title: Congenital heart disease in adults: Quantitative and qualitative evaluation of IR FLASH and IR SSFP MRA techniques using a blood pool contrast agent in the steady state and comparison to first pass MRA.
abstract: OBJECTIVE
  To evaluate magnetic resonance angiography sequences during the contrast steady-state (SS-MRA) using inversion recovery (IR) with fast low-angle shot (IR-FLASH) or steady-state free precession (IR-SSFP) read-outs, following the injection of a blood-pool contrast agent, and compare them to first-pass MR angiography (FP-MRA) in adults with congenital heart disease (CHD).
  
  
  METHODS
  Twenty-three adult patients with CHD who underwent both SS-MRA and FP-MRA using a 1.5-T scanner were retrospectively identified. Signal-to-noise and contrast-to-noise ratios were obtained at eight locations within the aorta and pulmonary vessels.. Image quality and the presence of artifacts were subjectively assessed by two radiologists. The presence of pathology was noted and given a confidence score.
  
  
  RESULTS
  There was no difference in vessel dimensions among the sequences. IR-SSFP showed better image quality and fewer artifacts than IR-FLASH and FP-MRA. Confidence scores were significantly higher for SS-MRA compared to FP-MRA. Seven cases (30.4%) had findings detected at SS-MRA that were not detected at FP-MRA, and 2 cases (8.7%) had findings detected by IR-SSFP only.
  
  
  CONCLUSIONS
  SS-MRA of the thoracic vasculature using a blood pool contrast agent offers superior image quality and reveals more abnormalities compared to standard FP-MRA in adults with CHD, and it is best achieved with an IR-SSFP sequence. These sequences could lead to increased detection rates of abnormalities and provide a simpler protocol image acquisition.
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA. Electronic address: febbo.jennifer@gmail.com.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Febbo
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA; Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Mauricio S
authors.initials: MS
authors.lastname: Galizia
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Murphy
authors.affiliation: Department of Medical Imaging, Children's Memorial Hospital, Chicago, IL, USA.
authors.forename: Andrada
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Cardiovascular MR R&D, Siemens Healthcare, Chicago, IL, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Turin
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Collins
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA; Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Markl
authors.affiliation: Department of Radiology, North Shore University Health System, Evanston, IL, USA.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edelman
authors.affiliation: Department of Radiology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Carr
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000002:abnormalities; D001018:Aortic Diseases / Q000175:diagnosis; D001021:Aortic Valve / Q000002:abnormalities; D016477:Artifacts; D003287:Contrast Media / Q000008:administration & dosage*; D004108:Dilatation, Pathologic / Q000175:diagnosis; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011651:Pulmonary Artery / Q000002:abnormalities; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium
keywords: Blood-pool contrast agent; Congenital heart disease; MRA