Four-dimensional Multiphase Steady-State MRI with Ferumoxytol Enhancement: Early Multicenter Feasibility in Pediatric Congenital Heart Disease
Four-dimensional Multiphase Steady-State MRI with Ferumoxytol Enhancement: Early Multicenter Feasibility in Pediatric Congenital Heart Disease
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DOI：
10.1148/radiol.2021203696
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发表时间：
2021-07-01
期刊：
影响因子：
19.7
通讯作者：
Finn, J. Paul
中科院分区：
文献类型：
--
作者：
Nguyen, Kim-Lien;Ghosh, Reena M.;Finn, J. Paul
背景资料：MRI在小儿先天性心脏病（CHD）中的价值是公认的;然而，对专家监督的要求阻碍了其广泛使用。四维（4D）多相稳态成像与对比增强（MUSIC）是一种心血管MRI技术，使用ferumoxytol和捕捉所有的解剖features dynamically.Purpose：为了评估多中心的可行性4D MUSIC MRI在小儿CHD.Materials and Methods：在这项前瞻性研究中，参与者CHD在3.0 T或1.5 T之间2014年和2020年进行4D MUSIC MRI。从总共460项研究中，选择来自3个临床试验机构的相同数量的MRI研究（n = 60）进行详细分析。使用五点量表，根据伪影、图像质量和心内和血管连接的诊断置信度对4D MUSIC的可行性进行评分（n = 780）。呼吸运动抑制通过使用信号强度曲线进行评估。结果：206例CHD患者在3.0T条件下接受了MRI检查，254例患者在1.5T条件下接受了MRI检查。在选择用于分析的60项MRI检查中，（每个临床试验机构20例;中位受试者年龄，14.4个月[四分位距，2.3-49个月]; 33例女性受试者），56例（93%）在疾病复杂性范围内的图像质量评分为良好或极佳（平均评分+/-标准差：部位1为4.3 +/- 0.6，部位2为4.9 +/- 0.3，部位3为4.6 +/- 0.7; P
Background: The value of MRI in pediatric congenital heart disease (CHD) is well recognized; however, the requirement for expert oversight impedes its widespread use. Four-dimensional (4D) multiphase steady-state imaging with contrast enhancement (MUSIC) is a cardiovascular MRI technique that uses ferumoxytol and captures all anatomic features dynamically.Purpose: To evaluate multicenter feasibility of 4D MUSIC MRI in pediatric CHD.Materials and Methods: In this prospective study, participants with CHD underwent 4D MUSIC MRI at 3.0 T or 1.5 T between 2014 and 2020. From a pool of 460 total studies, an equal number of MRI studies from three sites (n = 60) was chosen for detailed analysis. With use of a five-point scale, the feasibility of 4D MUSIC was scored on the basis of artifacts, image quality, and diagnostic confidence for intracardiac and vascular connections (n = 780). Respiratory motion suppression was assessed by using the signalintensity profile. Bias between 4D MUSIC and two-dimensional (2D) cine imaging was evaluated by using Bland-Altman analysis; 4D MUSIC examination duration was compared with that of the local standard for CHD.Results: A total of 206 participants with CHD underwent MRI at 3.0 T, and 254 participants underwent MRI at 1.5 T. Of the 60 MRI examinations chosen for analysis (20 per site; median participant age, 14.4 months [interquartile range, 2.3-49 months]; 33 female participants), 56 (93%) had good or excellent image quality scores across a spectrum of disease complexity (mean score +/- standard deviation: 4.3 +/- 0.6 for site 1, 4.9 +/- 0.3 for site 2, and 4.6 +/- 0.7 for site 3; P