24 research outputs found
Real-time Assessment of Right and Left Ventricular Volumes and Function in Children Using High Spatiotemporal Resolution Spiral bSSFP with Compressed Sensing
Background: Real-time (RT) assessment of ventricular volumes and function
enables data acquisition during free-breathing. However, in children the
requirement for high spatiotemporal resolution requires accelerated imaging
techniques. In this study, we implemented a novel RT bSSFP spiral sequence
reconstructed using Compressed Sensing (CS) and validated it against the
breath-hold (BH) reference standard for assessment of ventricular volumes in
children with heart disease.
Methods: Data was acquired in 60 children. Qualitative image scoring and
evaluation of ventricular volumes was performed by 3 clinical cardiac MR
specialists. 30 cases were reassessed for intra-observer variability, and the
other 30 cases for inter-observer variability.
Results: Spiral RT images were of good quality, however qualitative scores
reflected more residual artefact than standard BH images and slightly lower
edge definition. Quantification of Left Ventricular (LV) and Right Ventricular
(RV) metrics showed excellent correlation between the techniques with narrow
limits of agreement. However, we observed small but statistically significant
overestimation of LV end-diastolic volume, underestimation of LV end-systolic
volume, as well as a small overestimation of RV stroke volume and ejection
fraction using the RT imaging technique. No difference in inter-observer or
intra-observer variability were observed between the BH and RT sequences.
Conclusions: Real-time bSSFP imaging using spiral trajectories combined with
a compressed sensing reconstruction is feasible. The main benefit is that it
can be acquired during free breathing. However, another important secondary
benefit is that a whole ventricular stack can be acquired in ~20 seconds, as
opposed to ~6 minutes for standard BH imaging. Thus, this technique holds the
potential to significantly shorten MR scan times in children
Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary artery anomaly. This study shows the role of cardiovascular magnetic resonance (CMR) in assessing young patients following surgical repair of ALCAPA.Methods: 6 patients, aged 9-21 years, with repaired ALCAPA (2 Tackeuchi method, 4 direct re-implantation) underwent CMR because of clinical suspicion of myocardial ischemia. Imaging used short and long axis cine images (assess ventricular function), late-gadolinium enhancement (LGE) (detect segmental myocardial fibrosis), adenosine stress perfusion (detect reversible ischaemia) and 3D whole-heart imaging (visualize proximal coronary arteries).Results: The left ventricular (LV) global systolic function was preserved in all patients (mean LV ejection fraction = 62.7% +/- 4.23%). The LV volumes were within the normal ranges, (mean indexed LVEDV = 75.4 +/- 3.5 ml/m(2), LVESV = 31.6 +/- 9.4 ml/m(2)). In 1 patient, hypokinesia of the anterior segments was visualized. Five patients showed subendocardial LGE involving the basal, antero-lateral wall and the anterior papillary muscle. Three patients had areas of reversible ischemia. In these 3, 3D whole-heart MRA showed that the proximal course of the left coronary artery was occluded (confirmed with cardiac catheterisation).Conclusions: CMR is a good, non-invasive, radiation-free investigation in the post-surgical evaluation of ALCAPA. In referred patients we show that basal, antero-lateral sub-endocardial myocardial fibrosis is a characteristic finding. Furthermore, stress adenosine CMR perfusion, can identify reversible ischemia in this group, and was indicative of left coronary artery occlusion