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Biomedical subjects

K Smolarz

Publications and source records attributed to K Smolarz.

At least 19 recordsLinked to original sources

Survey for neoplasia in Macoma balthica from the Gulf of Gdansk by flow cytometry.

Using flow cytometry, 234 Macoma balthica were examined during a survey to determine frequency of neoplasia in the Gulf of Gdansk (Poland). Clams were collected in 4 locations and DNA content in gill tissue cells was determined by flow cytometry using propidium iodide staining. Cell permeabilization was induced by osmotic shock. Prevalence of neoplasia ranged from 9.6 to 26.7% depending on location. DNA content in aneuploid cells was higher than in normal dividing cells. The fluorescence value for aneuploid cells corresponded to tetraploid/pentaploid cells. Three stages of neoplasia were defined, based on the percentage of aneuploid cells determined by flow cytometry. Histopathological and cytogenetic analyses were also carried out on the same clams for comparative study. Proportions of normal and affected clams detected using flow cytometry were similar to those identified using both methods. In the present study, no clear relationship was demonstrated between prevalence of neoplasia and pollutant detection in the different sampling sites.

Aneuploidy↗

Neoplasia detection in Macoma balthica from the Gulf of Gdansk: comparison of flow cytometry, histology and chromosome analysis.

A flow cytometry protocol was applied for the detection of neoplasia in Macoma balthica L. from the Gulf of Gdansk (Baltic Sea, Poland). A simple method, based on an osmotic shock, was used to permeabilise gill cells. The cytometric pattern of normal clams consisted of 2 peaks, a major peak B and a smaller peak C. The cytometric pattern of affected clams consisted of 2 peaks named B' and C'. Two parameters were used to define the stages of abnormalities in M. balthica clams based on the percentage of cells in peaks B, C, B' and C' and on the ratio between the fluorescence value of peaks B, C, B' and C' in all individuals. Three stages of neoplasia were clearly distinguished by flow cytometry considering peak C'. Stage 1 was characterised by a major population of cells in peak B' and more than 10% of cells in the C' peak. Stage 2 consisted of a lower percentage of cells in peak B' and more than 25% of cells in peak C'. Stage 3 of the neoplasia was characterised by a further reduction in peak B' and more than 40% of cells in peak C'. Flow cytometry allowed for objective detection of neoplasia and provided a rapid method for measuring the DNA content of thousands of cells per individual. The accuracy of flow cytometry was assessed by comparing with standard histological techniques, used here as a reference technique for the detection of neoplasia, and with chromosome analysis. All individuals were analysed in parallel using the 3 techniques. The proportion of normal and affected individuals diagnosed using flow cytometry was comparable to the proportion determined by histology and chromosome analysis.

Analysis of Variance↗

Argyrophilic nucleolar organizer regions (AgNORs) in interphases and metaphases of normal and neoplastic gill cells of Macoma balthica (Bivalvia: Tellinidae) from the Gulf of Gdansk, Baltic Sea.

Chromosome analysis of gill cells of different populations of Macoma balthica (L.) from the Bay of Gdansk (Baltic Sea) revealed 2 clam categories, 1 with neoplastic features and 1 without. Silver-staining was performed on interphase and metaphase cells of both categories. The mean argyrophilic nucleolar organizer region (AgNOR) count per abnormal interphase cell was significantly higher than in normal interphase cells. Normal silver-stained metaphases had 3 nucleolar organizer region (NOR) chromosome phenotypes. The location of the NORs in the most frequent phenotype (55.6% in 54 metaphases scored) was interstitial on the largest metacentric chromosome pair, Pair No. 1. Abnormal silver-stained metaphases had a higher number of active NOR sites. Different phenotypes were observed (frequency greater than 10% for 67 metaphases scored); 2 were similar to those in normal metaphases and 5 were ectopic. The higher activity of AgNORs observed in abnormal cells confirmed the diagnosis of malignant neoplasia.

Animals↗

Identification of hemodynamically significant restenosis after percutaneous transluminal coronary angioplasty in acute myocardial infarction by transesophageal dobutamine stress echocardiography and comparison with myocardial single photon emission computed tomography.

BACKGROUND: Beside thrombolysis, percutaneous transluminal coronary angioplasty (PTCA) has become a well-established treatment for acute myocardial infarction. However, restenosis occurs in approximately 15%-40% of patients. Despite a frequently occurring infarct-related regional systolic dysfunction at rest, the identification of hemodynamically relevant restenosis seems important in terms of risk stratification, adequate treatment, and possible improvement of prognosis in these patients. This study was designed to assess the role of transesophageal dobutamine stress echocardiography and myocardial scintigraphy for identification of hemodynamically significant restenosis after PTCA for acute myocardial infarction. METHODS: Multiplane transesophageal stress echocardiography (dobutamine 5, 10, 20, 30, and 40 micrograms/kg per min) studies and myocardial single photon emission computed tomography (SPECT) studies were performed in 40 patients, all of whom underwent PTCA in the setting of acute myocardial infarction > or = 4 months prior to the test. Repeated coronary angiography was performed in all study patients who showed stress-induced perfusion defects or wall-motion abnormalities, or both. RESULTS: Significant restenosis (> or = 50%) was angiographically found in 15 (37.5%) of 40 patients. Of these 15 patients, transesophageal dobutamine stress echocardiography identified restenosis in 12 (80%) and myocardial SPECT in 14 (93%), yielding diagnostic agreement in 70% of patients. Echocardiographic detection of restenosis was based mainly on a biphasic response to increasing doses of dobutamine. Sensitivity and specificity for identification of hemodynamically relevant restenosis in individual patients was 80% and 92%, respectively for dobutamine stress echocardiography versus 93% and 68% for myocardial SPECT. CONCLUSIONS: Both transesophageal dobutamine stress echocardiography and myocardial SPECT were highly sensitive in identifying significant restenosis after PTCA for acute myocardial infarction. Therefore, either test, as a single diagnostic tool or especially if performed together, are clinically valuable alternatives to coronary angiography for the detection of restenosis after PTCA for acute myocardial infarction.

Acute Disease↗

Hypothyroidism after therapy for larynx and pharynx carcinoma.

Early detection of local and regional recurrence is the main goal during follow-up of patients with larynx and pharynx cancer. Hypothyroidism occurring in those patients stays frequently undiagnosed as screening for hypothyroidism is not part of the routine follow-up. This study was performed to assess the prevalence of hypothyroidism in these patients. We included 120 patients (106 male, 14 female) with larynx or pharynx cancer treated more than 2 months earlier (mean = 41 months) in the study. Cancer treatment consisted of either surgery (n = 44), radiotherapy (n = 15), or surgery combined with postoperative radiotherapy (n = 61). In all patients, thyroid function studies (thyrotropin [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]) were performed. Twenty-six of all patients (22%) were hypothyroid; in two patients hypothyroidism was diagnosed postoperatively and these two patients were on replacement therapy with thyroid hormones. The highest rate of hypothyroidism (34%) was present in patients treated with surgery combined with radiotherapy, whereas among patients treated with surgery only 7% were hypothyroid (p < 0.001). There was no difference in the duration of follow-up between therapy and inclusion in the study between those two groups. Two of 15 patients treated only with radiotherapy were diagnosed hypothyroid, but in this group the latency was shorter (p < 0.05). The results indicate that thyroid function studies should be routinely performed in the follow-up of head and neck cancer patients, especially if radiotherapy was part of the treatment.

Aged↗

Positron emission tomography using 18F-fluorodeoxyglucose in advanced stages of malignant melanoma: a comparison of ultrasonographic and radiological methods of diagnosis.

The diagnostic and therapeutic impact and the cost-effectiveness of positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) will depend on the role for which the tests are used. In 68 patients with advanced malignant melanoma, original sets of FDG-PET images from various institutes were compared with findings obtained by ultrasonography, conventional radiology, computed tomography (CT) and magnetic resonance imaging. In 22 patients, all examinations were undertaken within 2 weeks and strategies of staging were analysed. In 46 patients, only some of these examinations were performed within this time period, and comparison of methods was restricted to the examined organs. The occurrence of metastasis, without specifying the number of foci, was detected by either conventional staging with CT or by PET in 20 of 22 patients. None of these patients were up- or down-staged by FDG-PET compared with CT staging. In the 68 patients as a whole, FDG-PET detected fewer pulmonary and hepatic metastases and fewer cerebral foci, but more lymph node and bone metastases than conventional radiology or CT. For the detection of lymph node or skeletal metastases, false-positive FDG-PET findings were taken into account when compared with follow-up data. In advanced melanoma, FDG-PET did not influence the pattern of subsequent diagnostic testing. Thus, indications for FDG-PET include pre-metastatic melanoma, localized lymph node metastases and monitoring of the response to treatment.

Adolescent↗

[Simultaneous occurrence of Graves' ophthalmopathy and autonomous thyroid nodules].

Estimations regarding the simultaneous occurrence of Graves' ophthalmopathy and autonomously functioning thyroid nodules expect frequencies of 0.05-0.2%. Contrary to these estimated numbers, only 3 patients with these simultaneous manifestations were identified in an out patient thyroid clinic within a period of 10 years. The possible protection by the autonomous thyroid nodules against the manifestations of Graves' disease is discussed.

Female↗

[Influence of disease prognosis and age on the radiation risk from diagnostic nuclear medicine (bone scintigraphy as an example)].

AIM: Of the study was to assess the influence of the patient age and the survival of patients undergoing bone scintigraphy on the calculations of the theoretical lifetime loss. PATIENTS AND METHODS: The evaluated data set included 216 patients undergoing a bone scan for the first time in 1980. From 182 patients a study end point (either the date of death, or existing registration in the German resident office on the 31.12.1995) was obtained. The theoretical life time loss was based on the formalism previously presented by Schicha und Wellner (13). RESULTS: In 74% of the examined patients a malignant disease was present. 28% of the patients had died within one year of the examination. At the end of the follow-up period, of at least 15 years, 58% of the patients were deceased. The theoretical lifetime loss due to radiation exposure within this specified patient group was estimated to be 0.152 d/mSv. Assuming an age distribution of the general population and statistically derived life expectancy, this value should be 0.437 d/mSv. CONCLUSION: The estimates regarding the risk of diagnostic procedures using ionizing radiation should take into account the limited life expectancy of patients in hospitals.

Adolescent↗

Regional 99mTc-methoxyisobutyl-isonitrile-uptake at rest in patients with myocardial infarcts: comparison with morphological and functional parameters obtained from gradient-echo magnetic resonance imaging.

It is not yet clear whether 99mTc-methoxyisobutyl-isonitrile (MIBI)-uptake is a reliable indicator of myocardial viability, and a threshold value, differentiating viable from scarred myocardium, in comparison to a morphological and functional standard of reference has not been defined. MIBI-uptake was quantified in 800 segments from 55 patients with angiographically proven coronary artery disease with and without a history of myocardial infarction. Viable myocardium was defined from gradient-echo magnetic resonance images (MRI) as regions with systolic wall thickening or an end-diastolic wall thickness above the mean value -2.5 SD of a healthy control group (n = 21). Scar was defined as end-diastolic wall thickness > 2.5 SD below the normal mean value and absent systolic wall thickening or wall thinning. Mean MIBI-uptake of viable (n = 676; 79 +/- 14%) and scar segments by MRI (n = 124; 31 +/- 16%) was significantly different (P < 0.001). Segmental MIBI-uptake vs end-diastolic wall thickness (r = 0.7) and systolic wall thickening (r = 0.71) yielded a fair correlation. The highest values as regards sensitivity and specificity of MIBI-uptake in predicting the presence of scar were 89% and 96% respectively for MIBI-uptake < or = 50%. However, of the 136 segments with MIBI-uptake < or = 50%, 26 (19%) were viable by MRI, resulting in a positive predictive accuracy for scar tissue of 81%. Of the 26 segments diagnosed as scarred by MIBI-SPECT but viable by MRI, 25 (96%) were located in the inferoseptal region. MIBI-SPECT seems useful in the detection of viable myocardium after anterior myocardial infarcts, but over-estimates scar in the inferoseptal regions. Perfusion defects in these regions could be confirmed or denied by additional evaluation of myocardial morphology and function by MRI or tissue metabolism by positron emission tomography (PET).

Adult↗

[Magnetic resonance imaging in screening for bone metastasis? A prospective comparison with bone scintigraphy].

To define the value of magnetic resonance imaging (MRI) in screening for bone metastases (BM) compared to bone scintigraphy (BSc) 102 patients with tumours with frequent BM were examined also by MRI of spine, pelvis, femora, and proximal tibiae. All patients had normal BSc and 96 (94%) normal MRI. Only 6% of the patients had focal abnormalities within the bone marrow. This indicates that there is a 94% probability of absence of BM if BSc is normal. Therefore, BSc should currently remain the method of choice for screening for BM. Despite MRI is sensitive and specific, with the common technique up to now it should not be used instead of BSc in screening because of costs, duration, and lack of whole body examination. MRI is a valuable adjunct in equivocal findings in BSc with negative results on radiographs.

Bone Marrow↗

Identification of hemodynamically significant coronary artery stenoses by dipyridamole-magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile-SPECT.

Magnetic resonance imaging (MRI) has been used in conjunction with dipyridamole induced wall motion abnormalities for the noninvasive detection of coronary artery disease (CAD). To assess the clinical usefulness of dipyridamole-MRI for the localization of CAD and to evaluate the relation between dipyridamole induced wall motion abnormalities and myocardial perfusion 33 patients with severe CAD (> 70% diameter reduction) underwent MRI at rest and after dipyridamole infusion (0.75 mg dipyridamole/kg over a period of 10 minutes). All patients performed exercise stress testing and 20 patients of the study group additionally had rest and exercise stress 99mTc-methoxyisobutyl-isonitrile-SPECT (MIBI-SPECT). Two patients (6%) could not be evaluated due to severe motion artifacts during dipyridamole MRI. Segmental wall motion and perfusion of corresponding short axis planes were related to the major coronary arteries using a standardized segmental coronary artery perfusion pattern. Detection of wall motion abnormalities or perfusion defects by 2 blinded observers in consensus was the criterion for grading a segment normal or pathologic. For localization of CAD, segmental gradings were related to the presumed coronary artery territories. Stress-ECG was pathologic in 19/31 patients yielding a sensitivity of 61% and dipyridamole induced angina was present in 68% (21/31) of patients. Dipyridamole-MRI detected coronary artery disease with a sensitivity of 84% (26/31 patients) and all patients with new wall motion abnormalities also had dipyridamole induced angina. For the subgroup of 20 patients with MIBI-SPECT images, CAD was detected by both MIBI-SPECT and Dipyridamole-MRI in 90% (18/20) of patients. Dipyridamole-MRI and MIBI-SPECT gradings agreed in 55/60 (92%) coronary artery perfusion territories. There were no significant differences with respect to the sensitivities of Dipyridamole-MRI/MIBI-SPECT for the localization of individual coronary artery stenoses yielding 81%/78% for left anterior descending, 80%/80% for left circumflex and 92%/89% for right coronary artery stenoses. However, specificity of Dipyridamole-MRI (89%) for the detection of RCA stenoses was slightly better than for MIBI-SPECT (80%).

Coronary Angiography↗

[Dobutamine versus dipyridamole magnetic resonance tomography: safety and sensitivity in the detection of coronary stenoses].

Safety and sensitivity of gradient-echo magnetic resonance imaging (MRI) for the identification of significant coronary artery stenoses using pharmacologic stress testing was assessed in 61 patients with > or = 70% stenosis of a major coronary artery and a normal left ventricle. After MRI at rest 28 patients underwent dobutamine-MRI during steady-state dobutamine infusion (5, 10, 15 and 20 micrograms/kg/min) and 33 patients had dipyridamole-MRI after high-dose dipyridamole infusion (0.75 mg/kg over 10 min). All patients additionally performed standard ECG exercise stress testing (EST). Segmental wall motion analysis was performed in basal and midventricular short axis tomograms by two observers. A segment was graded pathologic if transient dobutamine or dipyridamole induced wall motion abnormalities could be detected. For comparison to coronary angiography findings, each segment was assigned to one of the coronary artery perfusion territories. There were no serious side-effects during dobutamine and dipyridamole infusion leading to termination of the study protocol. Peak double product during dobutamine infusion was significantly higher (p < 0.001) than after dipyridamole infusion (18.493 +/- 4.311 versus 12.799 +/- 2.694 mm Hg/min). Overall sensitivity of dobutamine and dipyridamole-MRI for coronary artery disease (CAD) was 85% and 84%. Regional asynergy by dobutamine and dipyridamole-MRI was observed in 73% versus 79% patients with single- and 100% versus 92% with multi-vessel disease. Individual coronary artery stenoses were correctly identified by segmental wall motion abnormalities in 87% versus 81% for left anterior descending, 62% versus 86% for left circumflex and 78% versus 92% for right coronary artery stenoses. In conclusion, dobutamine and dipyridamole-MRI are well tolerated and safe non-exercise dependent tests for detection and localization of hemodynamically significant coronary artery stenoses with a similar diagnostic accuracy but with a better control of stress intensity and duration provided by dobutamine.

Adult↗

Feasibility of high-dose dipyridamole-magnetic resonance imaging for detection of coronary artery disease and comparison with coronary angiography.

To assess the feasibility, safety and usefulness of gradient-echo magnetic resonance imaging (MRI) combined with pharmacologic stress testing for the detection of coronary artery disease, 23 patients without previous myocardial infarction but with significant stenosis (greater than 70% diameter stenosis) of greater than or equal to 1 major coronary artery were selected for dipyridamole-MRI stress testing. Each patient underwent MRI at rest, and high-dose dipyridamole-MRI (0.75 mg/kg over 10 minutes) of corresponding basal and midventricular short-axis tomograms. Additionally, these patients performed symptom-limited exercise stress tests. All short-axis tomograms were evaluated on a standardized segmental basis by grading each segment as normal, hypokinetic, akinetic or dyskinetic. Dipyridamole-MRI was considered pathologic if segmental wall motion deteriorated by greater than or equal to 1 grade after dipyridamole. For comparison with coronary angiography, segmental wall motion gradings were related to the respective coronary artery territories in the short-axis plane. Pathologic dipyridamole-MRI was obtained in 18 of 23 (78%) patients. For 1- and 2-vessel diseases, sensitivity was 69 and 90%, respectively. Exercise stress tests were pathologic in 14 of 23 (66%) patients. For 1- and 2-vessel diseases, sensitivity of exercise stress test was 58% (7 of 12 patients) and 77% (7 of 9), respectively. Sensitivity/specificity of dipyridamole-MRI for the localization of the stenosed coronary artery was 78/100% for left anterior descending, 73/100% for left circumflex, and 88/87% for right coronary artery stenoses. It is concluded that dipyridamole-MRI is a feasible nonexercise-dependent test for detection and localization of functionally significant coronary artery disease.

Aged↗

Chronic myocardial infarction: assessment of morphology, function, and perfusion by gradient echo magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile SPECT.

To assess the ability of magnetic resonance imaging (MRI) to identify the anatomic and functional abnormalities associated with completely scarred myocardium, 20 patients with chronic transmural myocardial infarction confirmed by electrocardiography and cineventriculography were examined by gradient echo MRI. Myocardial perfusion at rest was assessed in corresponding transverse sections using 99mTc-methoxyisobutyl-isonitrile single-photon emission computed tomography (MIBI-SPECT). MRI scar was defined as diastolic wall thickness (DWT) 2.5 SD below corresponding normal values or systolic wall thickening (delta WT) less than or equal to 1 mm. For MIBI-SPECT images, scar was defined as a MIBI uptake less than 2.5 SD below normal values. By MIBI-SPECT, 152 segments contained normal tissue and 88 contained scarred myocardium. In 226 of 240 (94%) segments, MRI gradings by DWT and MIBI-SPECT gradings were identical. DWT by MRI was higher in normal than in scarred MIBI-SPECT segments (10 +/- 1 versus 4 +/- 2 mm, p less than 0.001). In 230 of 240 (96%) segments, MRI gradings by delta WT and MIBI-SPECT gradings were identical. Segments graded normal by MIBI-SPECT showed higher delta WT by MRI than scar segments (5 +/- 1 versus 0.3 +/- 1 mm, p less than 0.001). MIBI-SPECT perfusion defect size and regions with reduced DWT on MRI tomograms correlated well (r = 0.85). This study indicates that myocardial regions fulfilling electrocardiographic and ventriculographic criteria for transmural myocardial scar are clearly depicted by regional diastolic wall thinning and delta WT less than or equal to 1 mm on gradient echo MR images.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Magnetic resonance tomography image of transmural myocardial infarct in comparison with 99mTc-methoxyisobutylisonitrile SPECT].

To assess the ability of magnetic resonance imaging (MRI) to identify morphologic and functional abnormalities associated with transmural anterior and inferior myocardial infarction, 18 patients with anterior myocardial infarcts and 11 patients with inferior myocardial infarcts confirmed by ECG and cine-ventriculography underwent gradient-echo MRI of transverse and short-axis imaging planes. Myocardial perfusion of corresponding imaging planes was measured by 99mTc-methoxyisobutyl-isonitrile single-photon emission computed tomography (MIBI-SPECT). Transmural scar by MRI was defined as diastolic wall thickness 2.5 SD below corresponding normal values of a healthy control group (n = 21). MIBI-SPECT scar was defined as a MIBI uptake less than 2.5 SD below mean values of a healthy control group (n = 11). By MIBI-SPECT, 231 segments contained normal tissue and 161 contained scarred myocardium. In 352/392 (90%) segments gradings based on diastolic wall thickness and MIBI-SPECT gradings were identical. Diastolic wall thickness was significantly higher in normal than in scarred MIBI-SPECT segments (10.3 +/- 1.5 vs 5.2 +/- 2 mm, p less than 0.0001). Additionally, normal segments by MIBI-SPECT showed significantly higher systolic wall thickening than scar segments (5.5 +/- 1.5 vs 0.6 +/- 1.6 mm, p less than 0.0001). The correlation between MRI and MIBI-SPECT assessed infarct size was r = 0.91 for anterior and r = 0.77 for inferior myocardial infarcts. The agreement between MIBI-SPECT perfusion defect size and regions with reduced diastolic wall thickness on MRI tomograms was significantly better for anterior myocardial infarcts than for inferior myocardial infarcts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Effort-induced myocardial wall motion abnormalities in the magnetic resonance tomogram: a comparison with effort MIBI SPECT].

In 20 patients with an angiographically documented coronary artery stenosis of > or = 70% and normal LV function at rest MRI was performed before and after dipyridamole infusion (0.75 mg/kg BW). In all patients MIBI-SPECT was obtained at rest and after dynamic symptom-limited exercise. In 18 patients MIBI-SPECT showed ischemia and in 18 patients dipyridamole MRI showed a wall motion impairment. In the segments representing the 29 stenosed vessels ischemia in MIBI-SPECT was diagnosed correctly in 24 instances (sensitivity 83%, specificity 90%) and a wall motion abnormality was present in MRI in 23 instances (sensitivity 79%, specificity 90%). Dipyridamole GE-MRI is not superior to MIBI-SPECT in the diagnosis of ischemia.

Aged↗

[Assessment with magnetic resonance tomography of anatomy and ventricular function after Mustard correction of transposition of the great arteries].

In order to evaluate postoperative sequelae and ventricular function after Mustard-operation in patients with transposition of the great arteries (TGA), 30 patients were assessed by magnetic resonance imaging in EKG-triggered spin-echo (SE) and gradient-echo (GE) technique. Twenty-three patients, aged 4.7 to 15.8 years, had transposition of the great arteries with intact ventricular septum with or without left-ventricular outflow tract obstruction (TGA+IVS +/- SPS). Seven patients aged 9.5 to 21.7 years had transposition of the great arteries with ventricular septal defect (TGA+VSD). Five patients showed a residual baffle leak, one had a pulmonary venous obstruction, five an obstruction at the caval veins, 13 a left-ventricular outflow tract obstruction, and 14 a tricuspid regurgitation. Right-ventricular enddiastolic volume in patients with TGA+VSD (77.0 +/- 25.5 ml/m2) was significantly higher than in patients with TGA+IVS +/- SPS (61.2 +/- 12.0 ml/m2). In TGA+VSD right-ventricular ejection fraction (47.6 +/- 13.0%) was significantly lower than in patients with TGA+IVS +/- SPS (56.7 +/- 10.7%). The ratio of muscle masses of right to left ventricle was 1.8:1 in patients with TGA+IVS +/- SPS and 2.5:1 in patients with TGA+VSD. In conclusion, after Mustard-operation in patients with transposition of the great arteries (TGA) magnetic resonance imaging provides a comprehensive and noninvasive assessment of postoperative sequelae, residuae, and ventricular function and will, therefore, become the method of choice for postoperative evaluation.

Child, Preschool↗