講演情報
[I-OR16-06]Utility of ferumoxytol-enhanced 4D cardiac MRI in patients with complex congenital heart disease
○佐々木 奈央, プラカッシュ アッシュウィン (ボストン小児病院循環器科)
キーワード：
cardiac MRI、congenital heart disease、biventricular repair
Background
Cardiac MRI(CMR) has been widely used in patients with complex congenital heart disease (CHD). Commonly used sequences are; 2DSSFP which can assess cardiac motion in pre-defined imaging planes and static isotropic 3D angiography which can be used to evaluate anatomy in any imaging plane but is unable to assess cardiac motion. In 2021, our CMR laboratory introduced a new technique, ferumoxytol-enhanced 4D CMR (FE4DCMR) which provides 3D dataset in full motion. This isotropic cine technique provides detailed and dynamic visualization of anatomy. The aim of this study is to describe our experience in FE4DCMR.
Method
Medical record and images were reviewed retrospectively from 2021-2024.
Results
A total of 155 FE4DCMR studies were performed in complex CHD patients. Median (range) age was 15 months (1.2-245) and weight was 9.7 kg (3.8-51). All but 3 were performed under general anesthesia. No patients had adverse reaction. 75% had malposed great arteries, 34% had L-looped ventricles and 25% had heterotaxy syndrome. 85% of patients had at least one prior intervention. 61% achieved biventricular circulation, 17% had 1.5 ventricle palliation and 15% had single ventricle palliation. Number of studies increased over time; 19 in 2021, 21 in 2022, 43 in 2023 and 72 in 2024.
DiscussionUse of FE4DCMR has increased over time likely due to excellent visualization of complex anatomy in motion. This appears to be particularly useful in patients undergoing biventricular repair. Further studies are needed to compare image quality of this new technique to the conventional CMR sequences.
Cardiac MRI(CMR) has been widely used in patients with complex congenital heart disease (CHD). Commonly used sequences are; 2DSSFP which can assess cardiac motion in pre-defined imaging planes and static isotropic 3D angiography which can be used to evaluate anatomy in any imaging plane but is unable to assess cardiac motion. In 2021, our CMR laboratory introduced a new technique, ferumoxytol-enhanced 4D CMR (FE4DCMR) which provides 3D dataset in full motion. This isotropic cine technique provides detailed and dynamic visualization of anatomy. The aim of this study is to describe our experience in FE4DCMR.
Method
Medical record and images were reviewed retrospectively from 2021-2024.
Results
A total of 155 FE4DCMR studies were performed in complex CHD patients. Median (range) age was 15 months (1.2-245) and weight was 9.7 kg (3.8-51). All but 3 were performed under general anesthesia. No patients had adverse reaction. 75% had malposed great arteries, 34% had L-looped ventricles and 25% had heterotaxy syndrome. 85% of patients had at least one prior intervention. 61% achieved biventricular circulation, 17% had 1.5 ventricle palliation and 15% had single ventricle palliation. Number of studies increased over time; 19 in 2021, 21 in 2022, 43 in 2023 and 72 in 2024.
DiscussionUse of FE4DCMR has increased over time likely due to excellent visualization of complex anatomy in motion. This appears to be particularly useful in patients undergoing biventricular repair. Further studies are needed to compare image quality of this new technique to the conventional CMR sequences.