MRI vs Echo vs Cath

[Brent]

MRI vs Echo vs Cath
I understand how Doppler echo can visualize
flowmetrics using false coloration.  This, in
itself, is a less "direct" method than X-ray
based catheterization with contrast media.

I was recently subjected to a Cardiac MRI, which
was arguably the most unpleasant and tortuous
exams I have ever undertaken.  My question is,
for multiple fenestrations or perimembraneous
defect search, how can MRI be definitive and
preferable to direct Catheterization for anatomic
shunt search and evaluation?  I know it is
non-invasive, but it is highly "detached" from
the underlying real-time phenomenon. Thanks.

[CCF CARDIO MD JMF]

Glad to be of some assistance.

[Brent]

Thanks.  That was my assessment.  This
is Children's Hospital, and I feel like
I'm being taken for a ride.  You are
absolutely correct, and I have a surgeon
straining at the leash to have his Cath
done, while the Cardios want to stay
"non-invasive".  IMHO, this is nonsense,
especially after a long history of complaints
and echo data suggesting shunt.
THANKS.

[CCF CARDIO MD JMF]

Catheterization is still the gold standard for evaluating the functional significance of a VSD or shunt.  

You are correct in your assessment.  MRI however, will likely become a very useful too in the near future as flow mechanics are visualized via computer modelling.