[Comparison of magnetic resonance imaging, echocardiography and catheterization in the diagnosis of congenital heart diseases]. / Evaluation comparée de l'IRM, de l'échocardiographie et du cathétérisme pour le diagnostic des cardiopathies congénitales.

The authors compared the diagnostic value of magnetic resonance imaging (MRI), echocardiography and cardiac catheterisation with angiography in 66 patients with congenital heart disease, to determine a diagnostic strategy in the use of these methods of cardiac imaging. The patients were 8 days to 44 years old. The congenital cardiac malformations were classified in three groups: 29 isolated vascular malformations (Group 1), 17 isolated intracardiac malformations (Group 2) and 20 complex malformations (Group 3). MRI was performed in all patients using a high field (1.5 tesla) magnet and spin-echo sequences in multiple incidences. The results were compared with those of echocardiography in 60 patients and/or cardiac catheterisation in 39 cases. Technical evaluation of MRI showed images of diagnostic quality in 62/66 cases (93.9%). MRI provided a diagnostic contribution in 56 cases (85%) which was less important in intracardiac malformations than in the other groups (p less than 0.05). In comparison with other imaging techniques, globally, the diagnostic value of MRI was lower than that of cardiac catheterisation (p less than 0.005) but there was no significant difference between MRI and echocardiography. When the type of malformation was taken into account, MRI was not as useful as catheterisation and echocardiography for the diagnosis of isolated intracardiac malformations (p less than 0.01) but gave comparable results in other malformations. On the other hand, MRI associated with echocardiography was more useful (p less than 0.05) than catheterisation in the diagnosis of complex congenital lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

[Lateral tracheal indentation or compression by the brachiocephalic arterial trunk in children]. / Empreinte ou compression trachéale latérale due au tronc artériel brachio-céphalique chez l'enfant.

Three cases of compression of the right wall of the trachea by buckling of the innominate artery in childhood are described. A coarctation of the thoracic aorta is associated in two cases, and a left cervical aortic arch in the third one. In one case, a severe tracheomalacia occurs following the surgical repair of the associated coarctation. This lateral indentation of the trachea is suggestive of right aortic arch but the absence of posterior oesophageal indentation excludes the diagnosis. Angiography is helpful and echography is unable to demonstrate the vascular origin of the tracheal compression. The authors analyse the correct diagnostic approach, emphasize the risk of tracheomalacia and the high rate of associated cardio-vascular malformations.