SCMR-LAC

First-Pass and Steady-State MR Angiography of Thoracic Vasculature in Children and Adolescents

Claas P. Naehle, MD*, Michael Kaestner, MD, Andreas Müller, MD*, Winfried W. Willinek, MD*, Juergen Gieseke, PhD, Hans H. Schild, MD*, Daniel Thomas, MD*,*

* Department of Radiology, University of Bonn, Bonn, Germany
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Kinderherzzentrum, Sankt Augustin, Germany
Philips Medical Systems, Hamburg, Germany

* Reprint requests and correspondence: Dr. Daniel Thomas, Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany (Email: daniel.thomas@ukb.uni-bonn.de).

Magnetic resonance angiography (MRA) is an established noninvasive imaging modality for detection and evaluation of vascular pathologies in children with congenital heart disease. Standard first-pass (FP)–MRA uses a 3-dimensional MRA sequence with an extracellular contrast agent, in which spatial resolution is limited by breath-hold duration, and image quality (IQ) is limited by motion artifacts. The purpose of this study was to compare the diagnostic confidence, IQ, and image artifacts of standard FP-MRA to a high-resolution, motion compensated steady-state (SS)–MRA of the thoracic vasculature in children and adolescents with congenital heart disease using a blood-pool contrast agent (gadofosveset trisodium). SS-MRA of the thoracic vasculature (technically successful in 90% of patients) offers superior diagnostic confidence and IQ compared with FP-MRA and shows fewer motion-related image artifacts. In addition, SS-MRA revealed findings missed by FP-MRA. Therefore, SS-MRA may prove specifically beneficial for imaging of thoracic vessels that are small and/or subject to motion.

Key Words: heart • cardiac magnetic resonance • angiography • gadofosveset trisodium • pediatric

Am Coll Cardiol Img, 2010; 3:504-513