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Febbo JA, Galizia MS, Murphy IG, Popescu A, Bi X, Turin A, Collins J, Markl M, Edelman RR, Carr JC. Congenital heart disease in adults: Quantitative and qualitative evaluation of IR FLASH and IR SSFP MRA techniques using a blood pool contrast agent in the steady state and comparison to first pass MRA. Eur J Radiol 2015; 84:1921-9. [PMID: 26253499 DOI: 10.1016/j.ejrad.2015.06.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/16/2015] [Accepted: 06/29/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate magnetic resonance angiography sequences during the contrast steady-state (SS-MRA) using inversion recovery (IR) with fast low-angle shot (IR-FLASH) or steady-state free precession (IR-SSFP) read-outs, following the injection of a blood-pool contrast agent, and compare them to first-pass MR angiography (FP-MRA) in adults with congenital heart disease (CHD). MATERIALS AND METHODS Twenty-three adult patients with CHD who underwent both SS-MRA and FP-MRA using a 1.5-T scanner were retrospectively identified. Signal-to-noise and contrast-to-noise ratios were obtained at eight locations within the aorta and pulmonary vessels.. Image quality and the presence of artifacts were subjectively assessed by two radiologists. The presence of pathology was noted and given a confidence score. RESULTS There was no difference in vessel dimensions among the sequences. IR-SSFP showed better image quality and fewer artifacts than IR-FLASH and FP-MRA. Confidence scores were significantly higher for SS-MRA compared to FP-MRA. Seven cases (30.4%) had findings detected at SS-MRA that were not detected at FP-MRA, and 2 cases (8.7%) had findings detected by IR-SSFP only. CONCLUSION SS-MRA of the thoracic vasculature using a blood pool contrast agent offers superior image quality and reveals more abnormalities compared to standard FP-MRA in adults with CHD, and it is best achieved with an IR-SSFP sequence. These sequences could lead to increased detection rates of abnormalities and provide a simpler protocol image acquisition.
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Affiliation(s)
- Jennifer A Febbo
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
| | - Mauricio S Galizia
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA; Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ian G Murphy
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
| | - Andrada Popescu
- Department of Medical Imaging, Children's Memorial Hospital, Chicago, IL, USA
| | - Xiaoming Bi
- Cardiovascular MR R&D, Siemens Healthcare, Chicago, IL, USA
| | - Alexander Turin
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
| | - Jeremy Collins
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
| | - Michael Markl
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA; Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, North Shore University Health System, Evanston, IL, USA
| | - James C Carr
- Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
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A welcome to the new journal, International Journal of Cardiology - Heart and Vessels (IJC-H + V). INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VESSELS 2013; 1:1-10. [PMID: 29450152 PMCID: PMC5801079 DOI: 10.1016/j.ijchv.2013.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 11/03/2013] [Indexed: 11/20/2022]
Abstract
A new journal has been launched: IJC - Heart and Vessels [1]. It builds upon the success of the main journal International Journal of Cardiology. As an introduction to the new journal we will be publishing a series of summaries of the topics to be covered, highlighting the most important papers in the field that have been published recently in the main journal, International Journal of Cardiology. This article describes a topic review of congenital heart disease. IJC has become one of the most important sources of quality papers in this field and many excellent publications have been published in the main journal. The expansion of space occasioned by the launch of IJC - Heart and Vessels will allow us to publish more high quality papers in the expanding field of congenital heart disease.
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Incremental value of color coding in 3D volume rendered CT images for interpretation of complex cardiothoracic vascular malformations. Int J Cardiol 2013; 168:4692-8. [DOI: 10.1016/j.ijcard.2013.07.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/17/2013] [Accepted: 07/20/2013] [Indexed: 11/21/2022]
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Current world literature. Curr Opin Cardiol 2013; 28:259-68. [PMID: 23381096 DOI: 10.1097/hco.0b013e32835ec472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Raman SV, Aneja A, Jarjour WN. CMR in inflammatory vasculitis. J Cardiovasc Magn Reson 2012; 14:82. [PMID: 23199343 PMCID: PMC3533951 DOI: 10.1186/1532-429x-14-82] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 11/16/2012] [Indexed: 12/18/2022] Open
Abstract
Vasculitis, the inflammation of blood vessels, can produce devastating complications such as blindness, renal failure, aortic rupture and heart failure through a variety of end-organ effects. Noninvasive imaging with cardiovascular magnetic resonance (CMR) has contributed to improved and earlier diagnosis. CMR may also be used in serial evaluation of such patients as a marker of treatment response and as an indicator of subsequent complications. Unique strengths of CMR favoring its use in such conditions are its abilities to noninvasively visualize both lumen and vessel wall with high resolution. This case-based review focuses on the large- and medium-vessel vasculitides where MR angiography has the greatest utility. Because of increasing recognition of cardiac involvement in small-vessel vasculitides, this review also presents evidence supporting greater consideration of CMR to detect and quantify myocardial microvascular disease. CMR's complementary role amidst traditional clinical, serological and other diagnostic techniques in personalized care for patients with vasculitis is emphasized. Specifically, the CMR laboratory can address questions related to extent and severity of vascular involvement. As ongoing basic and translational studies better elucidate poorly-defined underlying molecular mechanisms, this review concludes with a discussion of potential directions for the development of more targeted imaging approaches.
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Affiliation(s)
- Subha V Raman
- The Ohio State University, 473 W. 12th Ave, Suite 200, Columbus, OH, 43210, USA
| | - Ashish Aneja
- Division of Cardiovascular Medicine, The Ohio State University, 473 W. 12th Ave, Suite 200, Columbus, OH, 43210, USA
| | - Wael N Jarjour
- Division of Rheumatology, The Ohio State University, 480 Medical Center Drive, S2056 DMRC, Columbus, Oh, 43210, USA
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Abstract
The association between gadolinium-based contrast agents and neprogenic systemic fibrosis has helped propel noncontrast angiography techniques to center stage in the MR evaluation of vascular disease, especially in individuals with intrinsic renal diseases. Although balanced steady-state free precession, phase contrast, and time-of-flight sequences are currently being revisited and improved, new noncontrast angiographic methods have been created and are under development: ECG-gated 3D partial-Fourier fast spin echo (FSE) and 3D variable flip angle FSE (SPACE). All of these are attempts to develop noncontrast methods that offer equal or superior vascular diagnosis as compared with contrast-enhanced MR angiography.
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