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  • Title: Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone a Fontan operation or bidirectional cavopulmonary connection: initial experience.
    Author: Goo HW, Yang DH, Park IS, Ko JK, Kim YH, Seo DM, Yun TJ, Park JJ.
    Journal: J Magn Reson Imaging; 2007 Apr; 25(4):727-36. PubMed ID: 17335039.
    Abstract:
    PURPOSE: To evaluate the usefulness of time-resolved three-dimensional (3D) magnetic resonance angiography (MRA) using diluted contrast agent (CA) in patients who had undergone a Fontan operation or bidirectional cavopulmonary connection (BCPC). MATERIALS AND METHODS: Time-resolved 3D MRA (10 dynamic data sets, two seconds per dynamic data set) using parallel imaging and keyhole data sampling was performed on 15 patients (median age=10 years, range=1-20 years) who had undergone a Fontan operation (N=11) or BCPC (N=4). Diluted gadolinium (Gd) contrast agent (CA) was intravenously injected into the arm and/or leg veins. The flow dynamics and morphology of pulmonary circulation, and lung perfusion were assessed. RESULTS: Preferential or balanced pulmonary blood flow from each systemic vein was visualized on time-resolved 3D MRA in all patients. In addition, occlusion/stenosis of the central thoracic vein (N=4) and pulmonary artery (N=6), systemic venous (N=5) and arterial (N=6) collaterals, and lung perfusion defect (N=4) were identified. Persistent hepatic venous plexus, pulmonary arteriovenous malformation, and axillary arteriovenous fistula were delineated in three patients, respectively. CONCLUSION: Time-resolved 3D MRA with diluted CA is useful for evaluating patients who have undergone a Fontan operation or BCPC because it can reveal the flow dynamics and morphology of pulmonary circulation, and lung perfusion status.
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