Optimizing neonatal cardiac imaging (magnetic resonance/computed tomography)

Ramirez‐Suarez, Karen I.; Tierradentro-García, Luis Octavio; Otero, Hansel J.; Rapp, Jordan B.; White, Ammie M.; Partington, Sara L.; Harris, Matthew A.; Vatsky, Seth; Whitehead, Kevin K.; Fogel, Mark A.; Biko, David M.

doi:10.1007/s00247-021-05201-w

Cited by 10 publications

(2 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In pediatrics, echocardiography is the first‐line imaging modality but, while widely available and noninvasive, it is known to have limitations, particularly in blood flow quantification 4,5 . Traditionally, in the neonatal population, cardiac catheterization and CT scanning have been used to complement echocardiography, but both require intravenous access, contrast agent, and ionizing radiation 3,6,7 . As the life expectancy of patients with CHD increases, an imminently important consideration is that cumulative low‐dose ionizing radiation from cardiac procedures is independently associated with cancer in adults with CHD 8,9 .…”

Section: The Need For Neonatal Cardiac Mrimentioning

confidence: 99%

“…4,5 Traditionally, in the neonatal population, cardiac catheterization and CT scanning have been used to complement echocardiography, but both require intravenous access, contrast agent, and ionizing radiation. 3,6,7 As the life expectancy of patients with CHD increases, an imminently important consideration is that cumulative low-dose ionizing radiation from cardiac procedures is independently associated with cancer in adults with CHD. 8,9 Therefore, alternative modes of imaging should be considered where possible.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comprehensive Neonatal Cardiac, Feed and Wrap, Non‐contrast, Non‐sedated, Free‐breathing Compressed Sensing 4D Flow MRI Assessment

Panayiotou

Mills

Broadbent

et al. 2022

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background Cardiac MRI is an important imaging tool in congenital cardiac disease, but its use has been limited in the neonatal population as general anesthesia has been needed for breath‐holding. Technological advances in four‐dimensional (4D) flow MRI have now made nonsedated free‐breathing acquisition protocols a viable clinical option, but the method requires prospective validation in neonates. Purpose To test the feasibility of compressed sensing (CS) 4D flow MRI in the neonatal population and to compare with standard previously validated two‐dimensional (2D) phase‐contrast (PC) flow MRI. Study type Prospective, cohort, image quality. Population A total of 14 healthy neonates (median [range] age: 2.5 [0–80] days; 8 male). Field Strength and Sequence Noncontrast 2D cine gradient echo sequence with through‐plane velocity encoding (PC) sequence and compressed sensing (CS) three‐dimensional (3D), time‐resolved, cine phase‐contrast MRI with 3D velocity‐encoding (4D flow MRI) at 3 T. Assessment Aortic 2D PC, and aortic, pulmonary trunk and superior vena cava CS 4D flow MRI were acquired using the feed and wrap technique (nonsedated) and quantified using commercially available software. Aortic flow and peak velocity were compared between methods. Internal consistency of 4D flow MRI was determined by comparing mean forward flow of the main pulmonary artery (MPA) vs. the sum of left and right pulmonary artery flows (LPA and RPA) and by comparing mean ascending aorta forward flow (AAo) vs. the sum of superior vena cava (SVC) and descending aorta flows (DAo). Statistical Tests Flow and peak‐velocity comparisons were assessed using paired t‐tests, with P < 0.05 considered significant, and Bland–Altman analysis. Interobserver and intraobserver agreement and internal consistency were analyzed by intraclass correlation co‐efficient (ICC). Results There was no statistically significant difference between ascending aortic forward flow between 2D PC and CS 4D Flow MRI (P = 0.26) with a bias of 0.11 mL (−0.59 to 0.82 mL) nor peak velocity (P = 0.11), with a bias of −5 cm/sec and (−26 to 16 cm/sec). There was excellent interobserver and intraobserver agreement for each vessel (interobserver ICC: AAo 1.00; DAo 0.94, SVC 0.90, MPA 0.99, RPA 0.98, LPA 0.96; intraobserver ICC: AAo 1.00; DAo 0.99, SVC 0.98, MPA 1.00, RPA 1.00, LPA 0.99). Internal consistency measures showed excellent agreement for both mean forward flow of main pulmonary artery vs. the sum of left and right pulmonary arteries (ICC: 0.95) and mean ascending aorta forward flow vs. the sum of superior vena cava and descending aorta flows (ICC: 1.00). Conclusion Sedation‐free neonatal feed and wrap MRI is well tolerated and feasible. CS 4D flow MRI quantification is similar to validated 2D PC free‐breathing imaging with excellent interobserver and intraobserver agreement. Evidence Level 1 Technical Efficacy Stage 2

show abstract

Section: The Need For Neonatal Cardiac Mrimentioning

confidence: 99%