Original Research Article| Volume 7, ISSUE 6, P361-366, November 2013

Cardiovascular imaging trends in congenital heart disease: A single center experience

Published:November 11, 2013DOI:



      Cardiac magnetic resonance imaging (MRI) and CT are available in the recent era at many pediatric cardiac centers.


      The aim was to provide a contemporary description of diagnostic imaging trends for definition of congenital heart disease (CHD).


      Echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT use in patients with congenital heart disease at a single institution was retrospectively recorded (2005–2012). Surgical procedures were recorded. Total and modality-specific rates were estimated by Poisson regression and compared. The median age, studies in patients aged >17 years, and referral diagnosis were tabulated for the last year of review.


      An average of 11,940 cardiovascular diagnostic tests was performed annually. The number of total studies, echocardiograms, catheterizations, and surgical procedures, did not change significantly across time. Echocardiography comprised 95% to 97% of all studies performed during each year of review. The use of cardiac MRI (2%) and cardiac CT (1%) increased linearly (P < .001), and the use of diagnostic catheterization decreased (0.7%; P = .0005). The median age was 3 years for echocardiography, 15 years for MRI, 11 years for CT, and 3 years for catheterization. The percentage of patients aged >17 years was 9% for echocardiography, 33% for cardiac MRI, 29% for cardiac CT, and 8% for catheterization. Most patients undergoing CT, MRI, and diagnostic catheterization had moderate or complex CHD.


      Cardiac CT is used increasingly in the recent era for evaluation of CHD. The increased use of both cardiac CT and cardiac MRI are temporally associated with a decrease in diagnostic cardiac catheterization.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      Full access to the journal is a member benefit for SCCT Members, Login via the SCCT website to access all journal content.


      Subscribe to Journal of Cardiovascular Computed Tomography
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Warnes C.A.
        • Williams R.G.
        • Bashore T.M.
        • et al.
        ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease).
        Circulation. 2008; 118: e714-e833
        • Bergersen L.
        • Gauvreau K.
        • Foerster S.R.
        • et al.
        Catheterization for Congenital Heart Disease Adjustment for Risk Method (CHARM).
        JACC Cardiovasc Interv. 2011; 4: 1037-1046
        • Feltes T.F.
        • Bacha E.
        • Beekman III, R.H.
        • et al.
        Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association.
        Circulation. 2011; 123: 2607-2652
        • Gutgesell H.P.
        • Huhta J.C.
        • Latson L.A.
        • Huffines D.
        • McNamara D.G.
        Accuracy of two-dimensional echocardiography in the diagnosis of congenital heart disease.
        Am J Cardiol. 1985; 55: 514-518
        • Marino B.
        • Corno A.
        • Carotti A.
        • et al.
        Pediatric cardiac surgery guided by echocardiography. Established indications and new trends.
        Scand J Thorac Cardiovasc Surg. 1990; 24: 197-201
        • Tworetzky W.
        • McElhinney D.B.
        • Brook M.M.
        • Reddy V.M.
        • Hanley F.L.
        • Silverman N.H.
        Echocardiographic diagnosis alone for the complete repair of major congenital heart defects.
        J Am Coll Cardiol. 1999; 33: 228-233
        • Stern K.W.
        • McElhinney D.B.
        • Gauvreau K.
        • Geva T.
        • Brown D.W.
        Echocardiographic evaluation before bidirectional Glenn operation in functional single-ventricle heart disease: comparison to catheter angiography.
        Circ Cardiovasc Imaging. 2011; 4: 498-505
        • Margossian R.
        • Schwartz M.L.
        • Prakash A.
        • et al.
        Comparison of echocardiographic and cardiac magnetic resonance imaging measurements of functional single ventricular volumes, mass, and ejection fraction (from the Pediatric Heart Network Fontan Cross-Sectional Study).
        Am J Cardiol. 2009; 104: 419-428
        • Prasad S.K.
        • Soukias N.
        • Hornung T.
        • et al.
        Role of magnetic resonance angiography in the diagnosis of major aortopulmonary collateral arteries and partial anomalous pulmonary venous drainage.
        Circulation. 2004; 109: 207-214
        • Hong Y.K.
        • Park Y.W.
        • Ryu S.J.
        • et al.
        Efficacy of MRI in complicated congenital heart disease with visceral heterotaxy syndrome.
        J Comput Assist Tomogr. 2000; 24: 671-682
        • Geva T.
        • Greil G.F.
        • Marshall A.C.
        • Landzberg M.
        • Powell A.J.
        Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia: comparison with x-ray angiography.
        Circulation. 2002; 106: 473-478
        • Prakash A.
        • Torres A.J.
        • Printz B.F.
        • Prince M.R.
        • Nielsen J.C.
        Usefulness of magnetic resonance angiography in the evaluation of complex congenital heart disease in newborns and infants.
        Am J Cardiol. 2007; 100: 715-721
        • Garg R.
        • Powell A.J.
        • Sena L.
        • Marshall A.C.
        • Geva T.
        Effects of metallic implants on magnetic resonance imaging evaluation of Fontan palliation.
        Am J Cardiol. 2005; 95: 688-691
        • Baikoussis N.G.
        • Apostolakis E.
        • Papakonstantinou N.A.
        • Sarantitis I.
        • Dougenis D.
        Safety of magnetic resonance imaging in patients with implanted cardiac prostheses and metallic cardiovascular electronic devices.
        Ann Thorac Surg. 2011; 91: 2006-2011
        • Dorfman A.L.
        • Odegard K.C.
        • Powell A.J.
        • Laussen P.C.
        • Geva T.
        Risk factors for adverse events during cardiovascular magnetic resonance in congenital heart disease.
        J Cardiovasc Magn Reson. 2007; 9: 793-798
        • Ramamoorthy C.
        • Haberkern C.M.
        • Bhananker S.M.
        • et al.
        Anesthesia-related cardiac arrest in children with heart disease: data from the Pediatric Perioperative Cardiac Arrest (POCA) registry.
        Anesth Analg. 2010; 110: 1376-1382
        • Raman S.V.
        • Cook S.C.
        • McCarthy B.
        • Ferketich A.K.
        Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of Fallot or transposition of the great arteries.
        Am J Cardiol. 2005; 95: 683-686
        • Kilner P.J.
        Imaging congenital heart disease in adults.
        Br J Radiol. 2011; 84: S258-S268
        • Han B.K.
        • Lindberg J.
        • Grant K.
        • Schwartz R.S.
        • Lesser J.R.
        Accuracy and safety of high pitch computed tomography imaging in young children with complex congenital heart disease.
        Am J Cardiol. 2011; 107: 1541-1546
        • Dillman J.R.
        • Hernandez R.J.
        Role of CT in the evaluation of congenital cardiovascular disease in children.
        AJR Am J Roentgenol. 2009; 192: 1219-1231
        • Ben Saad M.
        • Rohnean A.
        • Sigal-Cinqualbre A.
        • Adler G.
        • Paul J.F.
        Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease.
        Pediatr Radiol. 2009; 39: 668-676
        • Paul J.F.
        • Rohnean A.
        • Elfassy E.
        • Sigal-Cinqualbre A.
        Radiation dose for thoracic and coronary step-and-shoot CT using a 128-slice dual-source machine in infants and small children with congenital heart disease.
        Pediatr Radiol. 2011; 41: 244-249
        • Siegel M.J.
        Cardiac CTA: congenital heart disease.
        Pediatr Radiol. 2008; 38: S200-S204
        • Hughes Jr., D.
        • Siegel M.J.
        Computed tomography of adult congenital heart disease.
        Radiol Clin North Am. 2010; 48: 817-835
        • Lell M.M.
        • May M.
        • Deak P.
        • et al.
        High-pitch spiral computed tomography: effect on image quality and radiation dose in pediatric chest computed tomography.
        Invest Radiol. 2011; 46: 116-123
      1. Ghoshhajra BB, Lee AM, Engel LC, et al. Radiation dose reduction in pediatric cardiac computed tomography: experience from a tertiary medical center [e-pub ahead of print July 20, 2013]. Pediatr Cardiol.

        • Watson T.G.
        • Mah E.
        • Joseph Schoepf U.
        • King L.
        • Huda W.
        • Hlavacek A.M.
        Effective radiation dose in computed tomographic angiography of the chest and diagnostic cardiac catheterization in pediatric patients.
        Pediatr Cardiol. 2013; 34: 518-524