Validation and application of single breath-hold cine cardiac MR for ventricular function assessment in children with congenital heart disease at rest and during adenosine stress.
OBJECTIVE
To validate the accuracy of ventricular function analysis using a single breath-hold real-time steady sate free precession (SSFP) cine MR method and demonstrate its application during adenosine stress imaging in children with congenital heart disease.


METHODS
Twenty-eight subjects with congenital heart disease were studied (mean age 12.4 +/- 2.3 years) with MR imaging at 1.5 T. Short-axis images covering the entirety of both ventricles were acquired at rest, with a conventional segmented SSFP cine sequence acquired over multiple breath-holds and a single breath-hold real-time SSFP sequence. Seventeen subjects were given an infusion of adenosine, and the single breath-hold real-time short-axis stack was repeated during stress. Two independent observers performed the ventricular function analysis. Data was compared between the 2 acquisition methods at rest and between the single breath-hold acquisition at rest and during adenosine stress.


RESULTS
There was good agreement between the multiple breath-hold and single breath-hold methods for measurement of end-diastolic volume (r = 0.95 and 0.96, p < .0001) and end-systolic volume (ESV) (r = 0.76 and 0.90, p < .0001) for the left and right ventricles respectively, and the left ventricular mass (r = 0.97, p < .0001). Adenosine was administered safely to all subjects. During stress there were significant changes in the heart rate and ESV, which led to a significant increase in cardiac output (mean 1.5 +/- 1.0 L/min, p < .001).


CONCLUSIONS
Single breath-hold real-time SSFP cine imaging is robust and accurate in assessing cardiac function in children with congenital heart disease. An application of this method is the rapid assessment of cardiac function during adenosine stress.
Taylor
Andrew M
AM
Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium. a.taylor@ich.ucl.ac.uk
Dymarkowski
Steven
S
De Meerleer
Kristof
K
Hamaekers
Pascal
P
Gewillig
Marc
M
Mertens
Luc
L
Bogaert
Jan
J
D000241:Adenosine; D000293:Adolescent; D002648:Child; D003199:Computer Systems; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D012119:Respiration; D012146:Rest; D013318:Stroke Volume; D014665:Vasodilator Agents; D016276:Ventricular Function / Q000187:drug effects
D014665:Vasodilator Agents; D000241:Adenosine