Free breathing contrast-enhanced time-resolved magnetic resonance angiography in pediatric and adult congenital heart disease

Contrast enhanced magnetic resonance angiography (MRA) is generally performed during a long breath-hold (BH), limiting its utility in infants and small children. This study proposes a free-breathing (FB) time resolved MRA (TRA) technique for use in pediatric and adult congenital heart disease (CHD)

Perturbed spiral real-time phase-contrast MR with compressive sensing reconstruction for assessment of flow in children

PURPOSE: we implemented a golden‐angle spiral phase contrast sequence. A commonly used uniform density spiral and a new ‘perturbed’ spiral that produces more incoherent aliases were assessed. The aim was to ascertain whether greater incoherence enabled more accurate Compressive Sensing reconstruction and superior measurement of flow and velocity. METHODS: A range of ‘perturbed’ spiral trajectories based on a uniform spiral trajectory were formulated. The trajectory that produced the most noise‐like aliases was selected for further testing. For in‐silico and in‐vivo experiments, data was reconstructed using total Variation L1 regularisation in the spatial and temporal domains. In‐silico, the reconstruction accuracy of the ‘perturbed’ golden spiral was compared to uniform density golden‐angle spiral. For the in‐vivo experiment, stroke volume and peak mean velocity were measured in 20 children using ‘perturbed’ and uniform density golden‐angle spiral sequences. These were compared to a reference standard gated Cartesian sequence. RESULTS: In‐silico, the perturbed spiral acquisition produced more accurate reconstructions with less temporal blurring (NRMSE ranging from 0.03 to 0.05) than the uniform density acquisition (NRMSE ranging from 0.06 to 0.12). This translated in more accurate results in‐vivo with no significant bias in the peak mean velocity (bias: −0.1, limits: −4.4 to 4.1 cm/s; P = 0.98) or stroke volume (bias: −1.8, limits: −9.4 to 5.8 ml, P = 0.19). CONCLUSION: We showed that a ‘perturbed’ golden‐angle spiral approach is better suited to Compressive Sensing reconstruction due to more incoherent aliases. This enabled accurate real‐time measurement of flow and peak velocity in children