Technologist Track Session 4: Pediatric and Congenital Heart Disease (2020)-Cardiac Shunts

Video Transcription

Video Summary

The speaker reviews how cardiac MRI is used to evaluate shunts after echocardiography when echo is inconclusive, especially in teens and young adults. MRI provides detailed ventricular volumes, ejection fraction, stroke volume, mass, and Qp:Qs shunt quantification using ventricular stroke volumes or phase-contrast flow across the aortic and pulmonary valves. The talk outlines a typical shunt protocol: localizers, multiple ECG-gated SSFP views, oblique anatomy, free-breathing navigator-gated non-contrast MRA, contrast-enhanced imaging if needed, phase-contrast flow, and late gadolinium enhancement. Examples include ASD, sinus venosus defects, anomalous pulmonary venous return, scimitar syndrome, VSD, and PDA, emphasizing how MRI clarifies anatomy and flow direction. The speaker also highlights a newer preoperative sagittal sternum view for patients with prior surgery to assess RVOT adherence and potentially avoid CT.

Keywords

cardiac MRI

shunt quantification

phase-contrast flow

congenital heart defects

late gadolinium enhancement