The role of cardiac magnetic resonance imaging in determination of cardiyovascular anomalies in children and young adults with turner syndrome

INTRODUCTION: Congenital cardiovascular anomalies and aortic dilatation are common in patients with Turner syndrome. The aim of this study was to compare echocardiography findings with cardiovascular anomalies and aortic dilatation identified using magnetic resonance imaging in children and young adults with Turner syndrome.
METHODS: Twenty-six girls with TS aged 11-20 years were recruited through tertiary centers. Cardiovascular anomalies and aortic diameter were evaluated using cardiovascular magnetic resonance imaging (CVMR). Auxological measurements, karyotype analyses, medical therapies (growth hormone, estrogen, and thyroid replacement therapy) and transthoracic echocardiography findings were recorded for all participants.
RESULTS: Normal cardiac anatomy was identified in 16 (61.5%) of our 26 cases, with no cardiac pathology being identified at either CVMR or echocardiography. Cardiovascular anomalies were identified in 5 of the 26 (19.2%) patients at CVMR. Aortic dilatation was determined in four patients (one with descending and ascending aorta, one with ascending aorta, and two with descending aorta). Aortic size index was < 2 cm/m² in all patients. Echocardiography was normal for the three patients with malformation detected at CVMR.
DISCUSSION AND CONCLUSION: CVMR identifies significant cardiac lesions missed by echocardiography in pediatric patients with Turner syndrome, especially aortic dilatation and other vascular anomalies.