Prospective comparison of echocardiography versus cardiac magnetic resonance imaging in patients with Ebstein’s anomaly

  • Christine H. Attenhofer Jost
  • Whitney D. Edmister
  • Paul R. Julsrud
  • Joseph A. Dearani
  • M. Savas Tepe
  • Carole A. Warnes
  • Christopher G. Scott
  • Nandan S. Anavekar
  • Naser M. Ammash
  • Heidi M. ConnollyEmail author
Original paper


Ebstein’s anomaly (EA) is primarily diagnosed by echocardiography. The purpose of this study was to compare echocardiography and magnetic resonance imaging (MRI) in EA. Data from cardiac MRI and echocardiography were prospectively collected from 16 patients with EA. Imaging data also were compared with intraoperative findings. Information provided by MRI and echocardiography were comparable for left ventricular size and function, tricuspid valve repairability, qualitative assessment of right-sided cavities, and visibility of septal and anterior tricuspid valve leaflets. The posterior tricuspid valve leaflet and tricuspid valve fenestrations were better visualized with MRI; associated heart defects were equally recognized, apart from small shunts that tended to be more readily diagnosed with echocardiography. Quantification of right-cavity size and right ventricular ejection fraction was possible only with cardiac MRI. The degree of tricuspid valve regurgitation was underestimated by echocardiography (2 patients) and by MRI (4 patients) when compared with intraoperative assessment. When evaluating EA, echocardiography and MRI provide complementary data. For visualization of the posterior tricuspid valve leaflet and quantitative assessment of right ventricular size and function, MRI is preferable. For appropriate risk stratification in EA, both MRI and echocardiography should be performed before cardiac surgery.


Ebstein’s anomaly Echocardiography Magnetic resonance imaging Tricuspid valve 



Body surface area


Ebstein’s anomaly


Left ventricle, left ventricular


Left ventricular internal dimension at end diastole


Magnetic resonance imaging


Posterior wall thickness at end diastole


Right ventricle, right ventricular


Septal wall thickness at end diastole


Transesophageal echocardiography


Conflict of interest



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Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • Christine H. Attenhofer Jost
    • 1
  • Whitney D. Edmister
    • 2
  • Paul R. Julsrud
    • 2
  • Joseph A. Dearani
    • 3
  • M. Savas Tepe
    • 2
  • Carole A. Warnes
    • 4
  • Christopher G. Scott
    • 5
  • Nandan S. Anavekar
    • 4
  • Naser M. Ammash
    • 4
  • Heidi M. Connolly
    • 4
    Email author
  1. 1.Cardiovascular Center ZurichZurichSwitzerland
  2. 2.Department of Diagnostic RadiologyMayo ClinicRochesterUSA
  3. 3.Division of Cardiovascular SurgeryMayo ClinicRochesterUSA
  4. 4.Division of Cardiovascular DiseasesMayo ClinicRochesterUSA
  5. 5.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA

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