Imaging of the pulmonary vasculature in congenital heart disease without gadolinium contrast: Intraindividual comparison of a novel Compressed SENSE accelerated 3D modified REACT with 4D contrast-enhanced magnetic resonance angiography.
Pennig L, Wagner A, Weiss K, Lennartz S, Grunz JP, Maintz D, Laukamp KR, Hickethier T, Naehle CP, Bunck AC, Doerner J.
J Cardiovasc Magn Reson. 2020 Jan 23;22(1):8. doi: 10.1186/s12968-019-0591-y.
PMID: 31969137 Free PMC Article
Select item 31974688
Take Home Points:
- A novel 3D non-contrast-enhanced magnetic resonance angiography (modified REACT-non-CE-MRA) is a good alternative for the visualization of the pulmonary arteries and pulmonary veins in congenital heart disease patients.
- Compared to 4D contrast-enhanced magnetic resonance angiography, modified REACT-non-CE-MRA offers a better image quality.
Comment from Dr. Inga Voges (Kiel, Germany), section editor of Pediatric Cardiology Journal Watch: In this cardiovascular magnetic resonance study the authors applied a new 3D Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACT-non-CE-MRA) to visualize the pulmonary arteries in congenital heart disease (CHD) patients and compared the novel technique with the standard non-ECG-triggered time-resolved 4D contrast-enhanced magnetic resonance angiography (4D CE-MRA). 25 patients with known or suspected CHD were included and images were analysed independently by two radiologists. Measurements were taken at seven distinct measurement points, namely main pulmonary artery, left and right pulmonary artery, right superior and inferior pulmonary vein as well as left superior and inferior pulmonary vein. Furthermore, image quality was assessed using a four-point scale including the parameters sharpness, presence of pulsation artifacts, and anatomic delineation.
Out of 25 patients, 23 had a CHD including atrial septal and ventricular septal defect, transposition of the great arteries, tetralogy of Fallot and pulmonary atresia. Regarding the interobserver agreement, the modified REACT-non-CE-MRA had a higher agreement for the pulmonary veins compared to the 4D CE-MRA. For the pulmonary arteries interobserver agreement was comparable between the modified REACT-non-CE-MRA and the 4D CE-MRA. 4D CE-MRA showed larger diameters for all measurement points and this was demonstrated to be significant for the pulmonary arteries but not the pulmonary veins. 4D CE-MRA image quality scores wore lower compared to the scores for the modified REACT-non-CE-MRA (Figures 3 and 5).
This study has nicely demonstrated that a novel non-contrast MRA technique, the so-called modified REACT-non-CE-MRA, has the potential to be a good alternative to CE-MRA techniques in CHD patients.