Juvenile and Adult Congenital Heart Disease: Time-resolved 3D Contrast-enhanced MR Angiography

Fenchel, Michael; Saleh, Roya; Dinh, Howard; Lee, Margaret H.; Nael, Kambiz; Krishnam, Mayil S.; Ruehm, Stefan G.; Miller, Stephan; Child, John S.; Finn, J. Paul

doi:10.1148/radiol.2442061045

Cited by 39 publications

(23 citation statements)

References 26 publications

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“…Congenital anomalies of the thoracic vascular system are an important cause of morbidity and mortality in infants and children (5), and although the perioperative and long-term morbidity and mortality have decreased, correct diagnosis is crucial for planning of surgery and the life long follow-up of these patients (1,5). In the past decade, MRA has become an important imaging modality for evaluation of pathologies of the thoracic vasculature.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance angiography (MRA) has been established as a noninvasive alternative to conventional angiography for detection and evaluation of vascular pathologies in children See page 514 and adolescents with congenital and acquired heart disease (1,2). The main advantages of MRA over conventional radiographic angiography and echocardiography for visualization of the thoracic vasculature are lack of radiation, noninvasiveness, a relatively large field of view, and independence of an acoustic window (1,2).…”

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confidence: 99%

“…The main advantages of MRA over conventional radiographic angiography and echocardiography for visualization of the thoracic vasculature are lack of radiation, noninvasiveness, a relatively large field of view, and independence of an acoustic window (1,2). To date, standard MRA for assessment of arterial and venous anomalies in children and adolescents is performed using a 3-dimensional (3D) single-or multiphase first-pass (FP)-MRA sequence with an extracellular contrast agent without cardiac gating during 1 (or more) breathhold(s).…”

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confidence: 99%

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First-Pass and Steady-State MR Angiography of Thoracic Vasculature in Children and Adolescents

Naehle¹,

Kaestner²,

Müller³

et al. 2010

JACC: Cardiovascular Imaging

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Magnetic resonance angiography (MRA) is an established noninvasive imaging modality for detection and evaluation of vascular pathologies in children with congenital heart disease. Standard first-pass (FP)-MRA uses a 3-dimensional MRA sequence with an extracellular contrast agent, in which spatial resolution is limited by breath-hold duration, and image quality (IQ) is limited by motion artifacts. The purpose of this study was to compare the diagnostic confidence, IQ, and image artifacts of standard FP-MRA to a high-resolution, motion compensated steady-state (SS)-MRA of the thoracic vasculature in children and adolescents with congenital heart disease using a blood-pool contrast agent (gadofosveset trisodium). SS-MRA of the thoracic vasculature (technically successful in 90% of patients) offers superior diagnostic confidence and IQ compared with FP-MRA and shows fewer motion-related image artifacts. In addition, SS-MRA revealed findings missed by FP-MRA. Therefore, SS-MRA may prove specifically beneficial for imaging of thoracic vessels that are small and/or subject to motion.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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First-Pass and Steady-State MR Angiography of Thoracic Vasculature in Children and Adolescents

Naehle¹,

Kaestner²,

Müller³

et al. 2010

JACC: Cardiovascular Imaging

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“…Initial work by Korosec et al (8) was soon adapted to cardiovascular imaging (15,33) and the pulmonary vessels where a large body of experience exists since the For abbreviations and localization, please see Fig. 4; P-value refers to two-sided t-test; bold type shows statistically significant values.…”

Section: Discussionmentioning

confidence: 99%

Image analysis in time‐resolved large field of view 3D MR‐angiography at 3T

Frydrychowicz

Bley

Zadeh

et al. 2008

Magnetic Resonance Imaging

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Purpose: To qualitatively and quantitatively evaluate the image quality in accelerated time-resolved 3D contrastenhanced MR angiography (tr-CE-MRA) at 3T. Materials and Methods:In all, 113 MRA were performed in 107 patients on a 3T MR system after written informed consent and approval by the ethics committee. Twenty consecutive thoracic (n ϭ 87) or craniocervical (n ϭ 26) 3D data volumes were acquired. The timeframes with maximum arterial and venous contrast were determined and a total of 663 arterial and venous segments were analyzed by two blinded observers. Diagnostic image quality was graded by applying a 0 (low) to 3 (excellent) scale. Additionally, local signal-to-noise (SNR) and contrast-to-noise ratios (relative CNR) were evaluated.Results: Tr-CE-MRA was successfully performed in all patients. Good to excellent image quality (2.42 Ϯ 0.31) was observed in all individuals with preserved discrimination of arteries (2.43 Ϯ 0.48) and veins (2.20 Ϯ 0.56). Minor image degradation due to artifacts (2.62 Ϯ 0.25) and constantly high vascular signal and contrast were detected. There was a significant superiority of coronal orientation during thoracic MRA (P Ͻ 0.05). In 18 cases tr-CE-MRA provided additional information on vascular pathologies. Conclusion:Large field of view tr-CE-MRA enables constantly high-quality thoracic and craniocervical angiographies. In addition, the dynamics of tr-CE-MRA can offer additional information on vascular pathologies. OVER THE LAST DECADE, improvements in methodology have provided image acceleration techniques such as parallel imaging (1), view sharing (2-4), and partial Fourier transformation (5) that are highly beneficial for magnetic resonance (MR) image acquisition. Particularly for fast T1-weighted imaging, eg, in contrast-enhanced MR angiography (CE-MRA), the combination of such image acceleration methods provides faster acquisition schemes for improved sequence protocols with optimized spatial and/or temporal resolution. Based on a constant total acquisition time and a given spatial resolution, the temporal update rate can be increased to allow for dynamic angiographic imaging.Time-resolved imaging such as dynamic projection angiographies (6,7) and fully 3D sampling schemes (8) were presented as early as 1996. Time-resolved contrast-enhanced 3D MR-angiography (tr-CE-MRA) is constantly gaining importance since the protocols are easy to use in clinical routine, ie, no additional bolus timing and time-consuming sequence adjustments are necessary and the protocol can principally be performed without breath-hold. Furthermore, tr-CE-MRA techniques provide good separation between arteries and veins, and may offer additional "dynamic" information on the contrast agent distribution over time.Previous studies have shown that CE-MRA can benefit from imaging at 3T. In addition to the potential twofold increase in signal-to-noise ratio (SNR) (9), vessel contrast can be further enhanced due to the decrease of T1 relaxation times and thus enhanced T1 shortening effect of gadolinium (Gd)-b...

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“…At the same time, time-resolved and high-spatial resolution contrast-enhanced magnetic resonance angiography (MRA) can provide supplementary information about cardiac hemodynamics and vascular anatomy. 5,6 The versatility of CMR in this regard has been due in no small part to advances in radiofrequency (RF) hardware and the introduction of parallel data acquisition techniques, whereby k-space undersampling and coil sensitivity profile calculation of missing data can greatly enhance temporal resolution, spatial resolution, or coverage, although at the expense of signal-to-noise ratio (SNR). 7,8 Initial experience with whole-body, 3-T MRI systems has produced mostly, if not completely, positive results.…”

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confidence: 99%

Current Status of 3-T Cardiovascular Magnetic Resonance Imaging

Lohan

Saleh²,

Tomasian³

et al. 2008

Topics in Magnetic Resonance Imaging

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Continued advances in radiofrequency hardware and tailored software have, in recent times, greatly increased the power and performance of magnetic resonance imaging for noninvasive evaluation of cardiovascular diseases. Magnetic resonance imaging can uniquely be manipulated to trade temporal resolution and spatial resolution against each other, depending on whether detailed structural or functional information is required. However, to date, a number of cardiovascular magnetic resonance applications have been somewhat limited due to signal-to-noise ratio constraints, reflecting the narrow imaging window imposed by physiological cardiac motion. By increasing the operating field strength from 1.5 to 3 T, it is possible (in principle) to double the signal-to-noise ratio, which in turn may be "traded" for improvements in spatial resolution, coverage, or imaging speed. In this context, the development of parallel imaging has set the stage for impressive performance improvements in contrast-enhanced magnetic resonance angiography at 3 T. Indeed, one could argue that without parallel acquisition, the bang for the buck in going from 1.5 to 3 T would be limited. In this paper, we discuss the current status of 3-T magnetic resonance imaging for cardiovascular imaging, considering the relative gains and limitations relative to 1.5 T.

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Juvenile and Adult Congenital Heart Disease: Time-resolved 3D Contrast-enhanced MR Angiography

Abstract: Compared with conventional MR angiography, time-resolved MR angiography yields clinically relevant information in a substantial number of patients; hence, the two techniques should be regarded as complementary.

Cited by 39 publications

References 26 publications

First-Pass and Steady-State MR Angiography of Thoracic Vasculature in Children and Adolescents

First-Pass and Steady-State MR Angiography of Thoracic Vasculature in Children and Adolescents

Image analysis in time‐resolved large field of view 3D MR‐angiography at 3T

Current Status of 3-T Cardiovascular Magnetic Resonance Imaging

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