Imaging

Patent Ductus Arteriosus

Preliminary Diagnosis: Patent Ductus Arteriosus

I. What imaging technique is first-line for this diagnosis?

  • Echocardiograph

II. Describe the advantages and disadvantages of this technique for diagnosis of patent ductus arteriosus.

Advantages

  • Highly portable

  • Does not expose patients to ionizing radiation

  • Offers exquisite detail of the cardiac chambers, valvular structures, and great detail of the cardiac and great vessel pressure measurements.

  • Offers dynamic imaging of the heart

Disadvantages

  • Highly operator dependent.

  • Less adept in detailing the surrounding soft tissues, vasculature, and osseous structures than other imaging modalities

III. What are the contraindications for the first-line imaging technique?

  • No specific contraindications to echocardiography exist.

IV. What alternative imaging techniques are available?

  • PA and lateral plain radiograph of the chest

  • Cardiac MR utilizing a cardiac gating technique

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of patent ductus arteriosus.

PA and lateral plain radiograph of the chest

Advantages

  • Highly portable imaging modality

Disadvantages

  • Severely limited in sensitivity and much more limited in specificity in detecting and diagnosing a PDA

  • Offers poor evaluation of the surrounding cardiac chambers, valvular structures, and surrounding soft tissues

Cardiac MR utilizing a cardiac gating technique

Advantages

  • Highly specific and sensitive in detecting cardiac chamber and valvular abnormalities

  • Offers dynamic imaging of the heart and associated cardiac wall motion and valvular motion

Disadvantages

  • Must be cardiac gated to eliminate motion artifact

  • May be subject to susceptibility-weighted artifact

  • Less adept in characterizing and detailing the surrounding osseous structures

VI. What are the contraindications for the alternative imaging techniques?

PA and lateral plain radiograph of the chest

  • No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.

Cardiac MR utilizing a cardiac gating technique

  • May be contraindicated in patients with non–MR-compatible hardware

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