Magnetization Transfer BOOST Noncontrast Angiography Improves Pulmonary Vein Imaging in Adults With Congenital Heart Disease.


Journal

Journal of magnetic resonance imaging : JMRI
ISSN: 1522-2586
Titre abrégé: J Magn Reson Imaging
Pays: United States
ID NLM: 9105850

Informations de publication

Date de publication:
02 2023
Historique:
revised: 14 05 2022
received: 16 01 2022
accepted: 17 05 2022
pubmed: 2 6 2022
medline: 20 1 2023
entrez: 1 6 2022
Statut: ppublish

Résumé

Cardiac MRI plays an important role in the diagnosis and follow-up of patients with congenital heart disease (CHD). Gadolinium-based contrast agents are often needed to overcome flow-related and off-resonance artifacts that can impair the quality of conventional noncontrast 3D imaging. As serial imaging is often required in CHD, the development of robust noncontrast 3D MRI techniques is desirable. To assess the clinical utility of noncontrast enhanced magnetization transfer and inversion recovery prepared 3D free-breathing sequence (MTC-BOOST) compared to conventional 3D whole heart imaging in patients with CHD. Prospective, image quality. A total of 27 adult patients (44% female, mean age 30.9 ± 14.8 years) with CHD. A 1.5 T; free-breathing 3D MTC-BOOST sequence. MTC-BOOST was compared to diaphragmatic navigator-gated, noncontrast T2 prepared 3D whole-heart imaging sequence (T2prep-3DWH) for comparison of vessel dimensions, lumen-to-myocardium contrast ratio (CR), and image quality (vessel wall sharpness and presence and type of artifacts) assessed by two experienced cardiologists on a 5-point scale. Mann-Whitney test, paired Wilcoxon signed-rank test, Bland-Altman plots. P < 0.05 was considered statistically significant. MTC-BOOST significantly improved image quality and CR of the right-sided pulmonary veins (PV): (CR: right upper PV 1.06 ± 0.50 vs. 0.58 ± 0.74; right lower PV 1.32 ± 0.38 vs. 0.81 ± 0.73) compared to conventional T2prep-3DWH imaging where the PVs were not visualized in some cases due to off-resonance effects. MTC-BOOST demonstrated resistance to degradation of luminal signal (assessed by CR) secondary to accelerated or turbulent flow conditions. T2prep-3DWH had higher image quality scores than MTC-BOOST for the aorta and coronary arteries; however, great vessel dimensions derived from MTC-BOOST showed excellent agreement with standard T2prep-3DWH imaging. MTC-BOOST allows for improved contrast-free imaging of pulmonary veins and regions characterized by accelerated or turbulent blood flow compared to standard T2prep-3DWH imaging, with excellent agreement of great vessel dimensions. 1 TECHNICAL EFFICACY: Stage 2.

Sections du résumé

BACKGROUND
Cardiac MRI plays an important role in the diagnosis and follow-up of patients with congenital heart disease (CHD). Gadolinium-based contrast agents are often needed to overcome flow-related and off-resonance artifacts that can impair the quality of conventional noncontrast 3D imaging. As serial imaging is often required in CHD, the development of robust noncontrast 3D MRI techniques is desirable.
PURPOSE
To assess the clinical utility of noncontrast enhanced magnetization transfer and inversion recovery prepared 3D free-breathing sequence (MTC-BOOST) compared to conventional 3D whole heart imaging in patients with CHD.
STUDY TYPE
Prospective, image quality.
POPULATION
A total of 27 adult patients (44% female, mean age 30.9 ± 14.8 years) with CHD.
FIELD STRENGTH/SEQUENCE
A 1.5 T; free-breathing 3D MTC-BOOST sequence.
ASSESSMENT
MTC-BOOST was compared to diaphragmatic navigator-gated, noncontrast T2 prepared 3D whole-heart imaging sequence (T2prep-3DWH) for comparison of vessel dimensions, lumen-to-myocardium contrast ratio (CR), and image quality (vessel wall sharpness and presence and type of artifacts) assessed by two experienced cardiologists on a 5-point scale.
STATISTICAL TESTS
Mann-Whitney test, paired Wilcoxon signed-rank test, Bland-Altman plots. P < 0.05 was considered statistically significant.
RESULTS
MTC-BOOST significantly improved image quality and CR of the right-sided pulmonary veins (PV): (CR: right upper PV 1.06 ± 0.50 vs. 0.58 ± 0.74; right lower PV 1.32 ± 0.38 vs. 0.81 ± 0.73) compared to conventional T2prep-3DWH imaging where the PVs were not visualized in some cases due to off-resonance effects. MTC-BOOST demonstrated resistance to degradation of luminal signal (assessed by CR) secondary to accelerated or turbulent flow conditions. T2prep-3DWH had higher image quality scores than MTC-BOOST for the aorta and coronary arteries; however, great vessel dimensions derived from MTC-BOOST showed excellent agreement with standard T2prep-3DWH imaging.
DATA CONCLUSION
MTC-BOOST allows for improved contrast-free imaging of pulmonary veins and regions characterized by accelerated or turbulent blood flow compared to standard T2prep-3DWH imaging, with excellent agreement of great vessel dimensions.
EVIDENCE LEVEL
1 TECHNICAL EFFICACY: Stage 2.

Identifiants

pubmed: 35642573
doi: 10.1002/jmri.28280
pmc: PMC10084321
doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

521-531

Subventions

Organisme : Wellcome Trust
ID : WT 203148/Z/16/Z
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/18/59/33955
Pays : United Kingdom

Informations de copyright

© 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.

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Auteurs

Imran Rashid (I)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

Giulia Ginami (G)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Giovanna Nordio (G)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Anastasia Fotaki (A)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Radhouene Neji (R)

MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK.

Harith Alam (H)

Guy's and St Thomas' Hospital, Department of Cardiology, London, UK.

Kuberan Pushparajah (K)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Guy's and St Thomas' Hospital, Department of Cardiology, London, UK.

Alessandra Frigiola (A)

Guy's and St Thomas' Hospital, Department of Cardiology, London, UK.

Israel Valverde (I)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Paediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville, IBIS Ciber-CV, Seville, Spain.

René M Botnar (RM)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Claudia Prieto (C)

School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

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Classifications MeSH