New Cardiac Imaging Method Directly Visualizes Pediatric Heart Defects, With Matthew Jolley, MD

Clinicians at the Children’s Hospital of Philadelphia have developed a new magnetic resonance imaging (MRI) technique to view both heart tissue and blood flow simultaneously, allowing direct visualization of heart defects.1

Volume rendering, a rapid visualization technique applied to see the blood pool in cardiac MRI images, is routinely used to visualize the myocardium and cardiac valves in 3D echocardiography and cine CT. Cardiac MRI-based valve evaluation is often complementary, especially in conditions with limited acoustic windows.2

“That information was there, but nobody had put together the ability to visualize both at the same time in a rapid or near-instant manner,” Matthew Jolley, MD, Topolewski Endowed Chair in Pediatric Cardiology at Children’s Hospital of Philadelphia, told HCPLive in an exclusive interview. “So, we worked together in teams consisting of both clinicians and engineers to use a technique called volume rendering to visualize both.”

Jolley and colleagues conducted a retrospective study to evaluate the efficacy of this new technique. A total of 4 pediatric patients with complex congenital heart disease were enrolled in the study, all of whom underwent clinically indicated cardiac MRI between April 2023 and January 2025. These patients were identified via a search of the Children’s Hospital of Philadelphia’s institutional imaging database.2

Investigators reported that the parsing and loading of DICOM files took between 100 and 150 seconds, and converting these into a 5-dimensional array took between 10 and 15 seconds. Velocity vector component images were then processed with automatic phase unwrapping and bias correction in 5 to 10 seconds. Rendering ultimately took less than 0.5 seconds after loading the DICOM image into 3D Slicer.2

In Patient 1, who had aortic valve insufficiency and aortic valve stenosis and had undergone MUSIC cardiac MRI to evaluate aortic regurgitation in consideration of valve repair or replacement, Jolley and colleagues’ new volume rendering technique was found to be both visually analogous and complementary to existing echocardiography data.2

Patient 2 exhibited situs inversus segmental anatomy {I, D, X}, right ventricle to aorta pulmonary atresia, discontinuous pulmonary arteries, and malaligned ventricular septal defects. Investigators believed that the path from the left ventricle to the aorta could be occluded by tricuspid valve tissue and chords. Following the MRI, a virtual baffle was placed to inform surgical planning.2

Patient 3 exhibited multiple complex ventricular septal defects, undergoing navigation cardiac MRI to visualize the anatomy of these defects. Ultimately, the visualization was used to model the placement of a virtual patch to close the conoventricular VSD. Finally, patient 4 had a history of Taussig-Bing type double-outlet right ventricle after arterial switch operation and presented with neoaortic valve regurgitation from a moderate central coaptation defect. After imaging, investigators found that the visualizations were similar and complementary to an echocardiogram.2

Ultimately, Jolley and colleagues determined that further development is crucial to avoid issues such as the varying quality of cardiac MRI images. Additionally, other devices, such as photon-counting detector CT scanners, can provide similar results at a potentially decreased radiation exposure compared to traditional scanners.2

“We are visualizing data that has existed in a new way. That said, many of these image acquisitions are novel and allowing this visualization to be more impactful,” Jolley said. “I think that further development of both the acquisitions and refinement of those acquisitions, in concert with further development of visualization methods, will realize the true potential of this technique. We’re just scratching the surface.”

Editor’s Note: Jolley reports no relevant disclosures.

References

1. Brooks L. 3D MIR technique guides precision treatment of kids’ heart conditions. Eurekalert. February 12, 2026. Accessed February 24, 2026. https://www.eurekalert.org/news-releases/1116035

2. Iacovella J, Vaiyani D, Pressley S, et al. Rapid visualization of valves and myocardium using volume rendering of 3D cardiac MRI, 4D CINE, and 4D flow images. Radiology: Cardiothoracic Imaging. 2026;8(1). doi:10.1148/ryct.250129