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(Circulation. 2003;108:1355.)
© 2003 American Heart Association, Inc.

Clinical Investigation and Reports

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

Philipp Beerbaum, MD; Hermann Körperich, PhD; Jürgen Gieseke, MSc; Peter Barth, MSc; Matthias Peuster, MD; 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.

Correspondence to Philipp Beerbaum, MD, Herz- und Diabeteszentrum, Ruhr-Universität Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany. E-mail pbeerbaum{at}hdz-nrw.de

Received January 27, 2003; revision received June 30, 2003; accepted July 2, 2003.

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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