TY - JOUR
T1 - MRI for Guided Right and Left Heart Cardiac Catheterization
T2 - A Prospective Study in Congenital Heart Disease
AU - Velasco Forte, Mari Nieves
AU - Roujol, Sébastien
AU - Ruijsink, Bram
AU - Valverde, Israel
AU - Duong, Phuoc
AU - Byrne, Nick
AU - Krueger, Sascha
AU - Weiss, Steffen
AU - Arar, Yousef
AU - Reddy, Surendranath R.Veeram
AU - Schaeffter, Tobias
AU - Hussain, Tarique
AU - Razavi, Reza
AU - Pushparajah, Kuberan
N1 - Publisher Copyright:
© 2020 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC. on behalf of International Society for Magnetic Resonance in Medicine.
PY - 2021/5
Y1 - 2021/5
N2 - Background: Improvements in outcomes for patients with congenital heart disease (CHD) have increased the need for diagnostic and interventional procedures. Cumulative radiation risk is a growing concern. MRI-guided interventions are a promising ionizing radiation-free, alternative approach. Purpose: To assess the feasibility of MRI-guided catheterization in young patients with CHD using advanced visualization passive tracking techniques. Study Type: Prospective. Population: A total of 30 patients with CHD referred for MRI-guided catheterization and pulmonary vascular resistance analysis (median age/weight: 4 years / 15 kg). Field Strength/Sequence: 1.5T; partially saturated (pSAT) real-time single-shot balanced steady-state free-precession (bSSFP) sequence. Assessment: Images were visualized by a single viewer on the scanner console (interactive mode) or using a commercially available advanced visualization platform (iSuite, Philips). Image quality for anatomy and catheter visualization was evaluated by three cardiologists with >5 years' experience in MRI-catheterization using a 1–5 scale (1, poor, 5, excellent). Catheter balloon signal-to-noise ratio (SNR), blood and myocardium SNR, catheter balloon/blood contrast-to-noise ratio (CNR), balloon/myocardium CNR, and blood/myocardium CNR were measured. Procedure findings, feasibility, and adverse events were recorded. A fraction of time in which the catheter was visible was compared between iSuite and the interactive mode. Statistical Tests: T-test for numerical variables. Wilcoxon signed rank test for categorical variables. Results: Nine patients had right heart catheterization, 11 had both left and right heart catheterization, and 10 had single ventricle circulation. Nine patients underwent solely MRI-guided catheterization. The mean score for anatomical visualization and contrast between balloon tip and soft tissue was 3.9 ± 0.9 and 4.5 ± 0.7, respectively. iSuite provided a significant improvement in the time during which the balloon was visible in relation to interactive imaging mode (66 ± 17% vs. 46 ± 14%, P < 0.05). Data Conclusion: MRI-guided catheterizations were carried out safely and is feasible in children and adults with CHD. The pSAT sequence offered robust and simultaneous high contrast visualization of the catheter and cardiac anatomy. Level of Evidence: 2. Technical Efficacy Stage: 1.
AB - Background: Improvements in outcomes for patients with congenital heart disease (CHD) have increased the need for diagnostic and interventional procedures. Cumulative radiation risk is a growing concern. MRI-guided interventions are a promising ionizing radiation-free, alternative approach. Purpose: To assess the feasibility of MRI-guided catheterization in young patients with CHD using advanced visualization passive tracking techniques. Study Type: Prospective. Population: A total of 30 patients with CHD referred for MRI-guided catheterization and pulmonary vascular resistance analysis (median age/weight: 4 years / 15 kg). Field Strength/Sequence: 1.5T; partially saturated (pSAT) real-time single-shot balanced steady-state free-precession (bSSFP) sequence. Assessment: Images were visualized by a single viewer on the scanner console (interactive mode) or using a commercially available advanced visualization platform (iSuite, Philips). Image quality for anatomy and catheter visualization was evaluated by three cardiologists with >5 years' experience in MRI-catheterization using a 1–5 scale (1, poor, 5, excellent). Catheter balloon signal-to-noise ratio (SNR), blood and myocardium SNR, catheter balloon/blood contrast-to-noise ratio (CNR), balloon/myocardium CNR, and blood/myocardium CNR were measured. Procedure findings, feasibility, and adverse events were recorded. A fraction of time in which the catheter was visible was compared between iSuite and the interactive mode. Statistical Tests: T-test for numerical variables. Wilcoxon signed rank test for categorical variables. Results: Nine patients had right heart catheterization, 11 had both left and right heart catheterization, and 10 had single ventricle circulation. Nine patients underwent solely MRI-guided catheterization. The mean score for anatomical visualization and contrast between balloon tip and soft tissue was 3.9 ± 0.9 and 4.5 ± 0.7, respectively. iSuite provided a significant improvement in the time during which the balloon was visible in relation to interactive imaging mode (66 ± 17% vs. 46 ± 14%, P < 0.05). Data Conclusion: MRI-guided catheterizations were carried out safely and is feasible in children and adults with CHD. The pSAT sequence offered robust and simultaneous high contrast visualization of the catheter and cardiac anatomy. Level of Evidence: 2. Technical Efficacy Stage: 1.
KW - cardiac catheterization
KW - congenital heart disease
KW - interventional MR
KW - passive tracking
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U2 - 10.1002/jmri.27426
DO - 10.1002/jmri.27426
M3 - Article
C2 - 33155758
AN - SCOPUS:85096767469
SN - 1053-1807
VL - 53
SP - 1446
EP - 1457
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 5
ER -