Magnetic resonance imaging (MRI) is a proven safe and noninvasive imaging modality for pediatric and adult patients. Cardiac applications for MRI in adults are still relatively new, but proven to be safe and effective for the diagnosis of many forms of heart disease. Cardiac MRI (CMR) in pediatric heart disease is rapidly becoming a preferred method of noninvasive imaging because of its use of strong magnetic fields instead of ionizing radiation, as well as non-nephrotoxic intravenous (IV) contrast. For some patients in whom echocardiography cannot supply adequate clinical information, such as in cases of technically difficult patients who have poor imaging windows from prior surgeries or preexisting lung diseases, CMR is an ideal choice for second-line imaging. CMR can provide the high temporal and spatial resolution necessary to identify thickened pericardium and the physiologic information necessary to investigate for ventricular interdependence. With the addition of IV contrast (gadolinium) CMR can also look for active pericardial inflation when delayed enhancement imaging techniques are used. In patients without contraindications to MRI (eg, non–MRI-compatible implants) CMR can be safely used as a noninvasive diagnostic imaging alternative for pericardial disease.
After reading this article, the participant should be able to:
- Identify pulse sequences necessary for visualization and characterization of pericardial disease in the pediatric population.
- Describe abnormal pericardial anatomy and cardiac MRI findings of pericardial disease.
- Modify pulse sequences to use in sedated pediatric patients undergoing cardiac MRI.
Categories: Magnetic Resonance Imaging (MRI), Radiology