Boston Children’s Hospital has long been a world leader in cardiac imaging of congenital and pediatric heart disease. Our team is committed to providing the highest-quality clinical care to patients, training the next generation of experts in cardiac imaging, and developing novel approaches to diagnostics and therapy.
The Division of Cardiac Imaging, led by Andrew Powell, MD, is among the largest, most advanced programs in the world. It includes 21 physicians, all specifically trained in cardiac imaging in congenital and acquired pediatric heart disease, and a broad range of clinical and research interests.
Patient-centered, multimodal approach
Clinical care is driven by a patient-centered, multimodal approach to diagnostic imaging that considers the goals and safety considerations of each situation. With expertise in all imaging modalities, the team ensures that each patient receives the right test at the right time with the right technique.
Broad depth of expertise
The team is uniquely equipped to meet the imaging needs of both children and adults, providing a full range of imaging modalities.
- Echocardiography: The echocardiography lab performs about 25,000 echocardiograms each year, including transthoracic, transesophageal, stress and fetal echocardiograms, utilizing the latest cardiac ultrasound techniques.
- Cardiac MRI: The cardiac MRI program performs about 1,200 examinations each year on a scanner dedicated to cardiovascular imaging and research.
- Cardiac CT: The cardiac CT program performs about 300 examinations each year using advanced dual-source CT scanners. This technology delivers stunning image quality with lower x-ray doses and less frequent use of sedation than previously available.
Leading-edge research and innovation
The division’s mission is to continuously improve the treatment of patients with congenital heart disease and to advance the complex science that underlies these treatments. To that end, team members are focused on advancing imaging technology and its applications for use in pediatric cardiac medicine. Here’s a sample of current research:
Myocardial strain imaging in echocardiography
David Harrild, MD, PhD, is leading a project to apply myocardial strain imaging in the echocardiography laboratory to better evaluate left and right ventricular function. The team has gathered strain data in 400 healthy children to establish a normal range. They are now applying this technique to patients with the goal of detecting the onset or progression of dysfunction earlier compared to traditional measurements such as ejection fraction. Patients who may benefit from this research include those with cardiomyopathies, hypertrophied or globular hearts, single ventricles and contraction dyssynchrony (such as can be seen following pacemaker implantation).
Comprehensive whole-heart 3-D MRI
In the MRI program, Mehdi Hedjazi Moghari, PhD, has developed a technique to produce moving 3-D images of the heart. “3-D cine” allows cardiologists and cardiac surgeons to see a patient’s heart from any angle and observe its movement throughout the entire cardiac cycle. Combined with a matching set of 3-D velocity data, a comprehensive evaluation of cardiac and vascular function can be performed in 20 minutes. This whole-heart 3-D method is easier to perform and more comfortable for the patient compared to the traditional 2-D techniques. A multicenter trial of this innovative approach is now underway.
Cardiac CT to identify coronary artery compression by epicardial pacemaker and defibrillator leads
Douglas Mah, MD, and Puja Banka, MD, have recently reported a significantly higher rate of coronary artery compression from epicardial pacemaker leads than previously described, with an associated risk of sudden death, cardiac strangulation, troponin leak and cardiac dysfunction. Cine cardiac CT imaging using the now-available advanced scanners have allowed the team to identify patients with important coronary compression non-invasively. These findings were recently accepted for publication (Mah DY, Prakash A, Porras D, Fynn-Thompson F, DeWitt ES, Banka P. “Coronary artery compression from epicardial leads: More common than we think.” Heart Rhythm, 2018, in press) and have led to more careful screening of patients with epicardial pacing systems who may benefit from revision of their leads.