Sergio Andres Uribe PhD, MS, Presenter: Nothing to Disclose

Tarique Hussain, Abstract Co-Author: Nothing to Disclose

Isra Valverde, Abstract Co-Author: Nothing to Disclose

Philipp Beerbaum MD, Abstract Co-Author: Nothing to Disclose

Mario Fava MD, Abstract Co-Author: Nothing to Disclose

Pablo Irarrazaval PhD, Abstract Co-Author: Nothing to Disclose

Critían Tejos PhD, Abstract Co-Author: Nothing to Disclose

Rene Botnar PhD, Abstract Co-Author: Nothing to Disclose

Reza Razavi MD, Abstract Co-Author: Nothing to Disclose

Tobias R. Schaeffter PhD, Abstract Co-Author: Consultant, Koninklijke Philips Electronics NV

Gerald Greil MD, Abstract Co-Author: Nothing to Disclose

To investigate the best rest period to obtain Coronary Magnetic Resonance Angiography (CMRA) in children with Congenital Heart Diseases (CHD) using a dual cardiac phase whole heart MRI.

Thirty children with CHD (age=5.01±4.42, Heart-rate=89±16) were scanned under general anesthesia on a 1.5T Philips MR system. A previously developed free-breathing 3D SSFP dual cardiac phase sequence (Uribe et al, Radiology 2008) was acquired for imaging the whole heart including the coronary arteries (CA) and great vessels (resolution of 1-1.5 mm3 and 60-75 ms). Data was obtained during end-systole and mid-diastole and the acquisition window of the 3D scan was adapted accordingly to the shortest rest period (obtained from a cine image). Vessel Sharpness (VS) and Image Quality (IQ) were analyzed (by two observers) on reformatted images along the RCA and LCA using the “SoapBubble” software. Statistical analysis and Bland Altman plots were used to compare the different data sets (Linear regression, correlation, and t-test for VS, and Wilcoxon test for IQ).

Fig. a shows image examples. VS and IQ Systolic - Diastolic mean and SDV difference were: RCA 2.17±6.21% and 0.08±0.81; LM -3.16±6.43% and 0.02±0.8; LAD -1.07±6.49% and 0.02±0.8; LCx -0.56±0.11% and 0.17±0.86. Fig b shows Bland Altman plots of VS. No significant differences were found comparing mean VS and IQ between systolic and diastolic data. Also, no significant differences were found for interobserver reproducibility of IQ and VS. However, as demonstrated in the Bland Altman plot there were inter-patient and intra-segment (Fig. c) differences favoring either systolic or diastolic image acquisition. Fig. c, shows a color coded plot according to the IQ difference for all patients (blue favors systolic and red diastolic data).

The optimal cardiac rest period for CMRA in Children with CHD is patient dependent, and can be the end-systolic or mid-diastolic period. A dual phase whole heart CMRA scan acquires the complete CA tree during the systolic and diastolic rest period within a single scan. Retrospectively, the heart phase for optimal CA visualization can be chosen being as time efficient as a single phase whole heart scan.

Planning management in CHD requires knowledge of the CA anatomy. As the ideal rest period for CMRA in childhood is unpredictable, a dual cardiac phase sequence provides optimal CA imaging.

Uribe, S, Hussain, T, Valverde, I, Beerbaum, P, Fava, M, Irarrazaval, P, Tejos, C, Botnar, R, Razavi, R, Schaeffter, T, Greil, G, Coronary MR Angiography in CHD Children during Systole and Diastole Using a Dual Cardiac Phase Scan of the Whole Heart.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9011815.html