The three-dimensional balanced steady state free precession magnetic resonance imaging sequence in diagnosis of anomalous origin of the coronary artery from the pulmonary artery in children

doi:10.16150/j.1671-2870.2020.02.009

Abstract

Abstract:

Objective: To evaluate the value of three-dimensional balanced steady state free precession sequence (3D b-SSFP) magnetic resonance imaging (MRI) sequence in diagnosis of anomalous origin of the coronary artery from the pulmonary artery（ACAPA）. Methods: The whole heart MRI3D b-SSFP performed on 21 children with an age of (33.67±43.32) months was retrospectively analyzed. All the subjects had DSA or surgical operation confirmed ACAPA, and 19 cases were isolated heart abnormality. The imaging quality of 3D b-SSFP was evaluated and inter-observer agreement was validated by the Kappa coefficient. Relationship between heart rate and imaging quality was assessed by regression analysis. The diagnostic accuracy of 3D b-SSFP for ACAPA was assessed by comparison with findings from DSA or surgical operation. Results: The subjective scores on the image quality from two observers were 2.84±0.82 and 2.83±0.83, and inter-observer agreement was 81.8% (95% CI 57.0%-86.6%). The heart rate (HR) of investigated subjects was(105.85±18.20) beat/min, and the left ventricular end diastolic volume and ejection fraction were (79.63±37.46) mL/m² and (34.28±21.39)% respectively. Left ventricular late gadolinium enhancement(LGE) was positive in 8 of 10. Regression analysis showed negative correlations between vessel sharpness and HR in both 2 observers, and correlation coefficients were -0.277 and -0.263, respectively. MRI3D b-SSFP identified ACAPA in 18 out of the 21 cases investigated, yielding a diagnostic accuracy of 85.71%. The MRI imaging of 2 cases was beyond recognition due to blurred edge and 1 case was misdiagnosed as normal. Conclusion: Cardiac MRI displays cardiac anatomy and coronary artery and facilitates evaluation of cardiac function. The 3D b-SSFP is a valuable MRI sequence for diagnosing ACAPA.

Key words: Magnetic resonance imaging, Congenital heart disease, Anomalous origin of the coronary artery, Pediatric

CLC Number:

R543

GU Xiaohong, SUN Aimin, WANG Qian, ZHU Ming, ZHONG Yumin. The three-dimensional balanced steady state free precession magnetic resonance imaging sequence in diagnosis of anomalous origin of the coronary artery from the pulmonary artery in children[J]. Journal of Diagnostics Concepts & Practice, 2020, 19(02): 145-150.

Figures/Tables 4

References 23

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参数	2D cine b-SSFP	3D b-SSFP	CE-MRA	LGE-MRI
TR/TE（ms）	3.5/1.7	4.7/2.4	2.0/1.1	6.1/3.0
翻转角（°）	60	90	35	25
扫描视野（mm）	220~300	260~400	260~400	220~300
层数	12~16	70~90	70~90	10~12
采集像素（mm³）	1.3×1.6×（6~8）	0.5~0.6	1.3×1.3×1.8	1.5×1.5×（6~8）
重建像素（mm³）	1.0×0.9×（6~8）	（0.5~0.6）×（0.5~0.6）×（0.5~0.6）	0.76×0.76×0.9	0.63×0.63×（6~8）
加速因子	2.0	2.0	1.8	无
激励次数	3~4	1	1	1
膈肌导航	无	无	无	无
心电门控	是	是	是	是