As more pediatric patients are infected with severe acute respiratory syndrome coronavirus 2 during the coronavirus disease 2019 (COVID-19) pandemic, more have been diagnosed with multisystemic inflammatory syndrome in children (MIS-C). Early research investigations into MIS-C show cardiac involvement presenting as elevated troponins, ventricular dysfunction, electrical conduction abnormalities, and pericardial effusions. MIS-C may result in myocardial perfusion defects visualized with nuclear medicine imaging and magnetic resonance imaging (MRI), however these perfusion defects on contrast enhanced computed tomography (CT) have not yet been described. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Simmons Curtis, Goncalves Luis, Southard Richard, Bardo Dianna

Keywords: Cardiac, COVID

The ductus arteriosus is normal structure of fetal circulation derived from the embryologic left 6th aortic arch that connects the aorta to the pulmonary arterial circulation. Patent ductus arteriosus (PDA) is a congenital cardiac anomaly in which the ductus arteriosus fails to undergo physiologic closure after birth. PDA is associated with prematurity, trisomy 21, and other diseases. When isolated, a PDA acts as a left to right cardiac shunt. In the setting of a right aortic arch, a PDA completes the vascular ring. A PDA may be treated with medical closure with indomethacin, endovascular closure, or surgical closure. Several congenital heart defects are dependent on a PDA to maintain circulation either to the systemic or pulmonary circulations. In these cases of ductal-dependent postnatal circulation, the PDA can be kept open with prostaglandins. Examples include: - Pulmonary atresia without a ventricular septal defect - Critical pulmonary stenosis - Tricuspid atresia - Severe Ebstein anomaly - Severe tricuspid regurgitation - Hypoplastic left heart syndrome - Critical aortic valve stenosis - Interruption of the aortic arch - Severe coarctation of the aorta Additional important anatomic and physiologic variations of PDA anatomy will be presented: - Reverse oriented ductus - To and fro blood flow - Reversal of PDA blood flow - Right ductus arteriosus - Completion of a vascular ring Other important structures to evaluate: - Trachea and main bronchi which may be compressed by the PDA - Main and branch pulmonary arteries which may be stenotic or have isolated origin from the PDA - Aortic arch sidedness and caliber (arch hypoplasia, coarctation, interruption) which may only become physiologically apparent as the PDA closes - Vascular ring which may include the PDA or its ligament as a component of the ring The purpose of this education exhibit is to describe: - Embryology of the ductus arteriosus - Normal anatomy and blood flow physiology of the ductus arteriosus - Anatomy and physiology of the ductus arteriosus in congenital heart disease - Abnormalities of adjacent mediastinal structures (trachea, bronchi, aorta, pulmonary arteries) due to PDA Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Gilligan Leah, Popescu Andrada, Griffin Lindsay, Rigsby Cynthia, Bardo Dianna

Keywords: patent ductus arteriosus, congenital heart disease

The structure of the heart is more complex than 4 major chambers, 4 major valves, venous inflow and arterial outflow. Muscular and soft tissue ridges, perforated membranes, tissue flaps, electrical pathways, external grooves, endocardial surface characteristics, and a core architecture structured of fibrous tissue and embryonic tissue remnants form distinguishing anatomic landmarks. These structures provide insight into cardiac development, serve physiologic purpose, define structural and functional elements, as well as offer prognostic information. Specific details of cardiac anatomy may not be recognized on cardiac MR and CT examinations. Structural anomalies that affect cardiac function and anatomic or physiologic relationships may be abnormal in hearts with congenital malformations. The fine structural details of the heart are typically not part of an imagers search pattern and are therefore overlooked or underreported. Each minute structure and anatomic characteristic provides clues to errors in cardiac formation and may provide clinically relevant diagnostic information. After palliation of CHD defining anatomic structure may be lost, displaced, interrupted or even restored. Important processes, corresponding anatomic landmarks, and effects of malformation in defining congenital heart disease anatomy, physiology and functional variation from normal include basal structures such as the central fibrous body of the heart, atrial structures including the crista terminalis, the sinus venarum, and eustacian valve, and ventricular structures such as the crista supraventricularis. Each structure is described along with its normal location, anatomy functional and physiologic importance, the effect of congenital malformation, and imaging findings as in the example of the central fibrous body (table 1). Minute cardiac anatomy will be shown in illustration as well as in CT and MR images (figure 1). Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Southard Richard, Ellsworth Erik, Moe Tabitha, Augustyn Robyn, Thorkelson Marrit, Bardo Dianna

Keywords: Cardiac anatomy, Cardiac MR, Cardiac CT, Congenital heart disease, Embryology

The purpose of this study is to report visualization rates for standard cardiac axial views by FCMR using a prospective ECG pseudogating method and compare visualization rates for acquisitions performed in 1.5 and 3T. Secondary aims include a comparison of image quality between 2 observers and between 1.5 and 3T. Specific absorption rates (SAR) are also compared. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Goncalves Luis, Lindblade Christopher, Cornejo Patricia, Patel Mittun, Wishah Fidaa, Bardo Dianna

Keywords: fetal cardiac MRI, 3T, image quality

Purpose is to describe how FCMR is instrumental in diagnosis of congenital heart disease (CHD) and to present imaging findings and correlation in 50 fetuses with CHD. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Bardo Dianna, Lindblade Christopher, Wishah Fidaa, Patel Mittun, Cornejo Patricia, Ellsworth Erik, Awerbach Jordan, Goncalves Luis

Keywords: fetal cardiac MRI, congenital heart disease

The purpose of this educational exhibit is to show FCMR images of congenital heart disease (CHD) and anatomical findings associated with CHD. We will describe currently available FCMR image acquisition techniques and use a case-based approach to show a variety of CHD diagnosis with teaching points to highlight the added value of FCMR in diagnosis and prognosis. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Bardo Dianna, Lindblade Christopher, Wishah Fidaa, Cornejo Patricia, Patel Mittun, Ellsworth Erik, Awerbach Jordan, Goncalves Luis

Keywords: Fetal cardiac MRI, congenital heart disease