title: Congenital heart disease in children: coronary MR angiography during systole and diastole with dual cardiac phase whole-heart imaging.
abstract: OBJECTIVE
  To assess the optimal timing for coronary magnetic resonance (MR) angiography in children with congenital heart disease by using dual cardiac phase whole-heart MR imaging.
  
  
  METHODS
  The local institutional review board approved this study, and informed consent was obtained from parents or guardians. Thirty children (13 girls; overall mean age, 5.01 years) were examined with a 1.5-T MR system. A free-breathing three-dimensional steady-state free precession dual cardiac phase sequence was used to obtain MR angiographic data during end-systolic and middiastolic rest periods. Vessel length, diameter, and sharpness, as well as image quality of the coronary artery segments, were analyzed and compared by using Bland-Altman plots, linear regression analysis, the t test, and Wilcoxon signed rank tests.
  
  
  RESULTS
  Optimal coronary artery imaging timing was patient dependent and different for each coronary artery segment (36 segments favored end systole, 28 favored middiastole). In 15 patients (50%), different segments favored different cardiac phases within the same patient. Image quality and vessel sharpness degraded with higher heart rates, with a similar correlation for end systole (right coronary artery [RCA], 0.39; left main [LM] coronary artery, 0.46; left anterior descending [LAD] artery, 0.51; and left circumflex [LCX] artery, 0.50) and middiastole (RCA, 0.34; LM, 0.45; LAD, 0.48; and LCx, 0.55). Mean image quality difference or mean vessel sharpness difference showed no indication to prefer a specific cardiac phase.
  
  
  CONCLUSIONS
  The optimal cardiac rest period for coronary MR angiography in children with congenital heart disease is specific for each coronary artery segment. Dual cardiac phase whole-heart coronary MR angiography enables optimal coronary artery visualization by retrospectively choosing the optimal imaging rest period.
authors.affiliation: Department of Radiology, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 8330024, Chile. suribe@med.puc.cl
authors.forename: Sergio
authors.initials: S
authors.lastname: Uribe
authors.forename: Tarique
authors.initials: T
authors.lastname: Hussain
authors.forename: Israel
authors.initials: I
authors.lastname: Valverde
authors.forename: Cristian
authors.initials: C
authors.lastname: Tejos
authors.forename: Pablo
authors.initials: P
authors.lastname: Irarrazaval
authors.forename: Mario
authors.initials: M
authors.lastname: Fava
authors.forename: Philipp
authors.initials: P
authors.lastname: Beerbaum
authors.forename: Rene M
authors.initials: RM
authors.lastname: Botnar
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Tobias
authors.initials: T
authors.lastname: Schaeffter
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Greil
mesh_terms: D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity