Utility of Free-Breathing, Whole-Heart, Three-Dimensional Magnetic Resonance Imaging in the Assessment of Coronary Anatomy for Congenital Heart Disease
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Prabhakar Rajiah • Randolph M. Setser • Milind Y. Desai • Scott D. Flamm • Janine L. Arruda
- چاپ و سال / کشور: 2011
Description
The incidence of coronary anomalies is increased in congenital heart disease (CHD). Whole-heart magnetic resonance imaging (MRI) has been proposed as a robust approach to coronary artery imaging without ionizing radiation. The proximal coronary arteries were imaged in 112 CHD patients (63 males) age 17 ± 13 years (range 11 days–68 years) using a navigator-gated, wholeheart, three-dimensional (3D) technique at 1.5 T. Two observers assessed image quality overall and for left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), and right coronary artery (RCA) using a 5-point scale ranging from 0 (not visible) to 4 (clear margins). Weighted kappa was used to assess interobserver agreement. Coronary artery origins were visible in 99% of the patients. The left main origin was not visualized in one patient, although the LAD, LCX, and RCA were visualized. Eight patients (7%) had anomalies. The overall image quality was 3.3 ± 0.8 for reader 1 and 3.1 ± 1.0 for reader 2. Age had a significant effect on image quality, with younger patients having lower scores. Agreement between readers was moderate (overall kappa, 0.60). Free-breathing, navigator-gated, whole-heart 3D MRI is a useful, robust, and reliable noninvasive technique for assessing coronary artery origins and their proximal course with diagnostic quality in CHD patients.
Pediatr Cardiol (2011) 32:418–425 DOI 10.1007/s00246-010-9871-x Received: 9 August 2010 / Accepted: 8 December 2010 / Published online: 6 January 2011
