Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography

• Published in: Pediatric radiology 2015-10, Vol.45 (11), p.1635-1643
• Main Authors: Zhang, Tao, Yousaf, Ufra, Hsiao, Albert, Cheng, Joseph Y., Alley, Marcus T., Lustig, Michael, Pauly, John M., Vasanawala, Shreyas S.
• Format: Article
• Language: English
• Subjects: Abdomen - anatomy & histology; Abdomen - blood supply; Adolescent; Arteries - anatomy & histology; Child; Child, Preschool; Contrast Media; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Imaging, Three-Dimensional - methods; Infant; Infant, Newborn; Magnetic Resonance Angiography - methods; Male; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Radiology; Reproducibility of Results; Respiratory Mechanics; Sensitivity and Specificity; Spatio-Temporal Analysis; Ultrasound
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-015-3384-y

Background Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. Objective To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography method for depicting abdominal arterial anatomy in young children. Materials and methods With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast-enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast-enhanced MR angiography studies. A radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Results Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9-5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Conclusion Free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries in young children.