Tips and Tricks for MR Angiography of Pediatric and Adult Congenital Cardiovascular Diseases

Abstract

We present some suggestions to overcome many of these obstacles to MRA in these patients, highlighted with illustrations from clinical cases.

Computed Tomography and Magnetic Resonance Imaging of the Coronary Sinus: Anatomic Variants and Congenital Anomalies

“…Since the coronary vein diameter is larger in systole, a systolic acquisition has been proposed [ 6 ]. Finally, phase-contrast imaging provides quantitative evaluation of shunt physiology and relates anatomic morphology to functional significance [ 9 ].…”

Recent advances in 3D time-resolved contrast-enhanced MR angiography

“…15), and improved thoracic coil designs and parallel imaging strategies have allowed portrayal of perfusion of lung parenchyma over the large FOV (106,107). Another application of timeresolved MRA is the evaluation of congenital cardiovascular disease (108,109), and for pediatric cases; in particular, the exposure-free aspect of MR makes it preferable to CT (110). A low-contrast-dose, timeresolved CE-MRA run (40) can be performed in In both (a,b) the reference curve, representing actual arterial signal enhancement, is shown in blue.…”

Pediatric Body MR Angiography: Principles, Techniques, and Current Status in Body Imaging

“…One of the most important aspects of contrast-enhanced MRA is to fill the center of the k-space at the time of peak arterial enhancement to obtain the maximum MRA signal. Most MRA techniques entail centric k-space filling in which the center of the k-space (low spatial frequencies) is filled during the initial 30% of the acquisition, and the rest of the k-space is subsequently filled from center to periphery [11]. An alternative approach involves filling the k-space sequentially from top to bottom whereby the center of the k-space is filled halfway through the acquisition.…”

“…For centric k-space filling, a higher injection rate, such as 3 mL/s, can be used to achieve higher peak arterial enhancement at the start of acquisition, when the center of the k-space is filled. However, higher injection rates are not suitable for longer acquisition times because if contrast material is washed out of the vessel when the periphery of the k-space is filled, the images are blurred owing to loss of the fine edge detail [11]. Contrast material can be diluted with normal saline solution to lengthen the bolus time and reduce the chance of missing the bolus; for example, 2 mL of contrast material can be diluted in normal saline solution to 10 mL [8,12].…”