Ashkan Akhavan Malayeri MD, Presenter: Nothing to Disclose

Philip J. Spevak, Abstract Co-Author: Stockholder, General Electric Company

Stefan L. Zimmerman MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the role of a high-resolution 3D dark blood turbo spine echo sequence with variable flip angles (SPACE) in evaluation of congenital heart disease. 

SPACE sequence was performed in 20 patients (mean age, 17.6 ± 12.6 years, range: 9 month – 57 years) with either unrepaired (N=3) or post repair (n=17) congenital heart disease. There were 13 males and 7 females; 10 patients with tetralogy of Fallot, 3 with transposition of great arteries and 7 other complex CHD. All scans were performed on 1.5T Aera Siemens scanners. Two separate observers with expertise in cardiovascular imaging scored the quality of the images for blood suppression and definition of key anatomical structures in a blinded fashion. A five grade scoring system was developed with score 1 being non-diagnostic and 5 being excellent quality diagnostic information. 

Mean of average overall quality scores for two observers was 4 ± 0.62. All overall quality scores were greater than 3. None of the studies were deemed nondiagnostic. Mean length of the SPACE acquisition time was 12.7 mins (4 – 21 mins). Typical matrix size, FOV, and slice thickness were 320 x 240, 30 x 40 cm and 1.3-1.5 mm respectively. There was no significant correlation between image quality and duration of scans. Ability of SPACE for defining borders of larger anatomical structures such as ventricles was better with mean score of 4.2 ± 0.54 compared to smaller structures, such as left main coronary artery with score of 2.1 ± 1.3 (p value <.0001). Lack of blood suppression was the limiting factor in image quality with the most common place being ascending aorta in 9 patients. However, overall blood suppression score was very good with score of 3.9 ± 0.43. There were no differences in image quality for patients under anesthesia compared to conscious patients. There was a positive correlation between the readers in overall scoring of the studies (r = 0.67, p: .0012).

The 3D SPACE dark blood sequence with near isotropic spatial resolution coupled with respiratory and cardiac gating can be feasibly performed in all age group with diagnostic image quality in all cases in this study.  

SPACE can be used as a one-stop shop for evaluation of cardiac anatomy without contrast in complex congenital heart disease and post repair changes with superb image quality and definition. 

Malayeri, A, Spevak, P, Zimmerman, S, Utility of a Novel High Resolution 3D MRI Sequence [SPACE] for Evaluation of Congenital Heart Disease.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015307.html