Chaves Alicia H, Cava Joseph R, Simpson Pippa, Hoffman George M, Samyn Margaret M
The Herma Heart Center, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Pediatr Cardiol. 2013 Jun;34(5):1201-5. doi: 10.1007/s00246-013-0630-7. Epub 2013 Jan 24.
Cardiac magnetic resonance imaging (CMR) for infants and young children typically requires sedation. General anesthesia with controlled ventilation can eliminate motion artifact with breath-holds during imaging to limit respiratory artifact, but these may lead to atelectasis or other complications. High-frequency oscillatory ventilation (HFOV) provides ventilation with near-constant mean airway pressure and minimal movement of chest wall and diaphragm, thus obviating the need for breath-holding. Clinical data were collected for 8 infants who underwent CMR with HFOV and 8 controls who underwent CMR with conventional ventilator and breath-hold technique. Data included demographic information, adverse events, and scan-acquisition time. Studies were reviewed for image quality by two cardiologists who were blinded to type of ventilation. There were no significant differences in patient characteristics between the two groups. There was no significant difference in average image quality for cine short-axis or black blood imaging. Total CMR scan time was not significantly different between groups, but the short-axis cine stack was acquired more quickly in the HFOV group (1.8 ± 0.8 vs. 5.0 ± 3.6 min). There were no adverse events in the HFOV group, but scans were terminated early for two patients in the conventional ventilator group. HFOV during CMR is feasible and well tolerated. Image quality is equivalent to that obtained with conventional ventilation with breath-holding technique and allows shorter cine scan times for some sequences.
婴幼儿的心脏磁共振成像（CMR）通常需要镇静。在成像过程中，采用控制通气的全身麻醉可通过屏气消除运动伪影，以限制呼吸伪影，但这些操作可能会导致肺不张或其他并发症。高频振荡通气（HFOV）可提供近乎恒定的平均气道压力通气，且胸壁和膈肌运动极小，从而无需屏气。收集了8例接受HFOV下CMR检查的婴儿及8例接受传统通气和屏气技术下CMR检查的对照者的临床数据。数据包括人口统计学信息、不良事件和扫描采集时间。由两位对通气类型不知情的心脏病专家对研究的图像质量进行评估。两组患者的特征无显著差异。在电影短轴成像或黑血成像的平均图像质量方面无显著差异。两组之间的CMR总扫描时间无显著差异，但HFOV组的短轴电影堆栈采集更快（1.8±0.8分钟对5.0±3.6分钟）。HFOV组未发生不良事件，但传统通气组有两名患者的扫描提前终止。CMR期间的HFOV是可行的，且耐受性良好。图像质量与采用屏气技术的传统通气所获得的图像质量相当，并且对于某些序列可缩短电影扫描时间。
