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No single imaging modality does it all in congenital heart disease
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Practitioners and imaging specialists face a variety of challenges when imaging adults with congenital heart disease.
Wilfred Mamuya, MD, PhD, a cardiologist at Massachusetts General Hospital, said the appropriate imaging modality may vary according to what the imager is looking for.
“Looking at the appropriateness criteria from the American College of Radiology, we see that ultrasound is the preferred modality, followed by MRI and then cardiac CT,” Mamuya said.
“The benefits of ultrasound are easy:There is no radiation, and you can get exquisite physiological evaluations,” Mamuya said. “The limitations are that it is difficult to see the aortic arch and almost impossible to look at coronary arteries, pulmonary arteries, veins and collaterals. It is difficult to look quantitatively at left ventricular function in the small field of view.”
Cardiac MRI should be used more frequently in the adult congenital heart disease population, because of its ability to image the pulmonary arterial vasculature and venous vasculature as well as vascular conduits. Potential drawbacks of CT include a lack of physiological information, and emission of radiation in a population that may require repeated imaging.