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State of the Art: Pediatric Cardiac MRI

State of the Art: Pediatric Cardiac MRI. Neil Mardis, DO Assistant Professor Radiology Children’s Mercy Hospital University of Missouri, Kansas City. Pediatric cMRI. When to order What does it involve Where and when we offer study What you get Who is not a candidate. When to order?.

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State of the Art: Pediatric Cardiac MRI

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  1. State of the Art:Pediatric Cardiac MRI Neil Mardis, DO Assistant Professor Radiology Children’s Mercy Hospital University of Missouri, Kansas City

  2. Pediatric cMRI • When to order • What does it involve • Where and when we offer study • What you get • Who is not a candidate

  3. When to order? Pediatric cMRI

  4. Pediatric cMRI • When? • When patient has complex congenital heart disease which requires more information than echocardiography • Best to discuss case with Cardiologist who manages patient • Coordinated and scheduled through Cardiology • When patient has risk for coarctation or other aortic anomaly • Turners • Noonans • Marfans

  5. Pediatric cMRI • When? • When there is concern for ARVD • Typically referred from Cardiology

  6. What does it involve? Pediatric cMRI

  7. Pediatric cMRI • What does it involve? • 1-2 hours of scanning time

  8. Pediatric cMRI • What does it involve? • Possibly sedation/anesthesia • Always administered and supervised by Anesthesia Department • Older children can often go without sedation

  9. Pediatric cMRI • What does it involve? • Multiple breath holds by patient • Often times IV gadolinium

  10. Where and when is it offered? Pediatric cMRI

  11. Pediatric cMRI • Where is it offered? • Main campus • Always supervised and directed by a Radiologist • Access to Sedation team

  12. Pediatric cMRI • When is it offered? • Tuesday for all complex congenital disease • Monday through Friday for limited aortic cases

  13. What do you get? Pediatric cMRI

  14. Pediatric cMRI • What do you get? • High resolution anatomic images

  15. Pediatric cMRI • What do you get? • Real-time assessment of wall motion and blood flow

  16. Pediatric cMRI • What do you get? • Functional data • Ventricle • Stroke volume • Cardiac output • Ejection fraction

  17. Pediatric cMRI • What do you get? • Functional data • Great vessels/valves • Flow velocity • Flow direction

  18. Pediatric cMRI • What do you get? • Functional data • Great vessels/valves • Flow velocity • Flow direction

  19. Who is not a candidate for cMRI? Pediatric cMRI

  20. Pediatric cMRI • Who is not a candidate? • Pacer dependant patients • Any patient with a typical contraindication to MRI • Surgical/orthopedic implant of unknown type • VNS • What is okay for MRI? • Sternal wires • Vascular stents/coils of known brand • Any implant we have adequate safety data on

  21. Summary Pediatric cMRI

  22. Pediatric cMRI • Summary • Great modality for assessing anatomic and functional aspects of congenital heart disease • Available downtown • When in doubt consult cardiology

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