Abstract 16548: Navigated 3D Dark Blood Provides Superior Imaging of Arch Anomalies in Children
Background: Cardiovascular magnetic resonance has become the gold standard for aortic arch (Ao) imaging in children, currently relying on steady-state free precession cine, double inversion recovery black blood images, and gadolinium angiography. Limitations include turbulence artifact on cine, diastolic gating of 2D dark blood, inadequate resolution and positioning errors from 2D techniques. We hypothesized that a 3D, T1-weighted turbo spin echo dark blood with navigator-triggered 1D prospective acquisition correction (3D-SPACE DB) technique would allow for improved Ao imaging in children due to its ability to gate in systole, excellent contrast between the wall and blood pool, and high spatial resolution.
Methods: We prospectively enrolled pts with suspected Ao anomalies to undergo 3D-SPACE DB imaging in addition to the standard clinical protocol. Images were compared with regard to image quality and Ao measurements. 3D-SPACE DB was timed to peak velocity in the Ao, with isotropic voxels from 1.2 to 1.4 mm, and the 3D slab oriented with the DAo parallel to readout direction. (mean acquisition time 6 minutes).
Results: Of 26 pts, 5 had vascular rings, 2 had native coarctation (CoA), 9 had repaired CoA, 7 had aortic dilation, 1 had an aberrant subclavian, and 2 were normal. In 2 CoA cases, 3D-SPACE DB showed arch patency when other modalities did not (see Figure A). In all ring cases, Ao and airway were delineated on a single sequence (see Figure B). 3D-SPACE DB measurements agreed more closely with maximal systolic cine than 2D dark blood.
Conclusions: 3D-SPACE DB provides superior imaging of the aortic arch in a variety of arch anomalies, and allows assessment of the airway in vascular rings. It can potentially decrease scan times by decreasing the number and type of acquisitions acquired.
- © 2012 by American Heart Association, Inc.