- Oral presentation
- Open Access
Cardiac magnetic resonance perfusion imaging and the effects of single intravenous cannulation with the Octopus bionector
© Kindler et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Cardiac Magnetic Resonance
- Magnetic Resonance Perfusion Imaging
- Magnetic Resonance Perfusion
- Significant Sinus
- Pass Perfusion
CMR perfusion (CMRP) imaging using adenosine traditionally requires bilateral arm cannulation. Patients with multiple comorbidities often have difficult venous access and dual cannulation often proves impossible. We used a standard two-way adapter (Octopus Vygon with no-reflow valve) to administer adenosine at a standard rate of 140 mcg/kg/minute over 3 minutes for maximum coronary vasodilatation following a bolus injection of gadolinium. High flow bolus injection may cause sinus arrest caused by a flush of residual adenosine in the same arm vein. We acquired 50 sequential R-wave triggered image frames to assess first pass myocardial perfusion and assessed the effect of significant sinus pauses on image acquisition.
First pass perfusion was performed on a Siemens Avanto1.5T MR scanner (Siemens Medical Solutions, USA) with a standardised acquisition protocol using intra-venous adenosine 140μg/kg/min for 3 minutes. Three sequential short axis slices of 8mm thickness were acquired per cardiac cycle using a hybrid EPI sequence (TR 175 ms, TE 1.03 ms, flip angle 25 degrees and voxel size 2.8 x 2.8 x mm2) after administration of a 0.1 mmol/Kg bolus of intravenous Gadolinium (Gadovist). Fifty sequential R-wave triggered frames were acquired to assess first pass perfusion. We assessed the effect of significant sinus pauses on patient safety and quality of image acquisition.
Crucial image frames are not acquired at the most important time points during first pass perfusion in 26% of patients with the Octopus Bionector. The introduction of a two-way intravenous adapter resulted in an unacceptably high number of patients having sinus pauses/sinus arrest over several seconds, And as image quality is heavily dependent on R wave intervals being regular, this adversely affected image quality. This could have led to underdiagnosis of perfusion defects in the affected patients.
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