SCMR/Medis: CMR in Congenital Heart Disease: How to do it?-SCMR/MEDIS: CMR in Heart Failure: How to do it?

Video Transcription

Video Summary

The webinar focused on cardiac MRI (CMR) in congenital heart disease, explaining both <strong>why</strong> it is done and <strong>how</strong> to perform it.

Dr. Francesca Raimondi emphasized that congenital heart disease is no longer just a pediatric issue, since many children now survive into adulthood. CMR is crucial for evaluating anatomy, ventricular volumes and function, valve flow, perfusion, and tissue characteristics. She stressed that MRI exams must be tailored to the clinical question, and that CMR is especially valuable for follow-up of complex conditions such as tetralogy of Fallot, univentricular heart, and transposition of the great arteries. She also highlighted the growing importance of 4D flow and the differences between MRI and CT, especially the fact that MRI avoids radiation.

Dr. Cynthia Rigsby then demonstrated the practical side of CMR using three pediatric cases:  
1. <strong>Sinus venosus defect with partial anomalous pulmonary venous return</strong>, where MRI defined pulmonary vein anatomy, right heart dilation, and QP/QS shunt severity.  
2. <strong>Repaired tetralogy of Fallot</strong>, where MRI quantified RV dilation, pulmonary regurgitation, branch pulmonary artery flow, and helped determine follow-up timing.  
3. <strong>Transposition of the great arteries after arterial switch</strong>, where MRI assessed neo-aortic regurgitation, ventricular size/function, coronary anatomy, and pulmonary artery dimensions.

In the Q&A, the speakers discussed fetal CMR, 4D flow as a preferred and reproducible technique, methods for QP/QS calculation, the role of late gadolinium enhancement, contrast choice in children, and why contrast is often useful for pulmonary vein assessment. The session concluded by encouraging further hands-on learning with available software resources.

Keywords

cardiac MRI

congenital heart disease

4D flow

tetralogy of Fallot

transposition of the great arteries

pulmonary venous return

QP/QS shunt

ventricular function

radiation-free imaging

late gadolinium enhancement