Abstract
BackgroundFor free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality.MethodsCHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression.ResultsSelf-navigated CMR was performed in 105 patients (55 % male, 23 ± 12y). Correct segmental description was achieved in 93 % and 96 % for observer 1 and 2, respectively. Diagnostic quality was obtained in 90 % of examinations, and it increased to 94 % if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93 %, 87 % and 98 %, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults.ConclusionIn patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.
Highlights
For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate
The aims of this work were to test the hypothesis that self-navigated 3D CMR with high isotropic spatial resolution enables the reliable assessment of cardiovascular anatomy in congenital heart disease (CHD) patients and to define factors that affect image quality
Study population Over the study period, 138 patients ≥2 years were referred for CMR at 1.5T with an established diagnosis of CHD
Summary
For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality. For the assessment of intra-thoracic anatomy, freebreathing approaches are increasingly performed, yielding a 3D representation of the heart, which can be reformatted off-line in any slice orientation For such acquisitions, respiratory gating is needed, which is traditionally performed by using a beam-navigator placed on the dome of the right hemi-diaphragm [9]. The aims of this work were to test the hypothesis that self-navigated 3D CMR with high isotropic spatial resolution enables the reliable assessment of cardiovascular anatomy in CHD patients and to define factors that affect image quality
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