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Coronary artery assessment using self-navigated free-breathing radial whole-heart magnetic resonance angiography in patients with congenital heart disease

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Abstract

Objectives

To evaluate a self-navigated free-breathing three-dimensional (SNFB3D) radial whole-heart MRA technique for assessment of main coronary arteries (CAs) and side branches in patients with congenital heart disease (CHD).

Methods

SNFB3D-MRA datasets of 109 patients (20.1±11.8 years) were included. Three readers assessed the depiction of CA segments, diagnostic confidence in determining CA dominance, overall image quality and the ability to freeze cardiac and respiratory motion. Vessel sharpness was quantitatively measured.

Results

The percentages of cases with excellent CA depiction were as follows (mean score): left main, 92.6 % (1.92); left anterior descending (LAD), 88.3 % (1.88); right (RCA), 87.8 % (1.85); left circumflex, 82.8 % (1.82); posterior descending, 50.2 % (1.50) and first diagonal, 39.8 % (1.39). High diagnostic confidence for the assessment of CA dominance was achieved in 56.2 % of MRA examinations (mean score, 1.56). Cardiac motion freezing (mean score, 2.18; Pearson’s r=0.73, P<0.029) affected image quality more than respiratory motion freezing (mean score, 2.20; r=0.58, P<0.029). Mean quantitative vessel sharpness of the internal thoracic artery, RCA and LAD were 53.1, 52.5 and 48.7 %, respectively.

Conclusions

Most SNFB3D-MRA examinations allow for excellent depiction of the main CAs in young CHD patients; visualisation of side branches remains limited.

Key Points

• Self-navigated free-breathing three-dimensional magnetic resonance angiography (SNFB3D-MRA) sufficiently visualises coronary arteries (CAs).

• Depiction of main CAs in patients with congenital heart disease is excellent.

• Visualisation of CA side branches using SNFB3D-MRA is limited.

• SNFB3D-MRA image quality is especially correlated to cardiac motion freezing ability.

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Author information

Author notes

  1. Moritz H. Albrecht and Akos Varga-Szemes contributed equally to this article and share first authorship.

Authors and Affiliations

  1. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA

    Moritz H. Albrecht, Akos Varga-Szemes, U. Joseph Schoepf, Georg Apfaltrer, Jiaqian Xu, Kwang-Nam Jin, Anthony M. Hlavacek, Shahryar M. Chowdhury, Pal Suranyi, Christian Tesche, Carlo N. De Cecco & Arni Nutting

  2. Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany

    Moritz H. Albrecht & Thomas J. Vogl

  3. Department of Radiology, University Hospital Graz, Graz, Austria

    Georg Apfaltrer

  4. Department of Radiology, Centre for Biomedical Imaging (CIBM), University Hospital of Lausanne (CHUV), Lausanne, Switzerland

    Davide Piccini, Matthias Stuber & Giulia Ginami

  5. Advanced Clinical Imaging Technology, Siemens Healthcare, IM BM PI, Lausanne, Switzerland

    Davide Piccini

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  1. Moritz H. Albrecht
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Corresponding author

Correspondence to U. Joseph Schoepf.

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Guarantor

The scientific guarantor of this publication is Prof. Dr. U. Joseph Schoepf.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: U. Joseph Schoepf is a consultant for and/or receives research support from Astellas, Bayer, Bracco, GE, and Siemens. Carlo N. De Cecco is a consultant for and/or receives research support from Guerbet and Siemens. Akos Varga-Szemes is a consultant for Guerbet. Davide Piccini is an employee of Siemens Healthcare.

The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

Part of this research was funded by the Swiss National Science Foundation Grant SNF 320030_143923.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• observational

• performed at one institution

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Albrecht, M.H., Varga-Szemes, A., Schoepf, U.J. et al. Coronary artery assessment using self-navigated free-breathing radial whole-heart magnetic resonance angiography in patients with congenital heart disease. Eur Radiol 28, 1267–1275 (2018). https://doi.org/10.1007/s00330-017-5035-1

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  • DOI: https://doi.org/10.1007/s00330-017-5035-1

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