Three-dimensional morphological magnetic resonance imaging in infants and children with congenital heart disease

Abstract

Cardiac MRI has become a clinically useful supplement to ECHO and conventional X-ray angiography in the diagnostic work-up of patients with congenital heart disease (CHD). Three-dimensional (3D) sequences are capable of depicting both intracardiac and extracardiac structures with high accuracy in adults and adolescents. However, diagnostic image quality in infants and young children has not yet been reported. To apply an optimized 3D steady-state free-precession (SSFP) MR sequence in infants and children with CHD. In 20 patients (median age 1.8 years; ten male) with CHD, whole-chest imaging was performed with navigator-gated, isotropic 3D SSFP MRI at 1.5 T. Sequence parameters were adapted to special requirements in infancy. Measurements of intra- and extracardiac structures were performed by two independent observers and compared to spin-echo and cine gradient-recalled-echo sequences. Diagnostic image quality was achieved with the 3D SSFP technique in all patients, allowing the establishment of a diagnosis in all cases. Interobserver comparison of measurements from reformatted 3D SSFP datasets revealed only minor differences with standard deviations ranging from 0.3-1.3 mm for intracardiac and 0.3-0.7 mm for extracardiac anatomy (P = ns). Isotropic 3D SSFP MRI allows reliable and accurate assessment of CHD, even in free-breathing infants and young children.