Noncontrast free-breathing ECG-gated 3D balanced steady-state free precession in congenital heart disease and aortopathy evaluation

• Published in: Pediatric radiology 2024-08, Vol.54 (10), p.1661-1673
• Main Authors: Kocaoglu, Murat, Lang, Sean M., Ta, Hieu, Moore, Ryan A., Pednekar, Amol
• Format: Article
• Language: English
• Subjects: Age; Angiography; Blood vessels; Cardiovascular disease; Comparative analysis; Congenital diseases; Coronary artery disease; Correlation coefficients; EKG; Evaluation; Heart diseases; Image contrast; Image enhancement; Image processing; Image quality; Imaging; Magnetic resonance imaging; Males; Median (statistics); Medical imaging; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Patients; Pediatrics; Precession; Quality control; Radiology; Respiration; Steady state; Ultrasound
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-024-06024-1

Background High-fidelity cardiac magnetic resonance (MR) imaging plays a pivotal role in the surveillance of congenital heart disease (CHD) and aortopathy. Objective We aimed to evaluate the quality and accuracy of free breathing, ECG-gated noncontrast three-dimensional (3D) balanced steady-state free precession (bSSFP) in cases of CHDs and aortopathies using contrast-enhanced 3D bSSFP as a reference. We also used one of our routinely used non-ECG-gated 2D-single-shot (SSh) bSSFP sequence as an adjunct to noncontrast 3D bSSFP. Materials and methods Institutional review board approval was obtained to perform a systematic retrospective analysis of image quality and vascular measurements. Patients with CHD and aortopathy, who were undergoing clinically indicated contrast-enhanced 3D bSSFP, were prospectively identified to also undergo additional noncontrast 3D bSSFP and 2D SSh bSSFP imaging as part of a clinical quality improvement initiative aimed at reducing the use of contrast when feasible. Two readers, blinded to each other’s evaluations, graded image quality on a 5-point Likert scale and performed vascular measurements in separate sessions for both 3D bSSFP images. They also reported the visibility of various mediastinal great vessels on 2D SSh bSSFP images. Raw agreement, the weighted kappa statistic, and intra-class correlation coefficients (ICCs) were computed to assess the consistency and agreement between the two readers. Comparative analysis of noncontrast and contrast-enhanced 3D bSSFP imaging was performed in adult and pediatric patients using a two-sided paired t -test and Bland–Altman analysis. A P -value