Compact pediatric cardiac magnetic resonance imaging protocols

Abstract

Cardiac MRI is in many respects an ideal modality for pediatric cardiovascular imaging, enabling a complete noninvasive assessment of anatomy, morphology, function and flow in one radiation-free and potentially non-contrast exam. Nonetheless, traditionally lengthy and complex imaging acquisition strategies have often limited its broader use beyond specialized centers. In this review, the author presents practical cardiac MRI imaging protocols to facilitate the performance of succinct yet successful exams that provide the most salient clinical data for the majority of congenital and acquired pediatric cardiac disease. In addition, the author reviews newer and evolving techniques that permit more rapid but similarly diagnostic MRI, including compressed sensing and artificial intelligence/machine learning reconstruction, four-dimensional flow acquisition and blood pool contrast agents. With the modern armamentarium of cardiac MRI methods, the goal of compact yet comprehensive exams in children can now be realized.

Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI

“…CHD affects an estimated 1% of live births, posing a significant health challenge during childhood [ 57 ]. The merits of using MRI in pediatric CHD are well-established.…”

MR imaging of primary benign cardiac tumors in the pediatric population

“…Breath hold acquisitions are more achievable in patients older than 7 years or under general anesthesia, since they can be guided in intubated patients [ 32 ]. As an alternative, sedation and/or free-breathing sequences can be an option.…”

“…As an alternative, sedation and/or free-breathing sequences can be an option. Changes in acquisition parameters are needed for free breathing imaging in order to avoid artifacts [ 32 ], such as increasing signal averages (to 2–3) and using respiratory navigator sequences triggered at end expiration.…”

Ferumoxytol-Enhanced Cardiac Magnetic Resonance Angiography and 4D Flow: Safety and Utility in Pediatric and Adult Congenital Heart Disease

“…However, at centers with specialized research agreements, ferumoxytol can be used with proprietary research pulse sequences to enable rapid acquisition of high-resolution, cardiac-phase-resolved 3D data with a requirement for only minimal technologist involvement. The addition of self-gating sequences and acceleration techniques, such as enhanced compressed sensing and artificial intelligence algorithms, may allow these examinations to approach the time efficiency of CTA [ 23 , 63 , 64 ]. Active collaborations with vendors are necessary to make these technical leaps more accessible at CHD centers that may not be attached to university hospital centers.…”