The use of magnetic resonance imaging in adult congenital heart disease.

Magnetic resonance (MR) imaging techniques have evolved sufficiently to produce clinically relevant studies that depict the anatomy and physiology of the heart. Applications to congenital cardiac disease in adult patients are numerous. MR imaging is particularly useful for noninvasive evaluation of the aorta in patients with aortic arch anomalies and coarctations and to study the results of palliative and corrective surgery for transposition of the great arteries and for reconstructive procedures that restore sufficient pulmonary blood flow. MR imaging is superior to transthoracic echocardiography in defining the anatomy of the central pulmonary arteries. Recent technological advances permit motion studies acquired during a single breath-hold and can be used to accurately measure stroke volume, ejection fraction, regional wall motion, and wall thickening from both ventricles. Functional parameters, such as the velocity and volume of blood flow in vessels, valve gradients, regurgitant flow, shunt flow, and pulmonary artery blood flow into each lung are readily performed. This review article documents the value of MR imaging in adult patients with congenital disorders of the heart, pulmonary arteries, and aorta, and includes illustrations of typical examples.