Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone a Fontan operation or bidirectional cavopulmonary connection: Initial experience

• Published in: Journal of magnetic resonance imaging 2007-04, Vol.25 (4), p.727-736
• Main Authors: Goo, Hyun Woo, Yang, Dong Hyun, Park, In-Sook, Ko, Jae Kon, Kim, Young Hwee, Seo, Dong-Man, Yun, Tae-Jin, Park, Jeong-Jun
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; bidirectional cavopulmonary connection; Child; Child, Preschool; congenital heart disease; Constriction, Pathologic - diagnosis; Contrast Media - administration & dosage; contrast-enhanced MRA; Female; Fontan operation; Fontan Procedure; Gadolinium - administration & dosage; Heart Bypass, Right; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - surgery; Humans; Imaging, Three-Dimensional; Infant; Magnetic Resonance Angiography - methods; Male; Pulmonary Circulation - physiology; Radiographic Image Enhancement; Thorax - blood supply; time-resolved MRA
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.20870

Purpose To evaluate the usefulness of time‐resolved three‐dimensional (3D) magnetic resonance angiography (MRA) using diluted contrast agent (CA) in patients who had undergone a Fontan operation or bidirectional cavopulmonary connection (BCPC). Materials and Methods Time‐resolved 3D MRA (10 dynamic data sets, two seconds per dynamic data set) using parallel imaging and keyhole data sampling was performed on 15 patients (median age = 10 years, range = 1–20 years) who had undergone a Fontan operation (N = 11) or BCPC (N = 4). Diluted gadolinium (Gd) contrast agent (CA) was intravenously injected into the arm and/or leg veins. The flow dynamics and morphology of pulmonary circulation, and lung perfusion were assessed. Results Preferential or balanced pulmonary blood flow from each systemic vein was visualized on time‐resolved 3D MRA in all patients. In addition, occlusion/stenosis of the central thoracic vein (N = 4) and pulmonary artery (N = 6), systemic venous (N = 5) and arterial (N = 6) collaterals, and lung perfusion defect (N = 4) were identified. Persistent hepatic venous plexus, pulmonary arteriovenous malformation, and axillary arteriovenous fistula were delineated in three patients, respectively. Conclusion Time‐resolved 3D MRA with diluted CA is useful for evaluating patients who have undergone a Fontan operation or BCPC because it can reveal the flow dynamics and morphology of pulmonary circulation, and lung perfusion status. J. Magn. Reson. Imaging 2007. © 2007 Wiley‐Liss, Inc.