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Shen Q, Lin C, Yao Q, Wang J, Zhou J, He L, Chen G, Hu X. Addition of gadolinium contrast to three-dimensional SSFP MR sequences improves the visibility of coronary artery anatomy in young children. Front Pediatr 2023; 11:1159347. [PMID: 37215588 PMCID: PMC10196256 DOI: 10.3389/fped.2023.1159347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
Objective This study aims to compare the value of a gadolinium contrast-enhanced 1.5-T three-dimensional (3D) steady-state free precession (SSFP) sequence with that of a noncontrast 3D SSFP sequence for magnetic resonance coronary angiography in a pediatric population. Materials and methods Seventy-nine patients from 1 month to 18 years old participated in this study. A 3D SSFP coronary MRA at 1.5-T was applied before and after gadolinium-diethylenetriaminepentaaceticacid (DTPA) injection. The detection rates of coronary arteries and side branches were assessed by McNemar's χ2 test. The image quality, vessel length, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the coronary arteries were analyzed by the Wilcoxon signed-rank test. The intra- and interobserver agreements were evaluated with a weighted kappa test or an intraclass correlation efficient test. Results A contrast-enhanced scan detected more coronary arteries than a noncontrast-enhanced scan in patients under 2 years old (P < 0.05). The SSFP sequence with contrast media detected more coronary artery side branches in patients younger than 5 years (P < 0.05). The image quality of all the coronary arteries was better after the injection of gadolinium-DTPA in children younger than 2 years (P < 0.05) but not significantly improved in children older than 2 years (P > 0.05). The contrast-enhanced 3D SSFP protocol detected longer lengths for the left anterior descending coronary artery in children younger than 2 years and the left circumflex coronary artery (LCX) in children younger than 5 years (P < 0.05). SNR and CNR of all the coronary arteries in children younger than 5 years and the LCX and right coronary artery in children older than 5 years enhanced after the injection of gadolinium-DTPA (P < 0.05). The intra- and interobserver agreements were high (0.803-0.998) for image quality, length, SNR, and CNR of the coronary arteries in both pre- and postcontrast groups. Conclusion The use of gadolinium contrast in combination with the 3D SSFP sequence is necessary for coronary imaging in children under 2 years of age and may be helpful in children between 2 and 5 years. Coronary artery visualization is not significantly improved in children older than 5 years.
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Affiliation(s)
- Quanli Shen
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Chengxiang Lin
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Qiong Yao
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Junbo Wang
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Jian Zhou
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
| | - Lan He
- Heart Centre, Children’s Hospital of Fudan University, Shanghai, China
| | - Gang Chen
- Heart Centre, Children’s Hospital of Fudan University, Shanghai, China
| | - Xihong Hu
- Department of Radiology, Children’s Hospital of Fudan University, Shanghai, China
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Unenhanced Whole-Heart Coronary MRA: Prospective Intraindividual Comparison of 1.5-T SSFP and 3-T Dixon Water-Fat Separation GRE Methods Using Coronary Angiography as Reference. AJR Am J Roentgenol 2022; 219:199-211. [PMID: 35293232 DOI: 10.2214/ajr.21.27292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Coronary MRA is commonly performed at 1.5 T using SSFP acquisitions. Coronary MRA at 3 T is limited using SSFP due to impaired fat suppression and has been investigated typically using contrast-enhanced techniques. A Dixon fat-water separation gradient-recalled echo (GRE) method may enable high-quality unenhanced 3-T coronary MRA. Objective: To compare 1.5-T SSFP and 3-T Dixon water-fat separation GRE methods for unenhanced whole-heart coronary MRA in patients with suspected coronary artery disease (CAD). Methods: This prospective study included 44 patients (27 men, 17 women; mean age 59±8 years) with intermediate-to-high risk of CAD who underwent both 1.5-T SSFP and 3-T Dixon GRE coronary MRA examinations before coronary angiography (CAG). Two radiologists independently assessed coronary arteries in terms of subjective image quality (1-5 scale; 5=highest image quality), number of visible segments, apparent contrast-to-noise ratio (CNR; vs myocardium)), and presence of significant stenoses. Methods were compared using readers' mean values for apparent CNR and consensus interpretations for other measures. CAG served as reference standard for presence of stenoses. Results: Interobserver agreement expressed as kappa was 0.85 for image quality, 0.85 for segment visibility, and 0.83 for stenosis, and expressed as intraclass correlation coefficient was 0.92 for apparent CNR. Mean overall image quality score was 4.0±1.1 for 3-T Dixon GRE versus 3.0±1.2 for 1.5-T SSFP. Percentage of visible segments for 3-T Dixon GRE versus 1.5-T SSFP was 96.7% versus 88.9% for all segments, 96.9% versus 90.1% for distal segments, and 93.1% versus 77.2% for branch segments. Mean overall apparent CNR was 93.2±29.2 for 3-T Dixon GRE versus 80.8±27.9 for 1.5-T SSFP. 3-T Dixon GRE, compared with 1.5-T SSFP, showed higher sensitivity and specificity in per-vessel analysis (87.9% vs 77.3%; 83.3% vs 60.6%), per-segment analysis (84.6% vs 74.8%, 90.9% vs 79.6%), and per-segment analysis of distal and branch segments (89.7% vs 75.9%, 89.7% vs 73.7%). Conclusion: For unenhanced coronary MRA, 3-T unenhanced Dixon GRE had better image quality and diagnostic performance than 1.5-T SSFP, particularly for distal and branch segments. Clinical Impact: The 3-T Dixon GRE technique may be preferred to the current clinical standard of 1.5-T SSFP for unenhanced coronary MRA.
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Lin L, Wang L, Zhang XN, Li X, Wang J, Shen ZJ, Chen W, Jin ZY, Wang YN. A clinical strategy to improve the diagnostic accuracy of 1.5-T non-contrast MR coronary angiography for detection of coronary artery disease: combination of whole-heart and volume-targeted imaging. Eur Radiol 2020; 31:1894-1904. [PMID: 32975662 DOI: 10.1007/s00330-020-07135-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/30/2020] [Accepted: 07/31/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of 1.5-T non-contrast MR coronary angiography (MRCA) for detection of coronary artery disease (CAD) using whole-heart imaging combined with volume-targeted imaging. METHODS Forty-five patients scheduled for conventional coronary angiography (CAG) underwent 1.5-T free-breathing non-contrast steady-state free-precession MRCA, including whole-heart and subsequent three-vessel volume-targeted imaging. Coronary stenosis was evaluated as follows: (1) by whole-heart MRCA alone; (2) by combined MRCA (whole-heart plus volume-targeted images). The diagnostic performance for significant stenosis (≥ 50% diameter reduction) was evaluated and compared using CAG as a reference standard. RESULTS Combined MRCA was completed in all 45 patients with a total acquisition time of 16.6 ± 3.3 min. The sensitivity, specificity, and accuracy of combined MRCA per patient were 97% (95% confidence interval 84-100%), 83% (52-98%), and 93% (82-98%), respectively. The areas under the receiver operating characteristic curve of combined MRCA were significantly higher than those of whole-heart MRCA on a per patient (0.97 versus 0.85, p = 0.0078) and per vessel (0.96 versus 0.86, p < 0.0001) basis. Compared with whole-heart MRCA, combined MRCA showed equally high sensitivity but significantly improved specificity on a per patient (83% versus 25%, p = 0.016) and per vessel (85% versus 50%, p < 0.0001) basis. CONCLUSIONS 1.5-T non-contrast MRCA combining whole-heart and volume-targeted imaging can detect significant CAD with high sensitivity and moderate specificity. Combined MRCA significantly improves specificity compared with whole-heart imaging alone. KEY POINTS • 1.5-T non-contrast MRCA with combined whole-heart and volume-targeted imaging can detect CAD with high sensitivity and moderate specificity comparable with coronary CTA. • Compared with whole-heart imaging alone, combined imaging provides improved diagnostic accuracy, especially specificity.
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Affiliation(s)
- Lu Lin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Liang Wang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Xiao-Na Zhang
- Department of Health Care & Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Xiao Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Jian Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Zhu-Jun Shen
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Wei Chen
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| | - Yi-Ning Wang
- Department of Health Care & Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
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Frommelt P, Lopez L, Dimas VV, Eidem B, Han BK, Ko HH, Lorber R, Nii M, Printz B, Srivastava S, Valente AM, Cohen MS. Recommendations for Multimodality Assessment of Congenital Coronary Anomalies: A Guide from the American Society of Echocardiography: Developed in Collaboration with the Society for Cardiovascular Angiography and Interventions, Japanese Society of Echocardiography, and Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr 2020; 33:259-294. [PMID: 32143778 DOI: 10.1016/j.echo.2019.10.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Peter Frommelt
- Children's Hospital of Wisconsin and the Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Leo Lopez
- Stanford University, Palo Alto, California
| | | | | | - B Kelly Han
- Children's Minnesota and the Minneapolis Heart Institute, Minneapolis, Minnesota
| | - H Helen Ko
- Kravis Children's Hospital, Mount Sinai Medical Center, New York, New York
| | - Richard Lorber
- Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas
| | - Masaki Nii
- Shizuoka Children's Hospital, Shizuoka, Shizuoka, Japan
| | - Beth Printz
- University of California San Diego and Rady Children's Hospital, San Diego, California
| | | | - Anne Marie Valente
- Boston Children's Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Meryl S Cohen
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Jin H, Yun H, Ma JY, Chen ZW, Chang SF, Ge MY, Zeng MS. Assessment of the acute effects of glucocorticoid treatment on coronary microembolization using cine, first-pass perfusion, and delayed enhancement MRI. J Magn Reson Imaging 2015; 43:921-8. [PMID: 26361889 DOI: 10.1002/jmri.25049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 09/01/2015] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To assess the acute effects of methylprednisone treatment (MPT) on coronary microembolization (CME) by cardiac cine, first-pass perfusion, and delayed gadolinium enhancement magnetic resonance imaging (DE-MRI) in an experimental swine model. MATERIALS AND METHODS Microembolization was established by intracoronary infusion of microspheres into the left anterior artery. Swine received placebo (n = 12) or methylprednisolone (n = 10, 30 mg/kg) intravenously 30 minutes before microembolization. Perfusion and DE-MRI was performed 6 hours after microembolization. Cine MR images of pre-/post-CME were obtained using 1.5T scanner. RESULTS Cine MRI demonstrated relative amelioration of the post-CME myocardial contractile dysfunction in the glucocorticoid-treated group compared to the placebo group (P < 0.001). Post-CME target myocardial perfusion parameters decreased in both groups after microembolization. The extent of these decreases were the same for the embolized-to-control area ratio of maximum upslope (P = 0.245; 95% confidence interval of the difference [CID], -0.041/0.148) and time to peak ratio (P = 0.122; 95% CID, -0.201/0.026); however, the maximum signal intensity was higher in the glucocorticoid-treated group (P = 0.012; 95% CID, 0.023/0.156). DE-MRI revealed patchy hyperenhancement in all placebo pigs (n = 12/12) after microembolization, but no hyperenhanced regions in the glucocorticoid-pretreated pigs (n = 0/10). CONCLUSION Standard, readily available, cardiac MRI techniques are useful in demonstrating post-CME myocardial dysfunction and the acute effects of glucocorticoid treatment on CME. Glucocorticoid pretreatment improves myocardial contractile dysfunction, prevents hyperenhancement, and partially ameliorates the decline of myocardial perfusion in the embolized area.
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Affiliation(s)
- Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hong Yun
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-ying Ma
- Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Zhang-wei Chen
- Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Shu-fu Chang
- Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Mei-ying Ge
- Department of Radiology, the 5th people's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Meng-su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
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Song KD, Kim SM, Choe YH, Jung W, Lee SC, Chang SA, Choi YH, Sung J. Integrated cardiac magnetic resonance imaging with coronary magnetic resonance angiography, stress-perfusion, and delayed-enhancement imaging for the detection of occult coronary artery disease in asymptomatic individuals. Int J Cardiovasc Imaging 2015; 31 Suppl 1:77-89. [DOI: 10.1007/s10554-015-0665-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
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Liu J, Nguyen TD, Zhu Y, Spincemaille P, Prince MR, Weinsaft JW, Saloner D, Wang Y. Self-gated free-breathing 3D coronary CINE imaging with simultaneous water and fat visualization. PLoS One 2014; 9:e89315. [PMID: 24586682 PMCID: PMC3930724 DOI: 10.1371/journal.pone.0089315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 01/22/2014] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to develop a novel technique for acquiring 3-dimensional (3D) coronary CINE magnetic resonance images with both water and fat visualization during free breathing and without external respiratory or cardiac gating. The implemented multi-echo hybrid 3D radial balanced Steady-State Free Precession (SSFP) sequence has an efficient data acquisition and is robust against motion. The k-space center along the slice encoding direction was repeatedly acquired to derive both respiratory and cardiac self-gating signals without an increase in scan time, enabling a free-breathing acquisition. The multi-echo acquisition allowed image reconstruction with water-fat separation, providing improved visualization of the coronary artery lumen. Ten healthy subjects were imaged successfully at 1.5 T, achieving a spatial resolution of 1.0×1.0×3.0 mm3 and scan time of about 5 minutes. The proposed imaging technique provided coronary vessel depiction comparable to that obtained with conventional breath-hold imaging and navigator gated free-breathing imaging.
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Affiliation(s)
- Jing Liu
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America ; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America
| | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
| | - Yanchun Zhu
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
| | - Pascal Spincemaille
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
| | - Martin R Prince
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
| | - Jonathan W Weinsaft
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States of America
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