- Walking poster presentation
- Open Access
4-dimensional, multiphase, steady-state imaging with contrast enhancement (MUSIC) in the heart; a feasibility study in children
© Han et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Congenital Heart Disease
- Subjective Image Quality
- Congenital Heart Disease Patient
- Subjective Image Quality Score
Conventional breath-held gadolinium-based contrast-enhanced MR angiography (CE-MRA) provides excellent definition of extra-cardiac anatomy, but does not provide diagnostic image quality for intra-cardiac anatomy because it is not gated to ECG due to time constraints associated with breath-holding and the need to capture the first-pass of gadolinium. To address this issue, we propose a 4D non-breath-held multiphase steady-state imaging sequence (MUSIC) using ferumoxytol, which is an FDA approved iron-oxide particle for treating iron-deficiency anemia, as an intravascular contrast agent and demonstrate its feasibility in children with congenital heart disease (CHD).
Eight pediatric CHD patients underwent cardiac MRI under general anesthesia and mechanical ventilation, which is our standard practice for young children who cannot cooperate with breath-holding instructions. The breath-held CE-MRA was first performed under ventilator-controlled breath-hold (VCBH) during the first-pass of a ferumoxytol bolus injection (4 mg-Fe/kg) and repeated 2-3 min later during the delayed-phase. Subsequently, the cardiac-phase-resolved 4D MUSIC acquisition (TR/TE= 2.9/0.9ms; FA=15°; isotropic resolution=0.6-0.9mm, 5-8 cardiac phases, scan time 4-8min, 65-95ms temporal resolution) was performed during the steady-state distribution phase of ferumoxytol without VCBH and the ventilator tubing air pressure signal was fed into the MR scanner for respiratory gating. Standard 2D cardiac cine images were also acquired under VCBH. Subjective image quality scores (1=poor, 2=fair, 3=good, 4=excellent) were visually assessed and the LV volumes were measured based on standard 2D cine and the 4D MUSIC data.
Our study represents a potential new paradigm of cardiovascular MRI for young children. The use of ferumoxytol (14 hours of intravascular half-life) eliminates the time constraints of conventional CE-MRA and enables much higher quality 4D dynamic cardiac imaging with sub-millimeter isotropic resolution.
NIH (NHLBI) 1R21 HL113427.
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