Juvenile and adult congenital heart disease: Time-resolved 3D contrast-enhanced MR angiography

Michael Fenchel, Roya Saleh, Howard Dinh, Margaret H. Lee, Kambiz Nael, Mayil Krishnam, Stefan G. Ruehm, Stephan Miller, John Child, J. Paul Finn

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the incremental diagnostic value of time-resolved three-dimensional (3D) magnetic resonance (MR) angiography over single-phase 3D MR angiography and cine MR imaging in juvenile and adult patients with congenital heart disease (CHD). Materials and Methods: The study was HIPAA compliant and was approved by the institutional review board. Written informed consent was obtained from each patient. Eighty-one consecutive patients (46 male and 35 female patients; mean age, 31.1 years ± 13.5 [standard deviation]) with CHD were examined with a 1.5-T MR imaging unit. The imaging protocol comprised time-resolved MR angiography (repetition time msec/echo time msec, 2.01/0.81) after injection of 0.03 mmol gadodiamide per kilogram of body weight at 4 mL/sec and single-phase high-spatial-resolution MR angiography (2.87/0.97) after injection of 0.15 mmol/kg gadodiamide at 1.5 mL/sec. After review of the time-resolved and conventional MR angiographic data sets, each of two independent observers listed the additional clinical information gained from time-resolved MR angiographic data. A Wilcoxon signed rank test was used to test for statistical differences between the image quality ratings of the two observers. Results: Time-resolved and single-phase high-spatial-resolution MR angiography yielded diagnostic image data in all patients. Observers 1 and 2 found functional information in time-resolved MR angiographic series in 52 and 51 patients, respectively, that was not seen at high-spatial-resolution MR angiography. Intra- and extracardiac shunts, respectively, were exclusively depicted by time-resolved MR angiography for observer 1 in 18 and two patients and for observer 2 in 15 and two patients. However, both observers reported higher confidence in the assessment of such smaller vascular structures as supraaortic vessels (in 12 patients for observer 1 and 11 patients for observer 2) and major aortopulmonary collateral arteries (in eight patients for observer 1 and 10 patients for observer 2) at high-spatial-resolution MR angiography. No significant difference was evident in image quality scoring between the two observers (P = .32 for time-resolved and P = .47 for conventional MR angiography). Conclusion: Compared with conventional MR angiography, time-resolved MR angiography yields clinically relevant information in a substantial number of patients; hence, the two techniques should be regarded as complementary.

Original languageEnglish (US)
Pages (from-to)399-410
Number of pages12
JournalRadiology
Volume244
Issue number2
DOIs
StatePublished - Aug 2007
Externally publishedYes

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Magnetic Resonance Angiography
Heart Diseases
gadodiamide
Magnetic Resonance Spectroscopy
Cine Magnetic Resonance Imaging
Health Insurance Portability and Accountability Act
Injections
Research Ethics Committees
Nonparametric Statistics
Informed Consent
Blood Vessels
Arteries

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Fenchel, M., Saleh, R., Dinh, H., Lee, M. H., Nael, K., Krishnam, M., ... Finn, J. P. (2007). Juvenile and adult congenital heart disease: Time-resolved 3D contrast-enhanced MR angiography. Radiology, 244(2), 399-410. https://doi.org/10.1148/radiol.2442061045

Juvenile and adult congenital heart disease : Time-resolved 3D contrast-enhanced MR angiography. / Fenchel, Michael; Saleh, Roya; Dinh, Howard; Lee, Margaret H.; Nael, Kambiz; Krishnam, Mayil; Ruehm, Stefan G.; Miller, Stephan; Child, John; Finn, J. Paul.

In: Radiology, Vol. 244, No. 2, 08.2007, p. 399-410.

Research output: Contribution to journalArticle

Fenchel, M, Saleh, R, Dinh, H, Lee, MH, Nael, K, Krishnam, M, Ruehm, SG, Miller, S, Child, J & Finn, JP 2007, 'Juvenile and adult congenital heart disease: Time-resolved 3D contrast-enhanced MR angiography', Radiology, vol. 244, no. 2, pp. 399-410. https://doi.org/10.1148/radiol.2442061045
Fenchel, Michael ; Saleh, Roya ; Dinh, Howard ; Lee, Margaret H. ; Nael, Kambiz ; Krishnam, Mayil ; Ruehm, Stefan G. ; Miller, Stephan ; Child, John ; Finn, J. Paul. / Juvenile and adult congenital heart disease : Time-resolved 3D contrast-enhanced MR angiography. In: Radiology. 2007 ; Vol. 244, No. 2. pp. 399-410.
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abstract = "Purpose: To assess the incremental diagnostic value of time-resolved three-dimensional (3D) magnetic resonance (MR) angiography over single-phase 3D MR angiography and cine MR imaging in juvenile and adult patients with congenital heart disease (CHD). Materials and Methods: The study was HIPAA compliant and was approved by the institutional review board. Written informed consent was obtained from each patient. Eighty-one consecutive patients (46 male and 35 female patients; mean age, 31.1 years ± 13.5 [standard deviation]) with CHD were examined with a 1.5-T MR imaging unit. The imaging protocol comprised time-resolved MR angiography (repetition time msec/echo time msec, 2.01/0.81) after injection of 0.03 mmol gadodiamide per kilogram of body weight at 4 mL/sec and single-phase high-spatial-resolution MR angiography (2.87/0.97) after injection of 0.15 mmol/kg gadodiamide at 1.5 mL/sec. After review of the time-resolved and conventional MR angiographic data sets, each of two independent observers listed the additional clinical information gained from time-resolved MR angiographic data. A Wilcoxon signed rank test was used to test for statistical differences between the image quality ratings of the two observers. Results: Time-resolved and single-phase high-spatial-resolution MR angiography yielded diagnostic image data in all patients. Observers 1 and 2 found functional information in time-resolved MR angiographic series in 52 and 51 patients, respectively, that was not seen at high-spatial-resolution MR angiography. Intra- and extracardiac shunts, respectively, were exclusively depicted by time-resolved MR angiography for observer 1 in 18 and two patients and for observer 2 in 15 and two patients. However, both observers reported higher confidence in the assessment of such smaller vascular structures as supraaortic vessels (in 12 patients for observer 1 and 11 patients for observer 2) and major aortopulmonary collateral arteries (in eight patients for observer 1 and 10 patients for observer 2) at high-spatial-resolution MR angiography. No significant difference was evident in image quality scoring between the two observers (P = .32 for time-resolved and P = .47 for conventional MR angiography). Conclusion: Compared with conventional MR angiography, time-resolved MR angiography yields clinically relevant information in a substantial number of patients; hence, the two techniques should be regarded as complementary.",
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AU - Nael, Kambiz

AU - Krishnam, Mayil

AU - Ruehm, Stefan G.

AU - Miller, Stephan

AU - Child, John

AU - Finn, J. Paul

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N2 - Purpose: To assess the incremental diagnostic value of time-resolved three-dimensional (3D) magnetic resonance (MR) angiography over single-phase 3D MR angiography and cine MR imaging in juvenile and adult patients with congenital heart disease (CHD). Materials and Methods: The study was HIPAA compliant and was approved by the institutional review board. Written informed consent was obtained from each patient. Eighty-one consecutive patients (46 male and 35 female patients; mean age, 31.1 years ± 13.5 [standard deviation]) with CHD were examined with a 1.5-T MR imaging unit. The imaging protocol comprised time-resolved MR angiography (repetition time msec/echo time msec, 2.01/0.81) after injection of 0.03 mmol gadodiamide per kilogram of body weight at 4 mL/sec and single-phase high-spatial-resolution MR angiography (2.87/0.97) after injection of 0.15 mmol/kg gadodiamide at 1.5 mL/sec. After review of the time-resolved and conventional MR angiographic data sets, each of two independent observers listed the additional clinical information gained from time-resolved MR angiographic data. A Wilcoxon signed rank test was used to test for statistical differences between the image quality ratings of the two observers. Results: Time-resolved and single-phase high-spatial-resolution MR angiography yielded diagnostic image data in all patients. Observers 1 and 2 found functional information in time-resolved MR angiographic series in 52 and 51 patients, respectively, that was not seen at high-spatial-resolution MR angiography. Intra- and extracardiac shunts, respectively, were exclusively depicted by time-resolved MR angiography for observer 1 in 18 and two patients and for observer 2 in 15 and two patients. However, both observers reported higher confidence in the assessment of such smaller vascular structures as supraaortic vessels (in 12 patients for observer 1 and 11 patients for observer 2) and major aortopulmonary collateral arteries (in eight patients for observer 1 and 10 patients for observer 2) at high-spatial-resolution MR angiography. No significant difference was evident in image quality scoring between the two observers (P = .32 for time-resolved and P = .47 for conventional MR angiography). Conclusion: Compared with conventional MR angiography, time-resolved MR angiography yields clinically relevant information in a substantial number of patients; hence, the two techniques should be regarded as complementary.

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