Table 2.
Summary of MRI techniques and possible protocols in repaired complex ACHD
| Technique | Repaired TOF | Repaired D-TGA | Fontan circuit |
|---|---|---|---|
| Bright or black blood imaging | Axial, coronal, sagittal, RVOT, main PAs | Axial, coronal, sagittal, RVOT (if atrial switch) | Axial, coronal, sagittal, main PAs |
| 2D SSFP Cine |
LV: 2, 3, and 4 chamber views, short-axis stacks RV: 3 chamber views, RVOT stacks Oblique axial stack of the main PAs |
LV: 2, 3, and 4 chamber views, short-axis stacks RV: 3 chamber views, RVOT stacks Oblique axial stack of the PAs (arterial switch) Coronal/axial planes of systemic/pulmonary venous pathways (atrial switch) |
LV: 2, 3, and 4 chamber views, short-axis stacks RV: 3 chamber views Short axis and axial stacks covering the whole circuit Coronal stack of the extra-cardiac conduit in long axis |
| 3D SSFP | Detailed assessment of thoracic vasculature | Evaluation of venous baffles (atrial switch) or proximal coronary arteries (arterial switch) | May be more suitable than contrast angiography due to timing of contrast injection issues |
| Phase contrast | Ao, pulmonary trunk, main PAs |
Ao, pulmonary trunk, main PAs IVC/SVC (if atrial switch and obstruction suspected) |
Ao, pulmonary trunk, main PAs, cavopulmonary connections, extracardiac conduit |
| Contrast angiography | Evaluation of main PAs if stenosis suspected | Evaluation of venous baffles (atrial switch) and pulmonary trunk (arterial switch) | Assessment of aortopulmonary collaterals and potential AVMs |
| Gadolinium enhancement |
LV: 2, 3, and 4 chamber views, short axis stacks RV: 3 chamber views, RVOT |
LV: 2, 3, and 4 chamber views, short axis stacks RV: 3 chamber views, RVOT |
LV: 2, 3, and 4 chamber views, short axis stacks RV: 3 chamber views |
Other techniques such as further tissue characterisation by T2-weighted imaging and myocardial mapping can also be considered, if there are relevant indications
Ao, aorta; AVM, arteriovenous malformation; IVC, inferior vena cava; LV, left ventricle; PA, pulmonary artery; RVOT, right ventricular outflow tract; RV, right ventricle; SVC, superior vena cava