Pediatric cardiology at Siriraj Hospital: past, present and future.

The incidence of congenital heart disease (CHD) at Siriraj Hospital for the year 2000 was 4.36 patients per 1,000 livebirths. Types of congenital heart diseases seen by the authors were VSD (18.3%), PDA (16.3%), ASD (16.3%), combined simple left to right shunt lesion (24.7%), tetralogy of Fallot (TF; 6%), D-TGA 2 per cent, other complex congenital heart 8 per cent. Overall 3 out of 1,000 livebirths will have congenital heart disease that will require immediate intervention including cardiac catheterization and surgical intervention. At the same period of time an average of 750 new cases of children were referred annually for evaluation and treatment of cardiac related problems. Reports of acquired heart disease such as acute rheumatic fever, myocarditis, Kawasaki's disease and arrhythmia problem were summarized here. The Division of Pediatric Cardiology performs both diagnostic and intervention cardiac catheterization in almost 310 children and adults with congenital heart disease yearly. Out of this 35 per cent had interventional procedures including balloon valvuloplasty, balloon angioplasty and stenting, device closure of atrial septal defect and patent ductus arteriosus and radiofrequecy ablation of abnormal conduction pathway. Major progress has been made in pediatric cardiac imaging over the past two decades. At Her Majesty's Cardiac Center, cardiac MRI has been used to evaluate patients with congenital heart disease since June 2000. There were 146 congenital heart disease patients who had cardiac MRI performed for the evaluation of anatomy, function, left to right shunt, and flow regurgitation quantification. Conclusion: Pediatric Cardiology practice has evolved over the past decade and expanded from clinical practice to therapeutic intervention procedures.

Angioresonancia magnética de tumores de cabeza y cuello

En el presente artícilo se describen las técnicas de angiografía por resonancia magnética y se muestran 7 casos de tumores de cabeza y cuello en los cuales se considera útil esta técnica tanto para su diagnóstico como para la toma de decisiones terapeúticas. Se describen 3 pacientes con meningioma 1 paciente con glomus yugolotimpánico, 1 paciente con cordoma, 2 pacientes con macroadenoma invasivo uno de ellos con un glomus carotídeo asociado.

Angiografía por Resonancia Magnética con un equipo de campo ultra bajo / MR angiography with an ultra low field equipment

Se presenta el desarrollo de una versión de software en etapa beta test, con una secuencia para la Angiografía por Resonancia Magnética, utilizando la técnica de Phase test, en un equipo de campo ultra bajo (0,064 Telsa), con imán permanente, de tipo vertical, abierto (Access, Toshiba, Toshiba America Inc., South San Francisco). El software provisto por Toshiba America, se encuentra en el período de Beta Test. (Testeo clínico, previo a la aprobación, dependiente de la FDA, para la comercialización del producto). El equipo es un resonador magnético a imán permanente, vertical y abierto, de campo ultra bajo = 0.064 Telsa. Los pacientes estudiados, en un período de tres meses, mayo a julio de 1994, fueron todos sujetos voluntarios, sanos, libres de enfermedad, y pacientes con diagnóstico clínico de enfermedad vascular cervical y/o cerebral. Los resultados demuestran que la secuencia de Phase Contrast, para la obtención de imágenes de los vasos del cuello y de la irrigación cerebral, presenta muy buena calidad de imagen, muy buena certeza diagnóstica, con buena reproducción de la anatomía y la patología. La Angiografía por Resonancia Magnética es un excelente método, no invasivo, para el estudio de la enfermedad vascular en el cuello y cerebro. La secuencia desarrollada, demuestra el potencial de los equipos de campo bajo en este terreno

Comparison of MR angiography with contrast angiography for the diagnosis of carotid artery stenosis.

To assess the accuracy of MR angiography for screening vascular stenosis of the extracranial carotid arteries, 20 consecutive patients with suspected extracranial carotid atherosclerotic disease were evaluated with time-of-flight MR angiography and intra-arterial contrast angiography. Both studies were independently reviewed by three observers in a blinded manner. The internal carotid arteries were graded as either normal or mildly stenotic (0%-29%), moderately stenotic (30%-69%), severely stenotic (70%-99%) or occluded. Results of the study indicate that time-of-flight MR angiography has a high rate of agreement with contrast angiography and is an accurate screening technique of the common carotid bifurcation in patients with suspected carotid stenosis.