Norihiko Yoshimura MD, PhD, Presenter: Nothing to Disclose

Yoshiro Hori, Abstract Co-Author: Nothing to Disclose

Yousuke Horii, Abstract Co-Author: Nothing to Disclose

Keisuke Sasai, Abstract Co-Author: Nothing to Disclose

To clarify MRI findings of coronary cusp prolapse (CCP) complicated with ventricular septal defect (VSD) and to compare these with transthoracic echocardiography (TTE).

Forty eight patients with VSD and suspected CCP were retrospectively reviewed. Duration between MRI and TTE was less than six months. Surgical correction of VSD was performed in 23patients. The MRI scanner was a 1.5 T, Siemens, Magnetom Vision. Scanning protocols were ECG-gated T1WI spin echo and ECG-gated cine gradient echo. Trans-axial images that included the aortic valve and ventricular septum were obtained by spin echo. Long axis and short axis images of the aortic valve were obtained by cine gradient echo. TTE was performed by pediatric cardiologists. On spin echo images, deviations of the right CCP and non-CCP were evaluated. On cine gradient echo images, deformities of the right CCP were evaluated, as were protrusions of non-CCP into the left ventricular outflow tract. Patients with positive findings by at least one image protocol were diagnosed as CCP. The positive ratio in each CCP was compared between MRI and TTE using a 2 x 2 Chi-square test. In the 23 patients who were operated on, the corresponding ratio between MRI and TTE was compared between type 1 and type 2 VSD using the 2 x 2 Chi-square test. P<0.05 was considered significant.

Forty-four patients showed positive MRI findings (39 right CCP, 2 non-CCP, and 3 both CCPs). TTE showed 41 CCP (41 right CCP and no non-CCP). MRI showed a significantly higher positive ratio of non-CCP. Of the 23 patients who were operated on, 17 were type 1 VSD. All type 1 VSD patients showed positive findings on both MRI and TTE. The corresponding ratio between MRI and TTE was significantly lower for type 2 VSD than for type 1.

MRI showed a significantly higher positive ratio of non-CCP. For type 2 VSD, the corresponding ratio between MRI and TTE was significantly lower than that for type 1.

MRI and TTE have a complementary role in the diagnosis of coronary cusp prolapse complicated with VSD.

Yoshimura, N, Hori, Y, Horii, Y, Sasai, K, Comparison of MRI Findings of Coronary Cusp Prolapse with Transthoracic Echocardiography.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005416.html