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To evaluate the detectability of cardiac septal defects by electrocardiographically synchronized (ECG-gated) magnetic resonance imaging (MRI), 48 subjects were imaged, including 18 normal and 30 abnormal subjects in whom 22 ventricular septal defects (VSDs) and nine atrial septal defects (ASDs) had been diagnosed angiographically. Two radiologists with ECG-gated cardiac MRI experience read the scans in a blinded fashion, and the results were evaluated by receiver operator characteristic curve analysis. The detectability of VSDs appeared greater than that of ASDs, although statistical significance at the .05 level was not achieved. The reported sensitivity and specificity of echocardiography in the detection of VSDs is comparable to MRI, whereas echocardiography probably is superior to MRI for detection of ASDs. Although MRI is potentially valuable in the diagnosis of various complex congenital cardiac defects, echocardiography is probably superior in the detection of VSDs and ASDs.
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