Gadolinium-enhanced CMR angiography has been demonstrated to be more accurate in the diagnosis of a collateral vessels in comparison to catheter angiography and offers promise to plan transcatheter interventions in those who prove to have clinically significant collateral vessels. Of note, MRA chest has lower spatial resolution compared with CTA chest for small vessels such as the coronary arteries [52]. MRA Neck There is no relevant literature to support the use of MRA neck after stage 3 repair. MRI Heart Function and Morphology CMR is used regularly in addition to echocardiography for long-term monitoring of Fontan patients. MRI for heart function and morphology is helpful in assessment of anatomy, ventricular and valve function, flows, and myocardial fibrosis. It allows for estimating ventricular function, quantifying valvular regurgitation, quantifying pulmonary and systemic blood flow, and aortopulmonary collaterals [54]. Late gadolinium enhancement CMR is used to detect myocardial fibrosis and infarction [55]. Phase-contrast MRA flow measurements in the branch pulmonary arteries are useful for the quantification of differential pulmonary blood flow in the Fontan patient compared with nuclear scintigraphy, due to venous streaming effects on caval flows [53]. Four-dimensional flow, with or without the use of blood pool contrast agents, has been used to simplify, accelerate, and abbreviate the MR scanning protocol in these patients [56]. MRI Heart Function with Stress There is no role for routine performance of vasodilator stress perfusion after stage 3 palliation in single ventricle. There is some evidence that vasodilator stress perfusion MRI can be used to assess latent diastolic dysfunction after stage 3 repair [57,58]. Congenital or Acquired Heart Disease Radiography Chest There is no relevant literature to support the routine use of chest radiography after stage 3 palliation in single ventricle.
Congenital or Acquired Heart Disease. Gadolinium-enhanced CMR angiography has been demonstrated to be more accurate in the diagnosis of a collateral vessels in comparison to catheter angiography and offers promise to plan transcatheter interventions in those who prove to have clinically significant collateral vessels. Of note, MRA chest has lower spatial resolution compared with CTA chest for small vessels such as the coronary arteries [52]. MRA Neck There is no relevant literature to support the use of MRA neck after stage 3 repair. MRI Heart Function and Morphology CMR is used regularly in addition to echocardiography for long-term monitoring of Fontan patients. MRI for heart function and morphology is helpful in assessment of anatomy, ventricular and valve function, flows, and myocardial fibrosis. It allows for estimating ventricular function, quantifying valvular regurgitation, quantifying pulmonary and systemic blood flow, and aortopulmonary collaterals [54]. Late gadolinium enhancement CMR is used to detect myocardial fibrosis and infarction [55]. Phase-contrast MRA flow measurements in the branch pulmonary arteries are useful for the quantification of differential pulmonary blood flow in the Fontan patient compared with nuclear scintigraphy, due to venous streaming effects on caval flows [53]. Four-dimensional flow, with or without the use of blood pool contrast agents, has been used to simplify, accelerate, and abbreviate the MR scanning protocol in these patients [56]. MRI Heart Function with Stress There is no role for routine performance of vasodilator stress perfusion after stage 3 palliation in single ventricle. There is some evidence that vasodilator stress perfusion MRI can be used to assess latent diastolic dysfunction after stage 3 repair [57,58]. Congenital or Acquired Heart Disease Radiography Chest There is no relevant literature to support the routine use of chest radiography after stage 3 palliation in single ventricle.