Computed tomography and magnetic resonance imaging findings in congenital cardiovascular anomalies

The incidence of congenital heart disease (CHD) is approximately 6-7 per 1,000 newborns. With advanced diagnostic, medical, and surgical methods, survival of CHD is increasing, as is the number of people living with CHD. Echocardiography is a useful modality in non-invasive imaging, whereas magnetic resonance imaging (MRI), cardiac MR (CMR), cardiac computed tomography (CT), and CT angiography (CTA) are increasingly gaining ground in congenital cardiac imaging with developing technology. Considering the limited postoperative use of echocardiography, these techniques have assumed vital roles with the increasing population of CHD in children and adults. CMR and cardiac CT can complement the information obtained with echocardiography and invasive cardiac catheterization and can sometimes provide more detail. In postoperative imaging of CHD, CMR allows an evaluation of anatomy, especially with spin echo MRI techniques, whereas cine MRI, created in gradient echo sequences, allows functional data to be obtained. Phase contrast CMR data provides information on flow direction and flow rate, allowing accurate measurement of regurgitation and shunt volume. In addition, in post-gadolinium imaging, data such as on MR angiography, myocardial perfusion, and fibrosis can be obtained with CMR. Cardiac CT and CTA provide great advantages, especially in newborns, by almost completely reducing movement and respiratory artifacts through capabilities such as high spatial and temporal resolution, fast acquisition, and short acquisition time. Three-dimensional reformatted images with contrast-enhanced CMR or cardiac CT/CTA provide excellent visualization of vascular structures in complex CHDs. Coronary imaging can be viewed more easily with CT imaging. This article reviews the literature to provide an overview of the diagnostic value, relative advantages, and overall evaluation of CMR and cardiac CT examinations in the diagnosis and postoperative follow-up of CHD.