title: Congenital heart disease: cardiovascular MR imaging by using an intravascular blood pool contrast agent.
abstract: OBJECTIVE
  To compare the image quality and diagnostic performance of a contrast agent-specific inversion-recovery (IR) steady-state free precession (SSFP) magnetic resonance (MR) imaging sequence performed by using an intravascular contrast agent (gadofosveset trisodium) with those of a commonly used T2-prepared SSFP sequence performed by using an extravascular (gadopentetate dimeglumine) and an intravascular (gadofosveset trisodium) contrast agent in patients with congenital heart disease (CHD).
  
  
  METHODS
  The local ethics committee and the United Kingdom Medicines and Healthcare products Regulatory Agency approved this study. Patient informed consent was obtained. Twenty-three patients with CHD were examined by using a 1.5-T MR imaging unit and a 32-channel coil. Gadopentetate dimeglumine and gadofosveset trisodium were used in the same patient on consecutive days. Vessel wall sharpness, contrast-to-noise ratios (CNRs), image quality, and diagnostic performance achieved by using the IR SSFP sequence with gadofosveset trisodium were compared with those achieved by using the T2-prepared SSFP sequence with gadopentetate dimeglumine and gadofosveset trisodium and with those achieved at respective contrast material-enhanced MR angiographic examinations. The Wilcoxon rank sum test was used to compare categoric variables; t tests were used to compare continuous variables.
  
  
  RESULTS
  Use of the IR SSFP sequence with gadofosveset trisodium significantly improved vessel wall sharpness, CNRs, and image quality (P < .05 for all) for all investigated intra- and extracardiac structures compared with the T2-prepared SSFP sequence with gadopentetate dimeglumine and gadofosveset trisodium and the respective contrast-enhanced MR angiographic examinations. With use of the IR SSFP sequence with gadofosveset trisodium, new, unsuspected diseases (five [22%] of 23) were diagnosed, while other diseases could be excluded (15 [65%] of 23). Information available from echocardiography (n = 23), conventional angiography (n = 4), and/or surgery (n = 1) confirmed all diagnoses.
  
  
  CONCLUSIONS
  IR SSFP with gadofosveset trisodium improved image quality and diagnostic performance, allowing a more accurate and complete assessment of cardiovascular anatomy in patients with CHD compared with T2-prepared SSFP with gadopentetate dimeglumine and gadofosveset trisodium and respective contrast-enhanced MR angiographic examinations.
authors: Division of Imaging Sciences, King's College London British Heart Foundation Centre, Biomedical Research Centre of Guy's and St. Thomas' Hospital, King's College London, National Health Service Foundation Trust, Lambeth Place Road, London SE1 7EH, England.
authors: Marcus R
authors: MR
authors: Makowski
authors: Andrea J
authors: AJ
authors: Wiethoff
authors: Sergio
authors: S
authors: Uribe
authors: Victoria
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authors: Parish
authors: René M
authors: RM
authors: Botnar
authors: Aaron
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authors: Bell
authors: Christoph
authors: C
authors: Kiesewetter
authors: Philipp
authors: P
authors: Beerbaum
authors: Christian H P
authors: CH
authors: Jansen
authors: Reza
authors: R
authors: Razavi
authors: Tobias
authors: T
authors: Schaeffter
authors: Gerald F
authors: GF
authors: Greil