title: Use of a 1.0 Tesla open scanner for evaluation of pediatric and congenital heart disease: a retrospective cohort study.
abstract: BACKGROUND
  Open cardiovascular magnetic resonance (CMR) scanners offer the potential for imaging patients with claustrophobia or large body size, but at a lower 1.0 Tesla magnetic field. This study aimed to evaluate the efficacy of open CMR for evaluation of pediatric and congenital heart disease.
  
  
  METHODS
  This retrospective, cross-sectional study included all patients ≤18 years old or with congenital heart disease who underwent CMR on an open 1.0 Tesla scanner at two centers from 2012-2014. Indications for CMR and clinical questions were extracted from the medical record. Studies were qualitatively graded for image quality and diagnostic utility. In a subset of 25 patients, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were compared to size- and diagnosis-matched patients with CMR on a 1.5 Tesla scanner.
  
  
  RESULTS
  A total of 65 patients (median 17.3 years old, 60% male) were included. Congenital heart disease was present in 32 (50%), with tetralogy of Fallot and bicuspid aortic valve the most common diagnoses. Open CMR was used due to scheduling/equipment issues in 51 (80%), claustrophobia in 7 (11%), and patient size in 3 (5%); 4 patients with claustrophobia had failed CMR on a different scanner, but completed the study on open CMR without sedation. All patients had good or excellent image quality on black blood, phase contrast, magnetic resonance angiography, and late gadolinium enhancement imaging. There was below average image quality in 3/63 (5%) patients with cine images, and 4/15 (27%) patients with coronary artery imaging. SNR and CNR were decreased in cine and magnetic resonance angiography images compared to 1.5 Tesla. The clinical question was answered adequately in all but 2 patients; 1 patient with a Fontan had artifact from an embolization coil limiting RV volume analysis, and in 1 patient the right coronary artery origin was not well seen.
  
  
  CONCLUSIONS
  Open 1.0 Tesla scanners can effectively evaluate pediatric and congenital heart disease, including patients with claustrophobia and larger body size. Despite minor artifacts and differences in SNR and CNR, the majority of clinical questions can be answered adequately, with some limitations with coronary artery imaging. Further evaluation is necessary to optimize protocols and image quality.
authors.affiliation: Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA. jimmyl@umich.edu.|Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA. jimmyl@umich.edu.
authors.forename: Jimmy C
authors.initials: JC
authors.lastname: Lu
authors.affiliation: Departments of Pediatrics and Radiology, Stony Brook University, Stony Brook, NY, USA. james.nielsen@stonybrookmedicine.edu.
authors.forename: James C
authors.initials: JC
authors.lastname: Nielsen
authors.affiliation: Departments of Pediatrics and Radiology, Stony Brook University, Stony Brook, NY, USA. Layne.morowitz@stonybrookmedicine.edu.
authors.forename: Layne
authors.initials: L
authors.lastname: Morowitz
authors.affiliation: Department of Medicine, Division of Cardiology, Stony Brook University, Stony Brook, NY, USA. Muzammil.musani@stonybrookmedicine.edu.
authors.forename: Muzammil
authors.initials: M
authors.lastname: Musani
authors.affiliation: Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA. maryamg@med.umich.edu.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghadimi Mahani
authors.affiliation: Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA. prachia@med.umich.edu.
authors.forename: Prachi P
authors.initials: PP
authors.lastname: Agarwal
authors.affiliation: Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA. elsayei@med.umich.edu.
authors.forename: El-Sayed H
authors.initials: el-SH
authors.lastname: Ibrahim
authors.affiliation: Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA. adamdorf@med.umich.edu.|Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA. adamdorf@med.umich.edu.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Dorfman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016477:Artifacts; D049628:Body Size; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000009:adverse effects / Q000295:instrumentation*; D019028:Magnetic Resonance Imaging, Cine / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009518:New York; D015588:Observer Variation; D010698:Phobic Disorders / Q000209:etiology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D059629:Signal-To-Noise Ratio; D055815:Young Adult