Preliminary Diagnosis: Patent Ductus Arteriosus
I. What imaging technique is first-line for this diagnosis?
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Echocardiograph
II. Describe the advantages and disadvantages of this technique for diagnosis of patent ductus arteriosus.
Advantages
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Highly portable
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Does not expose patients to ionizing radiation
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Offers exquisite detail of the cardiac chambers, valvular structures, and great detail of the cardiac and great vessel pressure measurements.
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Offers dynamic imaging of the heart
Disadvantages
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Highly operator dependent.
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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?
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No specific contraindications to echocardiography exist.
IV. What alternative imaging techniques are available?
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PA and lateral plain radiograph of the chest
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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
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Highly portable imaging modality
Disadvantages
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Severely limited in sensitivity and much more limited in specificity in detecting and diagnosing a PDA
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Offers poor evaluation of the surrounding cardiac chambers, valvular structures, and surrounding soft tissues
Cardiac MR utilizing a cardiac gating technique
Advantages
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Highly specific and sensitive in detecting cardiac chamber and valvular abnormalities
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Offers dynamic imaging of the heart and associated cardiac wall motion and valvular motion
Disadvantages
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Must be cardiac gated to eliminate motion artifact
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May be subject to susceptibility-weighted artifact
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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
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No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.
Cardiac MR utilizing a cardiac gating technique
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May be contraindicated in patients with non–MR-compatible hardware
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