Abstract
Background: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. Methods: Forty consecutive patients (mean age 6 ± 2.8 years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3 mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5–8 min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. Results: Scan time was similar for both sequences (5.3 ± 1.8 vs 5.2 ± 1.5 min, p =.532) and average heart rate (78 ± 14.7 vs 78 ± 14.5 bpm, p =.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6 ± 4.4 vs 31.1 ± 7.4, p <.001) and CNR (9.0 ± 1.8 vs 13.5 ± 3.7, p <.001) and provided improved coronary visualization in all coronary territories (VWS A = 0.53 ± 0.07 vs B = 0.56 ± 0.07, p =.001; and visual scoring A = 3.8 ± 0.59 vs B = 4.1 ± 0.53, p <.001). The number of non-diagnostic coronary segments was lower for sequence B [A = 42 (13.1%) segments vs B = 33 (10.3%) segments; p =.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients’ age, body surface area and HR. Conclusions: The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 47-54 |
| Number of pages | 8 |
| Journal | Magnetic Resonance Imaging |
| Volume | 49 |
| DOIs | |
| State | Published - Jun 1 2018 |
Fingerprint
Keywords
- Coronary magnetic resonance angiography
- Gadobenate dimeglumine
- Pediatric congenital heart disease
- Respiratory image-based navigation
ASJC Scopus subject areas
- Biophysics
- Biomedical Engineering
- Radiology Nuclear Medicine and imaging
Cite this
Improved coronary magnetic resonance angiography using gadobenate dimeglumine in pediatric congenital heart disease. / Silva Vieira, Miguel; Henningsson, Markus; Dedieu, Nathalie; Vassiliou, Vassilios S.; Bell, Aaron; Mathur, Sujeev; Pushparajah, Kuberan; Figueroa, Carlos Alberto; Hussain, Tarique; Botnar, René; Greil, Gerald F.
In: Magnetic Resonance Imaging, Vol. 49, 01.06.2018, p. 47-54.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Improved coronary magnetic resonance angiography using gadobenate dimeglumine in pediatric congenital heart disease
AU - Silva Vieira, Miguel
AU - Henningsson, Markus
AU - Dedieu, Nathalie
AU - Vassiliou, Vassilios S.
AU - Bell, Aaron
AU - Mathur, Sujeev
AU - Pushparajah, Kuberan
AU - Figueroa, Carlos Alberto
AU - Hussain, Tarique
AU - Botnar, René
AU - Greil, Gerald F.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. Methods: Forty consecutive patients (mean age 6 ± 2.8 years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3 mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5–8 min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. Results: Scan time was similar for both sequences (5.3 ± 1.8 vs 5.2 ± 1.5 min, p =.532) and average heart rate (78 ± 14.7 vs 78 ± 14.5 bpm, p =.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6 ± 4.4 vs 31.1 ± 7.4, p <.001) and CNR (9.0 ± 1.8 vs 13.5 ± 3.7, p <.001) and provided improved coronary visualization in all coronary territories (VWS A = 0.53 ± 0.07 vs B = 0.56 ± 0.07, p =.001; and visual scoring A = 3.8 ± 0.59 vs B = 4.1 ± 0.53, p <.001). The number of non-diagnostic coronary segments was lower for sequence B [A = 42 (13.1%) segments vs B = 33 (10.3%) segments; p =.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients’ age, body surface area and HR. Conclusions: The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
AB - Background: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients. Methods: Forty consecutive patients (mean age 6 ± 2.8 years; 73% males) were prospectively recruited for a 1.5-T MRI study under general anesthesia. Two electrocardiographic-triggered free breathing steady-state free precession (SSFP) angiography sequences (A and B) with isotropic spatial resolution (1.3 mm3) were acquired using a recently developed image-based self-navigation technique. Sequence A was acquired prior to contrast administration using T2 magnetization preparation (T2prep). Sequence B was acquired 5–8 min after a bolus of Gd-BOPTA with the T2prep replaced by an inversion recovery (IR) pulse to null the signal from the myocardium. Scan time, signal-to noise and contrast-to-noise ratios (SNR and CNR), vessel wall sharpness (VWS) and qualitative visual score for each sequence were compared. Results: Scan time was similar for both sequences (5.3 ± 1.8 vs 5.2 ± 1.5 min, p =.532) and average heart rate (78 ± 14.7 vs 78 ± 14.5 bpm, p =.443) remained constant throughout both acquisitions. Sequence B resulted in higher SNR (12.6 ± 4.4 vs 31.1 ± 7.4, p <.001) and CNR (9.0 ± 1.8 vs 13.5 ± 3.7, p <.001) and provided improved coronary visualization in all coronary territories (VWS A = 0.53 ± 0.07 vs B = 0.56 ± 0.07, p =.001; and visual scoring A = 3.8 ± 0.59 vs B = 4.1 ± 0.53, p <.001). The number of non-diagnostic coronary segments was lower for sequence B [A = 42 (13.1%) segments vs B = 33 (10.3%) segments; p =.002], and contrary to the pre-contrast sequence, never involved a proximal segment. These results were independent of the patients’ age, body surface area and HR. Conclusions: The use of Gd-BOPTA with a 3D IR SSFP CMRA sequence results in improved coronary visualization in small infants and young children with high HR within a clinically acceptable scan time.
KW - Coronary magnetic resonance angiography
KW - Gadobenate dimeglumine
KW - Pediatric congenital heart disease
KW - Respiratory image-based navigation
UR - http://www.scopus.com/inward/record.url?scp=85041667466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041667466&partnerID=8YFLogxK
U2 - 10.1016/j.mri.2017.12.023
DO - 10.1016/j.mri.2017.12.023
M3 - Article
C2 - 29339139
AN - SCOPUS:85041667466
VL - 49
SP - 47
EP - 54
JO - Magnetic Resonance Imaging
JF - Magnetic Resonance Imaging
SN - 0730-725X
ER -