title: Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease.
abstract: BACKGROUND
  For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality.
  
  
  METHODS
  CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression.
  
  
  RESULTS
  Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults.
  
  
  CONCLUSIONS
  In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. pierre.monney@chuv.ch.
authors.forename: Pierre
authors.initials: P
authors.lastname: Monney
authors.affiliation: Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland. davide.piccini@chuv.ch.|Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland. davide.piccini@chuv.ch.|Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland. davide.piccini@chuv.ch.
authors.forename: Davide
authors.initials: D
authors.lastname: Piccini
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. tobias.rutz@chuv.ch.
authors.forename: Tobias
authors.initials: T
authors.lastname: Rutz
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. maria-gabriella.vincenti@chuv.ch.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Vincenti
authors.affiliation: Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland. coppo.simone@gmail.com.|Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland. coppo.simone@gmail.com.
authors.forename: Simone
authors.initials: S
authors.lastname: Coppo
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. simon.koestner@hin.ch.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Koestner
authors.affiliation: Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. nicole.sekarski@chuv.ch.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sekarski
authors.affiliation: Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. stefano.di-bernardo@chuv.ch.
authors.forename: Stefano
authors.initials: S
authors.lastname: Di Bernardo
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. judith.bouchardy@chuv.ch.
authors.forename: Judith
authors.initials: J
authors.lastname: Bouchardy
authors.affiliation: Department of Radiology, University Hospital and University of Lausanne, Lausanne, Switzerland. matthias.stuber@chuv.ch.|Center for Biomedical Imaging and Center for Cardiovascular Magnetic Resonance Research, University of Lausanne, Lausanne, Switzerland. matthias.stuber@chuv.ch.
authors.forename: Matthias
authors.initials: M
authors.lastname: Stuber
authors.affiliation: Division of Cardiology and Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. jurg.schwitter@chuv.ch.
authors.forename: Juerg
authors.initials: J
authors.lastname: Schwitter
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000473:pathology; D015203:Reproducibility of Results; D012119:Respiration; D013557:Switzerland; D055815:Young Adult