![]() It has also been reported that such methods may fall short of providing sufficient spatial and temporal definition for structures such as chordae or subtleties of valve morphology. A specialized team of technologists and physicians is oftentimes mandatory for accurate scan planning in the presence of relatively complex anatomy. Conventional clinical practice includes first-pass magnetic resonance angiography and 2D cardiac cine acquisitions, which typically require lengthy scanning sessions with repeated breath-holding, under anesthesia and respiratory intubation at times. This approach, working without any external gating and for a wide range of heart rates and body sizes provided excellent definition of cardiac anatomy for both intubated and free-breathing patients.Ĭoronary cardiovascular magnetic resonance angiography (CCMRA) is employed in pediatric patients with congenital heart disease (CHD), where the accurate assessment of anatomic structures and coronary vessels constitutes a fundamental requirement for interventional planning. ConclusionsĪ simple-to-use push-button framework for 5D whole-heart CCMRA was successfully employed in pediatric CHD patients with ferumoxytol injection. These general findings applied to both intubated and free-breathing pediatric patients (no difference in terms of lung-liver interface sharpness), while image quality and coronary conspicuity between both cohorts was very similar. ![]() From the resulting SG 5D motion-resolved reconstructed images, coronary artery origins could be retrospectively extracted in 90% of the cases. Resultsĭata collection using the free-running framework was successful in all patients in less than 8 min scan planning was very simple without the need for parameter adjustments, while no ECG lead placement and triggering was required. Intubated and free-breathing patient sub-groups were compared for image quality using coronary artery length and conspicuity as well as lung-liver interface sharpness. To evaluate the performance of motion resolution, visibility of coronary artery origins was assessed. ![]() Cardiac and respiratory motion-resolved 5D images were reconstructed with a fully SG approach. All patients were slowly injected with ferumoxytol (4 mg/kg) over 15 minutes. Eleven patients were anesthetized and intubated, while seven were breathing freely without anesthesia. In 18 pediatric CHD patients, non-electrocardiogram (ECG) triggered 5D free-running gradient echo CCMRA with whole-heart 1 mm 3 isotropic spatial resolution was performed in seven minutes on a 1.5T CMR scanner. We tested the hypothesis that spatial and motion resolution suffice to visualize coronary artery ostia in a cohort of CHD subjects, both for intubated and free-breathing acquisitions. ![]() To address the above concerns and provide a single-click imaging solution, we applied our free-running framework for fully self-gated (SG) free-breathing 5D whole-heart CCMRA to CHD patients after ferumoxytol injection. Anesthesia and intubation are commonplace to minimize movements and control respiration in younger subjects. Coronary cardiovascular magnetic resonance angiography (CCMRA) of congenital heart disease (CHD) in pediatric patients requires accurate planning, adequate sequence parameter adjustments, lengthy scanning sessions, and significant involvement from highly trained personnel.
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