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  • Poster presentation
  • Open Access

Adenosine stress perfusion CMR in young children: assessment of optimal imaging parameters

  • 1,
  • 1,
  • 1 and
  • 1
Journal of Cardiovascular Magnetic Resonance201315 (Suppl 1) :P298

https://doi.org/10.1186/1532-429X-15-S1-P298

  • Published:

Keywords

  • Coronary Artery Disease
  • Diagnostic Quality
  • Stress Perfusion
  • Saturation Recovery
  • Optimize Image Quality

Background

Adenosine stress perfusion CMR is commonly used for assessing coronary artery disease (CAD) in adults. CAD is uncommon in children, but does occur. There is limited experience performing adenosine stress perfusion CMR in young children. Performing stress perfusion CMR in young children presents a number of technical imaging challenges.

Specific Aim: Evaluate image quality and optimal imaging parameters in young children undergoing adenosine stress perfusion CMR.

Methods

Consecutive patients, who completed clinically ordered CMR adenosine stress perfusion and were </= 5yo or </= 25kg, were enrolled. General anesthesia was utilized in all. All studies were performed on a 1.5T Siemens Avanto system. Adenosine stress perfusion was performed with administration of adenosine (140 μg/kg/min) for 2-4 minutes and gadolinium (0.1 mmol/kg). A prospectively gated saturation recovery turbo flash image was acquired. Imaging parameters were selected by the technician at the time of each scan to optimize image quality. Images were retrospectively reviewed to assess diagnostic quality. The following imaging parameters were recorded: field of view (FOV)-read, FOV-phase, matrix, inversion time, slice thickness and spatial resolution.

Results

7 patients were enrolled. Demographic information is listed in table 1. All completed stress perfusion CMR without adverse events. All had images of diagnostic quality. 2 patients had perfusion defects consistent with inducible ischemia. One underwent coronary angiography (1 lost to follow-up), and had CAD consistent with stress perfusion CMR. One patient with negative stress perfusion CMR underwent coronary angiography and did not have CAD.

Table 1

Patient Demographics

Patient

Age (yr)

Weight (kg)

Diagnosis

1

1

8.6

Transposition of the great arteries s/p arterial switch

2

2

14.6

Transposition of the great arteries s/p arterial switch

3

4

22.3

Pulmonary atresia/intact ventricular septum s/p Fontan

4

5

20.7

Anomalous origin of left coronary artery from pulmonary artery s/p repair

5

5

18.5

Transposition of the great arteries s/p arterial switch

6

5

22.5

Double outlet right ventricle s/p ventricular septal defect closure and pulmonary valvotomy

7

5

19.4

Transposition of the great arteries s/p arterial switch

Imaging parameters are listed in table 2. The average FOV-read was 237mm (180-300mm), FOV-phase was 175mm (135-239mm), matrix (frequency) was 198mm (160-300mm) and matrix (phase) was 146mm (112-139mm). The average inversion time was 136msec (100-200 msec). Slice thickness was 7-8mm. The average spatial resolution in both the read and phase direction was 1.2mm (0.9-1.6mm), and the average voxel size was 1.2 x 1.2 x 7.5mm.
Table 2

Stress Perfusion CMR: Imaging Parameters

Patient

Age (yr)

Weight (kg)

FOV-read (mm)

FOV-phase (mm)

Matrix-frequency (mm)

Matrix-read (mm)

TI (msec)

Slice thickness (mm)

Spatial resolution-read (mm)

Spatial resolution-phase (mm)

1

1

8.6

220

154

160

112

110

8

1.4

1.4

2

2

14.6

180

135

192

144

180

7

0.9

0.9

3

4

22.3

300

239

300

239

130

8

1.0

1.0

4

5

20.7

200

139

176

122

120

8

1.1

1.1

5

5

18.5

220

150

208

142

200

7

1.1

1.1

6

5

22.5

260

192

160

118

100

8

1.6

1.6

7

5

19.4

280

219

192

150

115

8

1.5

1.5

FOV=Field of view, TI=Inversion time

Conclusions

CMR adenosine stress perfusion can be performed in young children and images of diagnostic quality acquired. Young children present a number of technical challenges that can be overcome by appropriately adapting imaging parameters to the individual patient size.

Funding

None.

Authors’ Affiliations

(1)
Duke Cardiovascular Magnetic Resonance Center, Duke Unviersity Hospital, Durham, NC, USA

Copyright

© Campbell et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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