Noninvasive assessment of atrial septal defects and anomalous connection of pulmonary veins with MR imaging

Spin-echo (SE) MR imaging (N = 25) and gradient-echo (GE) MR imaging (N = 15) were performed in 25 patients with angiographically (N = 25) verified atrial septal defect (ASD). Type of ASD was correctly identified in 23 of 25 patients on SE images. Anomalous return of pulmonary veins was demonstrated in all five patients. Demonstrating shunt flow by GE MR imaging was useful in small ASDs that were not identified on SE images. With the use of both MR imaging methods, all ASDs were correctly diagnosed. Distinction of pulmonary veins from surrounding tissues also was facilitated by GE MR imaging. Shunt volumes determined by GE MR imaging in nine patients correlated well with angiographic values (r = .95). Combined SE and GE MR imaging characterizes the anatomic and functional abnormalities in ASD, including anomalous pulmonary vein connections