Time-resolved contrast-enhanced MR angiography of the thorax in adults with congenital heart disease.
OBJECTIVE
The aim of this study was to evaluate the diagnostic value of time-resolved contrast-enhanced MR angiography in adults with congenital heart disease.


METHODS
Twenty patients with congenital heart disease (mean age, 38 +/- 14 years; range, 16-73 years) underwent contrast-enhanced turbo fast low-angle shot MR angiography. Thirty consecutive coronal 3D slabs with a frame rate of 1-second duration were acquired. The mask defined as the first data set was subtracted from subsequent images. Image quality was evaluated using a 5-point scale (from 1, not assessable, to 5, excellent image quality). Twelve diagnostic parameters yielded 1 point each in case of correct diagnosis (binary analysis into normal or abnormal) and were summarized into three categories: anatomy of the main thoracic vessels (maximum, 5 points), sequential cardiac anatomy (maximum, 5 points), and shunt detection (maximum, 2 points). The results were compared with a combined clinical reference comprising medical or surgical reports and other imaging studies. Diagnostic accuracies were calculated for each of the parameters as well as for the three categories.


RESULTS
The mean image quality was 3.7 +/- 1.0. Using a binary approach, 220 (92%) of the 240 single diagnostic parameters could be analyzed. The percentage of maximum diagnostic points, the sensitivity, the specificity, and the positive and the negative predictive values were all 100% for the anatomy of the main thoracic vessels; 97%, 87%, 100%, 100%, and 96% for sequential cardiac anatomy; and 93%, 93%, 92%, 88%, and 96% for shunt detection.


CONCLUSIONS
Time-resolved contrast-enhanced MR angiography provides, in one breath-hold, anatomic and qualitative functional information in adult patients with congenital heart disease. The high diagnostic accuracy allows the investigator to tailor subsequent specific MR sequences within the same session.
Mohrs
Oliver K
OK
Darmstadt Radiology, Department of Cardiovascular Imaging at Alice Hospital, Dieburger Strasse 29-13, 64287 Darmstadt, Germany. mohrs@radiologie-darmstadt.de
Petersen
Steffen E
SE
Voigtlaender
Thomas
T
Peters
Jutta
J
Nowak
Bernd
B
Heinemann
Markus K
MK
Kauczor
Hans-Ulrich
HU
D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000473:pathology; D012680:Sensitivity and Specificity; D013909:Thorax / Q000098:blood supply*; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000473:pathology; D014684:Venae Cavae / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA