Kardiovaskuläre Magnetresonanztomografie im Kindesalter – klinische Indikationen und Beispiele

Zusammenfassung

Die kardiovaskuläre Magnetresonanztomografie (CMR) erhält zunehmend Einzug in die Routinediagnostik von angeborenen und erworbenen Herzerkrankungen bei Kindern und Jugendlichen. Dabei ergänzt sie die Echokardiografie und stellt bei einigen Indikationen ein alternatives Verfahren zur diagnostischen Herzkatheteruntersuchung dar. Im Gegensatz zur Echokardiografie wird die CMR nicht durch Schallbedingungen limitiert und bietet gegenüber Herzkatheteruntersuchungen zusätzlich den Vorteil einer fehlenden Belastung mit ionisierenden Strahlen. Mit der CMR können Gefäße und Organe des Thorax in jeder gewünschten Orientierung dargestellt und dreidimensionale Bilddatensätze akquiriert werden. Neben der Darstellung der kardiovaskulären Anatomie können auch Untersuchungen der globalen Herzfunktion, Blutflussmessungen, Gewebecharakterisierungen und in jüngerer Zeit auch Untersuchungen der myokardialen Perfusion und Vitalität vorgenommen werden. Diese Möglichkeiten machen die CMR insbesondere bei der Beurteilung von pädiatrischen Patienten mit angeborenen Herzfehlern zu einem wichtigen bildgebenden Verfahren. Der folgende Artikel gibt einen Überblick über die klinischen Indikationen anhand von Beispielen.

Abstract

In today's clinical practice cardiovascular magnetic resonance (CMR) imaging is increasingly used for assessment of congenital and acquired heart disease in children. CMR complements echocardiography and provides a noninvasive alternative to diagnostic cardiac catheterization. In contrast to echocardiography, CMR is not limited by acoustic windows, and unlike cardiac catheterization, CMR lacks ionizing radiation. Contiguous three and four dimensional data sets allow to display cardiac and thoracic vessel anatomy in any desired imaging plane. These characteristics provide unique images for the complete depiction of the pathological anatomy in particular in congenital heart disease. Furthermore CMR is also used for assessment of cardiac function, blood-flow measurements, tissue characterization, and, more recently, for evaluation of myocardial perfusion and viability. The following article reviews CMR indications in pediatric cardiology by means of clinical examples.

Schlüsselwörter

kardiovaskuläre Magnetresonanztomografie - Kinderkardiologie - kardiale Bildgebung - angeborene Herzfehler - erworbene Herzerkrankungen

Key words

cardiovascular magnetic resonance imaging - cardiac imaging - pediatric cardiology - congenital heart disease - acquired heart disease

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