Alan Groves

David Edwards

Gaia Chiesa

Giuliana Durighel

Jo Hajnal

Julie Fitzpatrick

Reza Razavi

Sergio Uribe

Stephen Goldring

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Development and validation of 3 Tesla functional cardiac magnetic resonance imaging in preterm and term newborns

BioMed Central
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Journal of Cardiovascular Magnetic 
Resonance
Open AccessOral presentation
Development and validation of 3 Tesla functional cardiac magnetic 
resonance imaging in preterm and term newborns
Alan Groves*1, Gaia Chiesa1, Giuliana Durighel1, Stephen Goldring1, 
Julie Fitzpatrick1, Sergio Uribe2, Reza Razavi2, Jo Hajnal1 and David Edwards1
Address: 1Imperial College London, London, UK and 2King's College London, London, UK
* Corresponding author    
Introduction
Circulatory failure causes significant mortality and mor-
bidity in newborn infants. Improvements in clinical circu-
latory care are limited by the paucity of accurate
biomarker outcome measures for clinical trials.
Purpose
To develop and validate cardiac magnetic resonance
(CMR) imaging techniques to assess ventricular function
and systemic perfusion in preterm and term newborns,
and to compare techniques to existing echocardiographic
methods.
Methods
All scans were performed with a Philips 3-Tesla MR scan-
ner. Infants were fed and allowed to fall into natural sleep
without the use of sedation or anesthesia. Infants were
laid in a custom made cradle, with ear protection and rou-
tine monitoring. A Flex-M surface receiver coil was placed
on the chest wall. No respiratory compensation tech-
niques were used. Acquisition parameters for phase con-
trast (PC) and balanced fast field echo (bFFE) imaging
were optimised. PC assessments of flow were performed
immediately distal to the aortic and pulmonary valves, as
well as in the superior vena cava (SVC) and descending
aorta (DAo). External validation of phase contrast meas-
ures was performed with a flow phantom. bFFE sequences
were applied for 2 chamber, 4 chamber and short axis
views. A short axis stack of 5-7 slices covered the left ven-
tricle from base to apex. Left (LVO) and right (RVO) ven-
tricular output were assessed using CMR Tools processing
software. Echocardiographic measurements of LVO were
performed within 24 hours of MR imaging.
Results
108 newborn infants with median birth weight 1627
(580-4140) grams, gestation 32 (25-42) weeks were stud-
ied. Mean (SD) flow volumes in 28 stable infants were
LVO 222 (46), RVO 219 (47), SVC 95 (27) and DAo 126
(32) ml.kg-1.min-1, with flow being higher at lower gesta-
tional age. Limits of agreement (LOA) for repeated PC
assessment of flow were LVO ± 50.2, RVO ± 55.5, SVC ±
20.9 and DAo ± 26.2 ml.kg-1.min-1. Phase contrast quan-
tification of flow in an external phantom was highly cor-
related with actual measured flow (r2 = 0.995). Mean (SD)
LVO in 75 stable infants by bFFE was 245 (47) ml.kg-
1.min-1, LOA for cine assessment of LVO were ± 58.3
ml.kg-1.min-1. LOA for repeated echocardiographic assess-
ment of LVO were ± 108.9 ml.kg-1.min-1.
Conclusion
Detailed CMR assessments of cardiac function and sys-
temic perfusion are feasible in newborn infants, and pro-
vide more complete data and with greater accuracy than
existing echocardiographic methods.
from 13th Annual SCMR Scientific Sessions
Phoenix, AZ, USA. 21-24 January 2010
Published: 21 January 2010
Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):O32 doi:10.1186/1532-429X-12-S1-O32
<supplement> <title> <p>Abstracts of the 13<sup>th </sup>Annual SCMR Scientific Sessions - 2010</p> </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement>
This abstract is available from: http://jcmr-online.com/content/12/S1/O32
© 2010 Alan et al; licensee BioMed Central Ltd. 


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Development and validation of 3 Tesla functional cardiac magnetic resonance imaging in preterm and term newborns

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