Pulmonary artery pulsatility and effect on vessel diameter assessment in magnetic resonance imaging

Congress:

ESCR 2014

Poster Number:

440

Type:

Scientific Poster

Keywords:

Cardiac, Cardiovascular system, MR, Diagnostic procedure, Congenital

Authors:

M. Shariat, D. Schantz, S.-J. Yoo, B. J. Wintersperger, M. Seed, B. Al Nafisi, L. Chu, C. Mcgowan, J. Van Ameron, L. Grosse-Wortmann; Toronto, ON/CA

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 1: Figure 1: Cross sectional images of the right pulmonary artery, acquired with...

Table 1: Table 2: Comparison of measurements on different imaging techniques TOF:...

Fig. 2: Figure 2: Bland Altman plots for comparison of RPA measurements on different...

Fig. 3: Figure 3: Bland Altman plots for comparison of RPA measurements on different...

Purpose

Information about thoracic vascular sizes can crucially affect clinical decision-making in cardiovascular disease. Depending on the clinical scenario, the concern may be vessel hypoplasia, narrowing or dilatation (1-5).A variety of imaging techniques such as catheter angiography, contrast enhanced computed tomography (CT) and Cardiac Magnetic Resonance Imaging (CMR) are routinely used to measure vascular diameters. Traditionally, CMR black blood sequences were the main anatomical tool for visualization of vascular anatomy and still are in many centers. More recently, the vessel diameters are measured on multiplanar reconstructions...

Methods and Materials

We recruited two groups of patients for this prospective study. One group included patients with repaired tetralogy of Fallot (TOF), with at least moderate pulmonary insufficiency and another group of patients who underwent CMR as part of a diagnostic work-up for arrhythmogenic right ventricular cardiomyopathy (ARVC). Additional images of the right pulmonary artery (RPA) were acquired in the double inversion recovery (DIR) black blood, cine steady state free precession (SSFP) and MRA (Figure 1). All images were reviewed by two CMR trained readers using the...

Results

A total of 52 patients were recruited for this study, 26 patients in the TOF group (15 male, age 12.55 ± 2.9) and 26 patients in the ARVC group (15 male, age 15.6 ± 2.3). In both groups, the RPA sizes were not significantly different between the DIR images and diastolic cine SSFP (p>0.05). Measurements on DIR were significantly smaller than those made on systolic cine SSFP or MRA in both groups (p<0.0001). Vessel diameters measured on systolic SSFP were significantly larger than measurements made...

Conclusion

Black blood, white blood and MRA sequences are all reproducible CMR methods for the assessment of arterial diameters in children and adolescents. Measurements from systolic phase SSFP images are comparable to those from contrast-enhanced MRA. Therefore, the administration of contrast medium is not necessary in every case. Cine SSFP images offer the additional advantage over the other methods in such that both the largest and the smallest diameter of the vessel during the cardiac cycle can be assessed using this technique. This is even more...

References

1. Milewicz DM, Dietz HC, Miller DC. Treatment of Aortic Disease in Patients With Marfan Syndrome. Circulation. 2005; 111: e150-e157 2. Hahn R, Romas M, Mogtader A. Association of aortic dilation with regurgitant, stenotic, and functionally normal bicuspid aortic valves. J Am Coll Cardiol 1992. 19283–288.288. 3. Davies RR, Gallo A, Coady MA, Tellides G, Botta DM, Burke, B, Coe MP, Kopf GS, Elefteriades JA. Novel Measurement of Relative Aortic Size Predicts Rupture of Thoracic Aortic Aneurysms. Ann Thorac Surg 2006; 81:169-177. 4. Mulder BJM,...