Moritz H Albrecht1, Akos Varga-Szemes2, U Joseph Schoepf3, John W Nance4, Carlo N De Cecco5, Domenico De Santis6, Christian Tesche7, Marwen H Eid8, Megha Penmetsa9, Virginia W Lesslie10, Davide Piccini11, Markus Goeller12, Julian L Wichmann13, Thomas J Vogl14, Shahryar M Chowdhury15, Arni Nutting16, Anthony M Hlavacek17. 1. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Department of Diagnostic and Interventional Radiology, Division of Experimental and Translational Imaging, University Hospital Frankfurt, Frankfurt, Germany. Electronic address: MoritzAlbrecht@gmx.net. 2. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: vargaasz@musc.edu. 3. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: schoepf@musc.edu. 4. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: nancej@musc.edu. 5. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: carlodececco@gmail.com. 6. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Department of Radiological Sciences, Oncological and Pathological Sciences University of Rome "Sapienza", Latina, Italy. Electronic address: domenico.desantis@hotmail.it. 7. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany. Electronic address: tesche.christian@googlemail.com. 8. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: eid.marwen@gmail.com. 9. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: penmetsa@musc.edu. 10. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425. Electronic address: lesslie@musc.edu. 11. Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland; Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland. Electronic address: davide.piccini@siemens-healthineers.com. 12. Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: Markus.Goeller@uk-erlangen.de. 13. Department of Diagnostic and Interventional Radiology, Division of Experimental and Translational Imaging, University Hospital Frankfurt, Frankfurt, Germany. Electronic address: docwichmann@gmail.com. 14. Department of Diagnostic and Interventional Radiology, Division of Experimental and Translational Imaging, University Hospital Frankfurt, Frankfurt, Germany. Electronic address: t.vogl@em.uni-frankfurt.de. 15. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston South Carolina. Electronic address: chowdhur@musc.edu. 16. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston South Carolina. Electronic address: nutting@musc.edu. 17. Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston South Carolina. Electronic address: hlavace@musc.edu.
Abstract
RATIONALE AND OBJECTIVES: To evaluate the diagnostic accuracy of a prototype noncontrast, free-breathing, self-navigated 3D (SN3D) MR angiography (MRA) technique for the assessment of coronary artery anatomy in children with known or suspected coronary anomalies, using CT angiography (CTA) as the reference standard. MATERIALS AND METHODS: Twenty-one children (15 male, 12.3 ± 2.6 years) were prospectively enrolled between July 2014 and August 2016 in this IRB-approved, HIPAA-compliant study. Patients underwent same-day unenhanced SN3D-MRA and contrast-enhanced CTA. Two observers rated the visualization of coronary artery segments and diagnostic confidence on a 3-point scale and assessed coronary arteries for anomalous origin, as well as interarterial and intramural course. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of SN3D-MRA for the detection of coronary artery abnormalities were calculated. Interobserver agreement was assessed using Intraclass Correlation Coefficients (ICC). RESULTS: Fourteen children showed coronary artery abnormalities on CTA. The visualization of coronary segments was rated significantly higher for CTA compared to MRA (p <0.015), except for the left main coronary artery (p = 0.301), with good to excellent interobserver agreement (ICC = 0.62-0.94). Diagnostic confidence was higher for CTA (p = 0.046). Sensitivity, specificity, PPV, and NPV of MRA were 92%, 92%, 96%, and 87% for the detection of coronary artery anomalies, 85%, 85%, 74%, and 92% for high origin, 71%, 92%, 82%, and 87% for interarterial, and 41%, 96%, 87%, and 80% for intramural course. CONCLUSIONS: Noncontrast SN3D-MRA is highly accurate for the detection of coronary artery anomalies in pediatric patients while diagnostic confidence and coronary artery visualization remain superior with CTA. Published by Elsevier Inc.
RATIONALE AND OBJECTIVES: To evaluate the diagnostic accuracy of a prototype noncontrast, free-breathing, self-navigated 3D (SN3D) MR angiography (MRA) technique for the assessment of coronary artery anatomy in children with known or suspected coronary anomalies, using CT angiography (CTA) as the reference standard. MATERIALS AND METHODS: Twenty-one children (15 male, 12.3 ± 2.6 years) were prospectively enrolled between July 2014 and August 2016 in this IRB-approved, HIPAA-compliant study. Patients underwent same-day unenhanced SN3D-MRA and contrast-enhanced CTA. Two observers rated the visualization of coronary artery segments and diagnostic confidence on a 3-point scale and assessed coronary arteries for anomalous origin, as well as interarterial and intramural course. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of SN3D-MRA for the detection of coronary artery abnormalities were calculated. Interobserver agreement was assessed using Intraclass Correlation Coefficients (ICC). RESULTS: Fourteen children showed coronary artery abnormalities on CTA. The visualization of coronary segments was rated significantly higher for CTA compared to MRA (p <0.015), except for the left main coronary artery (p = 0.301), with good to excellent interobserver agreement (ICC = 0.62-0.94). Diagnostic confidence was higher for CTA (p = 0.046). Sensitivity, specificity, PPV, and NPV of MRA were 92%, 92%, 96%, and 87% for the detection of coronary artery anomalies, 85%, 85%, 74%, and 92% for high origin, 71%, 92%, 82%, and 87% for interarterial, and 41%, 96%, 87%, and 80% for intramural course. CONCLUSIONS: Noncontrast SN3D-MRA is highly accurate for the detection of coronary artery anomalies in pediatric patients while diagnostic confidence and coronary artery visualization remain superior with CTA. Published by Elsevier Inc.
Authors: Karen I Ramirez-Suarez; Luis Octavio Tierradentro-García; Hansel J Otero; Jordan B Rapp; Ammie M White; Sara L Partington; Matthew A Harris; Seth A Vatsky; Kevin K Whitehead; Mark A Fogel; David M Biko Journal: Pediatr Radiol Date: 2021-10-17
Authors: Robert E Stroud; Davide Piccini; U Joseph Schoepf; John Heerfordt; Jérôme Yerly; Lorenzo Di Sopra; Jonathan D Rollins; Andreas M Fischer; Pal Suranyi; Akos Varga-Szemes Journal: Eur Radiol Exp Date: 2019-07-31
Authors: Basel Yacoub; Robert E Stroud; Davide Piccini; U Joseph Schoepf; John Heerfordt; Jérôme Yerly; Lorenzo Di Sopra; Jonathan D Rollins; D Alan Turner; Tilman Emrich; Fei Xiong; Pal Suranyi; Akos Varga-Szemes Journal: J Cardiovasc Magn Reson Date: 2021-02-08 Impact factor: 5.364