Velasco Forte, Mari NievesValverde, IsraelPrabhu, NandaCorreia, TeresaNarayan, Srinivas AnanthBell, AaronMathur, SujeevRazavi, RezaHussain, TariquePushparajah, KuberanHenningsson, Markus2020-08-252020-08-252019-02-25Velasco Forte MN, Valverde I, Prabhu N, Correia T, Narayan SA, Bell A, et al. Visualization of coronary arteries in paediatric patients using whole-heart coronary magnetic resonance angiography: comparison of image-navigation and the standard approach for respiratory motion compensation. J Cardiovasc Magn Reson. 2019 Feb 25;21(1):13.1097-6647http://hdl.handle.net/10668/3175Aims: To investigate the use of respiratory motion compensation using image-based navigation (iNAV) with constant respiratory efficiency using single end-expiratory thresholding (CRUISE) for coronary magnetic resonance angiography (CMRA), and compare it to the conventional diaphragmatic navigator (dNAV) in paediatric patients with congenital or suspected heart disease. Methods: iNAV allowed direct tracking of the respiratory heart motion and was generated using balanced steady state free precession startup echoes. Respiratory gating was achieved using CRUISE with a fixed 50% efficiency. Whole-heart CMRA was acquired with 1.3 mm isotropic resolution. For comparison, CMRA with identical imaging parameters were acquired using dNAV. Scan time, visualization of coronary artery origins and mid-course, imaging quality and sharpness was compared between the two sequences. Results: Forty patients (13 females; median weight: 44 kg; median age: 12.6, range: 3 months-17 years) were enrolled. 25 scans were performed in awake patients. A contrast agent was used in 22 patients. The scan time was significantly reduced using iNAV for awake patients (iNAV 7:48 ± 1:26 vs dNAV 9:48 ± 3:11, P = 0.01) but not for patients under general anaesthesia (iNAV = 6:55 ± 1:50 versus dNAV = 6:32 ± 2:16; P = 0.32). In 98% of the cases, iNAV image quality had an equal or higher score than dNAV. The visual score analysis showed a clear difference, favouring iNAV (P = 0.002). The right coronary artery and the left anterior descending vessel sharpness was significantly improved (iNAV: 56.8% ± 10.1% vs dNAV: 53.7% ± 9.9%, P < 0.002 and iNAV: 55.8% ± 8.6% vs dNAV: 53% ± 9.2%, P = 0.001, respectively). Conclusion: iNAV allows for a higher success-rate and clearer depiction of the mid-course of coronary arteries in paediatric patients. Its acquisition time is shorter in awake patients and image quality score is equal or superior to the conventional method in most cases.ngenital or suspected heart disease.enCoronary magnetic resonance angiographyRespiratory motion compensationCoronary artery diseaseImage-based navigationMagnetic resonance angiographyAngiografía por resonancia magnéticaEnfermedad de la arteria coronariaMedical Subject Headings::Persons::Persons::Age Groups::AdolescentMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::ArtifactsMedical Subject Headings::Persons::Persons::Age Groups::ChildMedical Subject Headings::Persons::Persons::Age Groups::Child::Child, PreschoolMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Diagnostic Uses of Chemicals::Contrast MediaMedical Subject Headings::Anatomy::Cardiovascular System::Blood Vessels::Arteries::Coronary VesselsMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Diseases::Cardiovascular Diseases::Cardiovascular Abnormalities::Heart Defects, CongenitalMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Persons::Persons::Age Groups::InfantMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Alcohols::Sugar Alcohols::Sorbitol::MeglumineMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Organometallic CompoundsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Sensitivity and Specificity::Predictive Value of TestsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Evaluation Studies as Topic::Reproducibility of ResultsMedical Subject Headings::Phenomena and Processes::Physical Phenomena::Time::Time FactorsMedical Subject Headings::Information Science::Information Science::Systems Analysis::WorkflowMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Cardiovascular::Angiography::Magnetic Resonance AngiographyMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Magnetic Resonance Imaging::Magnetic Resonance Imaging, CineMedical Subject Headings::Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Respiratory Physiological Phenomena::Respiratory Physiological Processes::Respirationresearch article30798789Acceso abierto10.1186/s12968-019-0525-81532-429XPMC6388473