Heart imaging guidelines could improve survival odds for sick children
European pediatric radiologists have updated best practices for diagnosing rare heart diseases in children using MRI scans. The guidance matters because these conditions are the leading reason children need heart transplants—and better early detection could change treatment decisions and outcomes.
Originaltitel: Magnetic resonance imaging of cardiomyopathies in children: Update by the European Society of Pediatric Radiology Cardiac Imaging Taskforce
Cardiomyopathies are rare diseases in children but are the primary indication for heart transplantation in this age group. Various causes of paediatric cardiomyopathies, ranging from gene-mediated to underlying infection or systemic disease, result in a wide spectrum of clinical presentations and imaging manifestations. Over the years, the classification and terminology of cardiomyopathy have evolved in children and are currently primarily based on the imaging phenotype (dilated, hypertrophic, and restrictive) and then subdivided based on pathogenesis, organ involvement, genetic or familial inheritance pattern, and aetiology. Dilated and hypertrophic cardiomyopathies are more common than non-compaction, restrictive, and arrhythmogenic cardiomyopathies. Echocardiography remains the first-line modality for functional and structural cardiac assessment. However, cardiac magnetic resonance imaging enhances diagnostic accuracy, provides serial cardiac functional evaluation and tissue characterization, and facilitates individual risk stratification and management in patients with heterogeneous phenotypes. This review provides an overview of paediatric cardiomyopathies with a focus on magnetic resonance imaging indications, technique, and key imaging findings that influence management decision-making.