Published Online
on August 25, 2003

A more recent version of this article appeared on September 16, 2003

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Submitted on January 27, 2003
Revised on June 30, 2003
Accepted on July 2, 2003

Rapid Left-to-Right Shunt Quantification in Children by Phase-Contrast Magnetic Resonance Imaging Combined With Sensitivity Encoding

Philipp Beerbaum MD^*, Hermann Körperich PhD, Jürgen Gieseke MSc, Peter Barth MSc, Matthias Peuster MD, and Hans Meyer MD

From Klinik für Angeborene Herzfehler, Herz- und Diabeteszentrum, Nordrhein-Westfalen, Ruhr-Universität Bochum, Germany, and Philips Medical Systems (J.G.), Best, The Netherlands.

^* To whom correspondence should be addressed. E-mail: pbeerbaum{at}hdz-nrw.de.

Background--Parallel imaging by sensitivity encoding (SENSE) may considerably reduce scan time in MRI. For rapid flow quantification in children with congenital heart disease, we evaluated phase-contrast MRI (PC-MRI) techniques combined with SENSE.

Methods and Results--In 22 pediatric patients (mean age, 7.2±6.2 years) with cardiac left-to-right shunt, blood flow rate in the pulmonary artery (Q_p) and ascending aorta (Q_s) and flow ratio Q_p/Q_s were determined by PC-MRI with SENSE reduction-factor 2 and 3 (SF-2 and SF-3). Additionally, we used PC-MRI with higher spatial in-plane resolution (1.6x2.1 versus 2.3x3.1 mm) with and without SF-3. Results were compared with a recently validated standard PC-MRI protocol and tested in vitro using a pulsatile flow phantom. Reduction of signal averages from 2 to 1 and application of SENSE accelerated flow measurements by a factor of 3.5 (5.2) using PC-MRI with SF-2 (SF-3) compared with standard PC-MRI. For blood flow rate through the pulmonary artery and aorta, as well as for the Q_p/Q_s ratio we found negligible differences of ±3%, lower limits of agreement (mean±2 SD) of -7% to -18%, and upper limits of agreement (mean±2 SD) of +3 to +24%, demonstrating good agreement with standard PC-MRI. Mean Q_p/Q_s ratio by standard PC-MRI was 1.69±0.45 (range, 1.27 to 2.79). Interobserver variability was low, and high accuracy was confirmed in vitro for all protocols.

Conclusions--PC-MRI for flow quantitation may be combined with SENSE to achieve a substantive reduction of scanning time. In children with left-to-right shunt, Q_p/Q_s quantification is possible by PC-MRI+SF-3 in <60 seconds. Use of higher in-plane resolution did not improve measurement results.

Key words: heart defects, congenital • pediatrics • magnetic resonance imaging • shunts • imaging

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