Abstract
BackgroundAssessment of the interatrial septum (IAS) has become an attractive area of interest for a variety of important interventional procedures. Newer imaging modalities like multi-slice computed tomography (MSCT) and cardiac MRI (CMR) can provide higher resolution and wider field of view than echocardiography. Moreover, high-field (3-Tesla) CMR can even enhance spatial and temporal resolution.The characteristics of the interatrial septum were retrospectively studied in 371 consecutive subjects (201 men, 31–73 years old) in whom MSCT was performed primarily for non-invasive evaluation of the coronary arteries. All subjects underwent both MSCT and MRI scans within 0–30 day’s interval. A 3D volume covering the whole heart was acquired across the heart with and without contrast enhancement. Also, patients underwent cardiac MSCT examinations using 64-row MSCT scanners.ResultsThe mean scan time of MSCT was 10.4 ± 2.8 s and 9.7 ± 2.9 min for CMR. The mean length of IAS by CMR and CT was 39.65 ± 4.6 mm and 39.28 ± 4.7 mm, respectively. The mean maximal thickness of IAS by CMR and CT was 3.1 ± 0.97 mm and 3.15 ± 0.95 mm, respectively. The mean thickness of fossa ovalis by CMR and CT was 1.04 ± 0.36 mm and 1.04 ± 0.44 mm, respectively. The mean length of fossa ovalis by CMR and CT was 12.8 ± 3.7 mm and 12.8 ± 3.5 mm, respectively. Finally, the mean angle of IAS by CMR and CT was identical (155 ± 9.2°). Measurements of various morphological features of IAS showed no statistically significant difference between CMR and CT, with an excellent correlation and close relationship regarding IAS length, maximal IAS thickness, fossa ovalis thickness, fossa ovalis length, and IAS angle (r = 0.98, 0.98, 0.95, 0.96, and 0.92, respectively).ConclusionWhole-heart 3D acquisition at 3-T MRI using a free-breathing technique provides a valuable non-invasive imaging tool for excellent assessment of the interatrial septum—as compared to MSCT—that may have significant clinical implication for diagnostic purposes and therapeutic interventional procedures, as it may facilitate planning, improve outcome, and shorten its duration.
Highlights
Assessment of the interatrial septum (IAS) has become an attractive area of interest for a variety of important interventional procedures
Assessment of the interatrial septum (IAS) has become an important requirement for the diagnosis of a variety of congenital and pathological diseases, as well as being considered an essential and attractive spot for a variety of important interventional procedures. These procedures demand precise and detailed characterization of the septum in order to facilitate the selection of procedurespecific devices, e.g., transseptal puncture [1,2,3] and closure of atrial septal defects [4], which subsequently increased the need for accurate pre-procedural assessment of atrial septum anatomy, morphology, and its spatial relationships
The purpose of this study is to demonstrate the feasibility of using a free-breathing 3-dimensional (3D) technique at 3-T MRI for the assessment of interatrial septum
Summary
Assessment of the interatrial septum (IAS) has become an attractive area of interest for a variety of important interventional procedures. The characteristics of the interatrial septum were retrospectively studied in 371 consecutive subjects (201 men, 31– 73 years old) in whom MSCT was performed primarily for non-invasive evaluation of the coronary arteries All subjects underwent both MSCT and MRI scans within 0–30 day’s interval. Assessment of the interatrial septum (IAS) has become an important requirement for the diagnosis of a variety of congenital and pathological diseases, as well as being considered an essential and attractive spot for a variety of important interventional procedures. Cardiac magnetic resonance imaging (CMR) has become a powerful clinical tool in the assessment of the cardiovascular system as it allows for non-invasive, multi-planar imaging with high intrinsic contrast, and most importantly, avoiding the hazards of MSCT [7,8,9]
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