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Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease.

Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner SC, Sekarski N, Di Bernardo S, Bouchardy J, Stuber M, Schwitter J - J Cardiovasc Magn Reson (2015)

Bottom Line: Factors associated with insufficient image quality were identified using multivariate logistic regression.Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality.However, a similar rate of diagnostic image quality was obtained in children and adults.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. pierre.monney@chuv.ch.

ABSTRACT

Background: For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality.

Methods: CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression.

Results: Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults.

Conclusion: In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.

No MeSH data available.


Related in: MedlinePlus

Image quality – Illustration of the 5-points scale for grading image quality (lower panel) and corresponding patient distribution (upper panel)
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Fig1: Image quality – Illustration of the 5-points scale for grading image quality (lower panel) and corresponding patient distribution (upper panel)

Mentions: Image quality was graded independently by two experienced readers using a 5-points scale as previously described [15, 16]. Grade 5 corresponds to an excellent and grade 4 to a good diagnostic quality with mild blurring (Fig. 1), whereas grade 3 indicates diagnostic quality despite moderate blurring of cardiac and vascular structures, i.e. of the blood-myocardial interface of the left and right ventricle and the contours of the great vessels, respectively. Grade 2 indicates marked blurring of the structures, preventing a complete anatomical diagnosis. In grade 1, a dataset was considered non-diagnostic. Visualization of the coronary arteries was graded separately (see below).Fig. 1


Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease.

Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner SC, Sekarski N, Di Bernardo S, Bouchardy J, Stuber M, Schwitter J - J Cardiovasc Magn Reson (2015)

Image quality – Illustration of the 5-points scale for grading image quality (lower panel) and corresponding patient distribution (upper panel)
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4496886&req=5

Fig1: Image quality – Illustration of the 5-points scale for grading image quality (lower panel) and corresponding patient distribution (upper panel)
Mentions: Image quality was graded independently by two experienced readers using a 5-points scale as previously described [15, 16]. Grade 5 corresponds to an excellent and grade 4 to a good diagnostic quality with mild blurring (Fig. 1), whereas grade 3 indicates diagnostic quality despite moderate blurring of cardiac and vascular structures, i.e. of the blood-myocardial interface of the left and right ventricle and the contours of the great vessels, respectively. Grade 2 indicates marked blurring of the structures, preventing a complete anatomical diagnosis. In grade 1, a dataset was considered non-diagnostic. Visualization of the coronary arteries was graded separately (see below).Fig. 1

Bottom Line: Factors associated with insufficient image quality were identified using multivariate logistic regression.Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality.However, a similar rate of diagnostic image quality was obtained in children and adults.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. pierre.monney@chuv.ch.

ABSTRACT

Background: For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality.

Methods: CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression.

Results: Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults.

Conclusion: In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.

No MeSH data available.


Related in: MedlinePlus