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Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease.

Fratz S, Chung T, Greil GF, Samyn MM, Taylor AM, Valsangiacomo Buechel ER, Yoo SJ, Powell AJ - J Cardiovasc Magn Reson (2013)

Bottom Line: The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols.Variations in practice are highlighted and expert consensus recommendations are provided.Indications and appropriate use criteria for CMR examination are not specifically addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (German Heart Center Munich) of the Technical University Munich, Munich, Germany. fratz@dhm.mhn.de

ABSTRACT
Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.

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3D steady-state free precession. A patient with transposition of the great arteries who has undergone a Senning operation. An ECG and respiratory navigator-gated 3D SSFP sequence was utilized to generate a 3D volume with 1.5 mm isotropic resolution timed to mid-diastole. The navigator efficiency was 45% and the acquisition time was 6 minutes. Multiplanar reformatting of this volume allows a comprehensive morphologic evaluation of the heart and great vessels including the Senning pathways (A, B, and C).
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Figure 4: 3D steady-state free precession. A patient with transposition of the great arteries who has undergone a Senning operation. An ECG and respiratory navigator-gated 3D SSFP sequence was utilized to generate a 3D volume with 1.5 mm isotropic resolution timed to mid-diastole. The navigator efficiency was 45% and the acquisition time was 6 minutes. Multiplanar reformatting of this volume allows a comprehensive morphologic evaluation of the heart and great vessels including the Senning pathways (A, B, and C).

Mentions: In its typical implementation, the ECG and respiratory navigator-gated 3D SSFP technique delivers a 3D anatomic dataset with an isotropic voxel size of approximately 1.2-2.0 mm without the use of a contrast agent (Table 3). Its utility and validation have been reported in patients with CHD [40-42]. Using ECG triggering, the data acquisition is confined to one or two portions of the cardiac cycle thereby minimizing blurring from cardiac motion. Intracardiac anatomy and coronary arteries can thus be more clearly visualized than with contrast-enhanced MRA. The 3D SSFP sequence is performed with free-breathing. Respiratory motion is compensated for by gating data acquisition to expiration with the use of a navigator beam tracking the motion of the diaphragm. This approach allows for improvement in spatial resolution including isotropic voxel size because scan time is not limited to the duration of a single breath-hold. The isotropic property of the anatomic data permits arbitrary reformatting in any desired imaging plane during review without the loss of resolution (Figure 4).


Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease.

Fratz S, Chung T, Greil GF, Samyn MM, Taylor AM, Valsangiacomo Buechel ER, Yoo SJ, Powell AJ - J Cardiovasc Magn Reson (2013)

3D steady-state free precession. A patient with transposition of the great arteries who has undergone a Senning operation. An ECG and respiratory navigator-gated 3D SSFP sequence was utilized to generate a 3D volume with 1.5 mm isotropic resolution timed to mid-diastole. The navigator efficiency was 45% and the acquisition time was 6 minutes. Multiplanar reformatting of this volume allows a comprehensive morphologic evaluation of the heart and great vessels including the Senning pathways (A, B, and C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3686659&req=5

Figure 4: 3D steady-state free precession. A patient with transposition of the great arteries who has undergone a Senning operation. An ECG and respiratory navigator-gated 3D SSFP sequence was utilized to generate a 3D volume with 1.5 mm isotropic resolution timed to mid-diastole. The navigator efficiency was 45% and the acquisition time was 6 minutes. Multiplanar reformatting of this volume allows a comprehensive morphologic evaluation of the heart and great vessels including the Senning pathways (A, B, and C).
Mentions: In its typical implementation, the ECG and respiratory navigator-gated 3D SSFP technique delivers a 3D anatomic dataset with an isotropic voxel size of approximately 1.2-2.0 mm without the use of a contrast agent (Table 3). Its utility and validation have been reported in patients with CHD [40-42]. Using ECG triggering, the data acquisition is confined to one or two portions of the cardiac cycle thereby minimizing blurring from cardiac motion. Intracardiac anatomy and coronary arteries can thus be more clearly visualized than with contrast-enhanced MRA. The 3D SSFP sequence is performed with free-breathing. Respiratory motion is compensated for by gating data acquisition to expiration with the use of a navigator beam tracking the motion of the diaphragm. This approach allows for improvement in spatial resolution including isotropic voxel size because scan time is not limited to the duration of a single breath-hold. The isotropic property of the anatomic data permits arbitrary reformatting in any desired imaging plane during review without the loss of resolution (Figure 4).

Bottom Line: The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols.Variations in practice are highlighted and expert consensus recommendations are provided.Indications and appropriate use criteria for CMR examination are not specifically addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München (German Heart Center Munich) of the Technical University Munich, Munich, Germany. fratz@dhm.mhn.de

ABSTRACT
Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.

Show MeSH
Related in: MedlinePlus