133–134. PMID: 7375228.
  5. Lai WW, Geva T, Shirali GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the task force of the Pediatric Council of the American Society of Echocardiography. 2006.
  6. Bartel T, Müller S, Biviano A, et al. Why is intracardiac echocardiography helpful? Benefits, costs, and how to learn. Eur Heart J 2014;35(2): 69–76. DOI: 10.1093/eurheartj/eht411.
  7. Singh Y, Tissot C, Fraga MV, et al. International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care 2020;24(1):1–16. DOI: 10.1186/s13054-020-2787-9.
  8. McNamara P, Lai W. Growth of neonatal hemodynamics programs and targeted neonatal echocardiography performed by neonatologists. J Am Soc Echocardiogr 2020;33(10):A15–A16. DOI: 10.1016/j.echo.2020.08.009.
  9. Bischoff AR, Giesinger RE, Rios DR, et al. Anatomic concordance of neonatologist-performed echocardiography as part of hemodynamics consultation and pediatric cardiology. J Am Soc Echocardiogr 2021;34(3):301–307. DOI: 10.1016/j.echo.2020.11.005.
  10. Hounsfield GN. Computerized transverse axial scanning (tomography): I. Description of system. Br J Radiol 1973;46(552):1016–1022. DOI: 10.1259/0007-1285-46-552-1016.
  11. Han BK, Rigsby CK, Leipsic J, et al. Computed tomography imaging in patients with congenital heart disease, Part 2: technical recommendations. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr 2015;9(6):493–513. DOI: 10.1016/j.jcct.2015.07.007.
  12. Han BK, Rigsby CK, Hlavacek A, et al. Computed tomography imaging in patients with congenital heart disease, Part I: rationale and utility. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr 2015;9(6):475–492. DOI: 10.1016/j.jcct.2015.07.004.
  13. Bloch F. Nuclear induction. Phys Rev 1946;70(7-8):460–474. DOI: 10.1103/PhysRev.70.460.
  14. Bloembergen N, Purcell EM, Pound RV. Relaxation effects in nuclear magnetic resonance absorption. Phys Rev 1948;73(7):679–712. DOI: 10.1103/PhysRev.73.679.
  15. Herfkens RJ, Higgins CB, Hricak H, et al. Nuclear magnetic resonance imaging of the cardiovascular system: Normal and pathologic findings. Radiology 1983;147(3):749–759. DOI: 10.1148/radiology.147.3.6601813.
  16. Crooks LE, Barker B, Chang H, et al. Magnetic resonance imaging strategies for heart studies. Radiology 1984;153(2):459–465. DOI: 10.1148/radiology.153.2.6484178.
  17. Fletcher BD, Jacobstein MD, Nelson AD, et al. Gated magnetic resonance imaging of congenital cardiac malformations. Radiology 1984;150(1):137–140. DOI: 10.1148/radiology.150.1.6689753.
  18. Lanzer P, Botvinick EH, Schiller NB, et al. Cardiac imaging using gated magnetic resonance. Radiology 1984;150(1):121–127. DOI: 10.1148/radiology.150.1.6227934.
  19. Laniado M, Weinmann HJ, Schörner W, et al. First use of GdDTPA/dimeglumine in man. Physiol Chem Phys Med NMR 1984;16(2):157–165. PMID: 6505042.
  20. Carr DH, Brown J, Bydder GM, et al. Gadolinium-DTPA as a contrast agent in MRI: Initial clinical experience in 20 patients. Am J Roentgenol 1984;143(2):215–224. DOI: 10.2214/ajr.143.2.215.
  21. Weber O, Higgins C. MR evaluation of cardiovascular physiology in congenital heart disease: Flow and function. J Cardiovasc Magn Reson 2006;8(4):607–617. DOI: 10.1080/10976640600740254.
  22. Sun L, Macgowan CK, Sled JG, et al. Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation 2015;131(15):1313–1323. DOI: 10.1161/CIRCULATIONAHA.114.013051.
  23. Portnoy S, Seed M, Zhu J, et al. Combined T1 and T2 measurement for non-invasive evaluation of blood oxygen saturation and hematocrit. 2015.
  24. Jansz MS, Seed M, van Amerom JFP, et al. Metric optimized gating for fetal cardiac MRI. Magn Reson Med 2010;64(5):1304–1314. DOI: 10.1002/mrm.22542.
  25. Lim JM, Porayette P, Marini D, et al. Associations between age at arterial switch operation, brain growth, and development in infants with transposition of the great arteries. Circulation 2019;139(24):2728–2738. DOI: 10.1161/CIRCULATIONAHA.118.037495.
  26. Van Praagh R. Terminology of congenital heart disease. Glossary and commentary. Circulation 1977;56(2):139–143. DOI: 10.1161/01.cir.56.2.139.
  27. Anderson R, Shirali G. Sequential segmental analysis. Ann Pediatr Cardiol 2009;2(1):24–35. DOI: 10.4103/0974-2069.52803.
  28. Fratz S, Chung T, Greil GF, et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson 2013;15(1):51. DOI: 10.1186/1532-429X-15-51.
  29. Beroukhim RS, Prakash A, Valsangiacomo Buechel ER, et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance imaging: a multicenter experience. J Am Coll Cardiol 2011;58(10):1044–1054. DOI: 10.1016/j.jacc.2011.05.027.
  30. Lewandowski AJ. The preterm heart: a unique cardiomyopathy? Pediatr Res 2019;85(6):738–739. DOI: 10.1038/s41390-019-0301-3.
  31. Grosse-Wortmann L, Yun TJ, Al-Radi O, et al. Borderline hypoplasia of the left ventricle in neonates: insights for decision-making from functional assessment with magnetic resonance imaging. J Thorac Cardiovasc Surg 2008;136(6):1429–1436. DOI: 10.1016/j.jtcvs.2008.04.027.
  32. Buechel ERV, Grosse-Wortmann L, Fratz S, et al. Indications for cardiovascular magnetic resonance in children with congenital and acquired heart disease: An expert consensus paper of the Imaging Working Group of the AEPC and the Cardiovascular Magnetic Resonance Section of the EACVI. Eur Heart J Cardiovasc Imaging 2015;16(3):281–297. DOI: 10.1093/ehjci/jeu129.
  33. Ticho BS, Goldstein AM, Van Praagh R. Extracardiac anomalies in the heterotaxy syndromes with focus on anomalies of midline-associated structures. Am J Cardiol 2000;85(6):729–734. DOI: 10.1016/s0002-9149(99)00849-8.
  34. Anderson RH, Brown NA, Meno C, et al. The importance of being isomeric. Clin Anat 2015;28(4):477–486. DOI: 10.1002/ca.22517.
  35. Simpson J, Lopez L, Acar P, et al. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016;17(1):1071–1097. DOI: 10.1093/ehjci/jew172.
  36. Schicchi N, Secinaro A, Muscogiuri G, et al. Multicenter review: role of cardiovascular magnetic resonance in diagnostic evaluation, pre-procedural planning and follow-up for patients with congenital heart disease. Radiol Medica 2016;121(5):342–351. DOI: 10.1007/s11547-015-0608-z.
  37. Windram J, Grosse-Wortmann L, Shariat M, et al. Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants. Pediatr Radiol 2012;42(2):183–187. DOI: 10.1007/s00247-011-2219-8.
  38. Ridgway JP. Cardiovascular magnetic resonance physics for clinicians: Part I. J Cardiovasc Magn Reson 2010;12(1):71. DOI: 10.1186/1532-429X-12-71.
  39. Shan K, Constantine G, Sivananthan M, et al. Role of cardiac magnetic resonance imaging in the assessment of myocardial viability. Lippincott Williams & Wilkins; 2004.
  40. Hedgire SS, Baliyan V, Ghoshhajra BB, et al. Recent advances in cardiac computed tomography dose reduction strategies: a review of scientific evidence and technical developments. J Med Imaging 2017;4(3):31211. PMID: 28894760.
  41. Ghoshhajra BB, Lee AM, Engel LC, et al. Radiation dose reduction in pediatric cardiac computed tomography: experience from a tertiary medical center. Pediatr Cardiol 2014;35(1):171–179. PMID: 23872908.
  42. Gao W, Zhong YM, Sun AM, et al. Diagnostic accuracy of sub-mSv prospective ECG-triggering cardiac CT in young infant with complex congenital heart disease. Int J Cardiovasc Imaging 2016;32(6):991–998. PMID: 26897005.
  43. Stolzmann P, Goetti RP, Maurovich-Horvat P, et al. Predictors of image quality in high-pitch coronary CT angiography. AJR Am J Roentgenol 2011;197(4):851–858. PMID: 21940572.
  44. Alkadhi H, Stolzmann P, Desbiolles L, et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart 2010;96(12):933–938. PMID: 20538669.
  45. Sun Z. Multislice CT angiography in cardiac imaging: prospective ECG-gating or retrospective ECG-gating? Biomed Imaging Interv J 2010;6(1):e4. PMID: 21611064.
  46. Lefrak L, Burch K, Caravantes R, et al. Sucrose analgesia: identifying potentially better practices. Pediatrics 2006;118 (Suppl 2):S197–S202. PMID: 17079623.
  47. Hussain T, Mathur S, Peel SA, et al. Coronary artery size and origin imaging in children: a comparative study of MRI and trans-thoracic echocardiography. BMC Med Imaging 2015;15:48. PMID: 26502883.
  48. Rigsby CK, deFreitas RA, Nicholas AC, et al. Safety and efficacy of a drug regimen to control heart rate during 64-slice ECG-gated coronary CTA in children. Pediatr Radiol 2010;40(12):1880–1889. PMID: 20499055.
  49. Attili AK, Schuster A, Nagel E, et al. Quantification in cardiac MRI: advances in image acquisition and processing. Int J Cardiovasc Imaging 2010;26 (Suppl 1):27–40. PMID: 20058082.
  50. Valverde I, Gomez-Ciriza G, Hussain T, et al. Three-dimensional printed models for surgical planning of complex congenital heart defects: an international multicentre study. Eur J Cardiothorac Surg 2017;52(6):1139–1148. PMID: 28977423.
  51. Bhatla P, Tretter JT, Ludomirsky A, et al. Utility and scope of rapid prototyping in patients with complex muscular ventricular septal defects or double-outlet right ventricle: does it alter management decisions? Pediatr Cardiol 2017;38(1):103–114. PMID: 27837304.
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