Department of Diagnostic Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Eur J Radiol. 2013 Oct;82(10):1743-8. doi: 10.1016/j.ejrad.2013.03.014. Epub 2013 Apr 30.
To assess potential benefits of three dimensional (3D) steady state free precession (SSFP) magnetic resonance sequence for congenital heart disease (CHD).
Twenty consecutive patients with CHD (male:female ratio,14:6, mean age, 27.5 ± 8.5 years) underwent both 3D SSFP and traditional MR imaging (TMRI) [including two dimensional (2D) SSFP and contrast enhanced magnetic resonance angiography (CEMRA)]. Image quality and diagnosis were compared, and Bland-Altman analysis was used to evaluate consistency of 3D SSFP and CEMRA for diameter measurements.
A total of 35 intra and 81 extra cardiac anomalies were identified in all patients. The image quality of 3D SSFP and TMRI for either intra or extra cardiac anomalies of all patients scored ≥3, which allowed an establishment of diagnosis for all cases. The diagnostic sensitivity, specificity, and accuracy of 3D SSFP for the detection of intra cardiac anomalies were all 100%, whereas for extra cardiac anomalies they were 93.8%, 93.8%, 100%, respectively. Mean differences (3D SSFP minus CEMRA) for aorta and pulmonary arteries were 0.5 ± 1.2 mm and 0.0 ± 1.7 mm, respectively, showing good consistency of 3D SSFP and CEMRA for diameter measurements.
3D SSFP MRI can be an alternative image modality to TMRI for patients with congenital heart disease, especially for those who have renal insufficiency, breath-hold difficulty or who are allergic to contrast agent. It can also provide powerful complementary information for patients who undergo TMRI, especially at ventriculoarterial connection site.
评估三维稳态自由进动(3D SSFP)磁共振序列在先天性心脏病(CHD)中的潜在益处。
连续 20 例 CHD 患者(男/女比例 14/6,平均年龄 27.5±8.5 岁)均接受 3D SSFP 和传统磁共振成像(TMRI)[包括二维(2D)SSFP 和对比增强磁共振血管造影(CEMRA)]检查。比较了图像质量和诊断结果,并使用 Bland-Altman 分析评估了 3D SSFP 和 CEMRA 直径测量的一致性。
所有患者共发现 35 例心内和 81 例心外畸形。3D SSFP 和 TMRI 对所有患者的心内或心外畸形的图像质量评分均≥3,可对所有病例进行诊断。3D SSFP 检测心内畸形的诊断敏感性、特异性和准确性均为 100%,而检测心外畸形的诊断敏感性、特异性和准确性分别为 93.8%、93.8%、100%。主动脉和肺动脉的 3D SSFP 与 CEMRA 差值的平均值分别为 0.5±1.2mm 和 0.0±1.7mm,显示出 3D SSFP 和 CEMRA 直径测量的良好一致性。
3D SSFP MRI 可作为 TMRI 的替代成像方式用于先天性心脏病患者,特别是对肾功能不全、屏气困难或对造影剂过敏的患者。它还可以为接受 TMRI 检查的患者提供强大的补充信息,特别是在心室动脉连接部位。