Open Access

ARTICLE

Optimized Three-Dimensional Cardiovascular Magnetic Resonance Whole Heart Imaging Utilizing Non-Selective Excitation and Compressed Sensing in Children and Adults with Congenital Heart Disease

Ingo Paetsch^1,*, Roman Gebauer², Christian Paech², Frank-Thomas Riede², Sabrina Oebel¹, Andreas Bollmann¹, Christian Stehning³, Jouke Smink⁴, Ingo Daehnert², Cosima Jahnke¹

1 Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
2 Department of Pediatric Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
3 Philips Research Laboratories, Hamburg, Germany
4 Philips Medical Systems, Best, The Netherlands

* Corresponding Author: Ingo Paetsch. Email:

Congenital Heart Disease 2023, 18(3), 279-294. https://doi.org/10.32604/chd.2023.029634

Received 28 February 2023; Accepted 03 April 2023; Issue published 09 June 2023

Abstract

Background: In congenital heart disease (CHD) patients, detailed three-dimensional anatomy depiction plays a pivotal role for diagnosis and therapeutical decision making. Hence, the present study investigated the applicability of an advanced cardiovascular magnetic resonance (CMR) whole heart imaging approach utilizing nonselective excitation and compressed sensing for anatomical assessment and interventional guidance of CHD patients in comparison to conventional dynamic CMR angiography. Methods: 86 consecutive pediatric patients and adults with congenital heart disease (age, 1 to 74 years; mean, 35 years) underwent CMR imaging including a free-breathing, ECG-triggered 3D nonselective SSFP whole heart acquisition using compressed SENSE (nsWHcs). Anatomical assessability and signal intensity ratio (SIR) measurements were compared with conventional dynamic 3D-/4D-MR angiography. Results: The most frequent diagnoses were partial anomalous pulmonary venous drainage (17/86, 20%), transposition of the great arteries (15/86, 17%), tetralogy of Fallot (12/86, 14%), and a single ventricle (7/86, 8%). Image quality of nsWHcs was rated as excellent/good in 98% of patients. nsWHcs resulted in a reliable depiction of all large thoracic vessels (anatomic assessability, 99%–100%) and the proximal segments of coronary arteries and coronary sinus (>90%). nsWHcs achieved a homogenously distributed SIR in all cardiac cavities and thoracic vessels without a significant difference between pulmonary and systemic circulation (10.9 ± 3.5 and 10.6 ± 3.4; p = 0.15), while 3D angiography showed significantly increased SIR for targeted vs. non-targeted circulation (PA-angiography, 15.2 ± 8.1 vs. 5.8 ± 3.6, p < 0.001; PV-angiography, 7.0 ± 3.9 vs. 17.3 ± 6.8, p < 0.001). Conclusions: The proposed nsWHcs imaging approach provided a consistently high image quality and a homogeneous signal intensity distribution within the pulmonary and systemic circulation in pediatric patients and adults with a wide spectrum of congenital heart diseases. nsWHcs enabled detailed anatomical assessment and three-dimensional reconstruction of all cardiac cavities and large thoracic vessels and can be regarded particularly useful for preprocedural planning and interventional guidance in CHD patients.

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Keywords

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Supplementary Material

Supplementary Material File

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