Pediatric cardiovascular imaging.

Cardiovascular imaging in children has stressed acquisition of information with the least possible stress to the child. Improvements in noninvasive imaging have now largely supplanted the use of invasive techniques for diagnostic imaging. During the past year, major improvements in the diagnosis of complex cardiac malformations have occurred together with the extension of such techniques to the operating room. This review focuses on improvements in echocardiography, color flow imaging, and magnetic resonance in the imaging of complex cardiovascular defects, both intra- and extracardiac. Imaging of abnormalities of the atrioventricular region, intracardiac and coronary artery fistulae, homograft valved conduits, and pulmonary artery anatomy is discussed. The use of magnetic resonance imaging for the evaluation of pulmonary artery anatomy, ventricular septal defects, and aortic arch abnormalities is reviewed, as is the use of magnetic resonance imaging in small infants. Finally, the use of both epicardial and transesophageal echocardiography in the operating room for evaluation of the adequacy of surgical repair is reviewed. These studies demonstrate the ability of these techniques to provide information critical for the proper management of children undergoing cardiac surgery.