The use of MRI for congenital cardiac disease

Cardiac magnetic resonance (CMR) imaging provides a tool for comprehensive cardiovascular assessment. The benefit of this imaging modality, particularly for paediatric and adult patients with congenital heart disease, is undisputed. At low risk, and often within one study, CMR can give invaluable morphologic, functional and haemodynamic data. This helps guide diagnosis, risk stratification and procedural planning for these
patients.

CMR is the recognised gold standard, non-ionising technique for anatomic evaluation, quantitative assessment of cardiac chamber size and function, flow quantification, and myocardial tissue characterisation. However, to realise its full potential and to avoid pitfalls, CMR for patients with congenital heart disease requires specific training and experience. These patients are a heterogenous population. To evaluate these patients effectively, the imaging teams need appropriate pathophysiological understanding of all the possible morphologic variants, their physiologic stages and the post-intervention issues. Ideally, specialists undertaking CMR imaging for patients with congenital disease should be committed to long-term collaboration with the clinicians and surgeons managing the patients, often within a tertiary referral centre.

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