Marc-Antoine Isorni1, Louis Moisson2, Nidal Ben Moussa3, Sébastien Monnot4, Francesca Raimondi5, Régine Roussin6, Angèle Boet7, Isabelle van Aerschot8, Emmanuelle Fournier9, Sarah Cohen10, Meriem Kara11, Sébastien Hascoet12. 1. Diagnostic and Therapeutic Radiology Service, Hopital Marie Lannelongue, 133, avenue de la résistance, 92350 Le Plessis Robinson, France. Electronic address: marco.isorni@gmail.com. 2. Diagnostic and Therapeutic Radiology Service, Hopital Marie Lannelongue, 133, avenue de la résistance, 92350 Le Plessis Robinson, France. Electronic address: l.moisson@hml.fr. 3. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: n.benmoussa@hml.fr. 4. Diagnostic and Therapeutic Radiology Service, Hopital Marie Lannelongue, 133, avenue de la résistance, 92350 Le Plessis Robinson, France. Electronic address: s.monnot@hml.fr. 5. Pediatric Radiology Unit, Hopital universitaire Necker Enfants-Malades, 149, rue de Sevres, 75743 Paris, Cedex 15, France. 6. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. 7. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: a.boet@hml.fr. 8. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: i.vanaerschot@hml.fr. 9. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: e.fournier@hml.fr. 10. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: s.cohen@hml.fr. 11. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: m.kara@hml.fr. 12. Pôle des cardiopathies congénitales de l'enfant et de l'adulte, Centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France. Electronic address: s.hascoet@hml.fr.
Abstract
BACKGROUND: Cardiac magnetic resonance (CMR) imaging with velocity encoding along all three directions of flow, known as 4DFlow CMR, provides both anatomical and functional information. Few data are available on the usefulness of 4DFlow CMR in everyday practice. Here, our objective was to investigate the usefulness of 4DFlow CMR for assessing congenital heart disease (CHD) in everyday practice. METHODS: From 2017 to 2019, consecutive patients who underwent 4DFlow CMR were included prospectively at a single high-volume centre. The parameters recommended by an expert's consensus statement for each diagnosis (congenital valvulopathy, septal defect, complex CHD, tetralogy of Fallot, aortic abnormalities) were assessed by two blinded experienced readers. 4DFlow CMRs that provided all recommended parameters were considered successful. Inter-observer and intra-observer agreement were investigated. RESULTS: We included 187 adults and 60 children covering broad ranges of weight (4.5-142 kg) and age (0.1-67 years). 4DFlow CMR was always the second-line imaging modality, after inconclusive echocardiography, and was successful in 231/247 (91%) patients, with no significant difference between children and adults (54/60, 90%; and 177/187, 95%; respectively; p = .13). Longer time using 4DFlow CMR at our centre was associated with success; in children, older age was also associated with exam success. There was an about 12-month learning curve in children. The success rate was lowest in neonates. Inter-observer and intra-observer agreement were substantial. CONCLUSION: Our results suggest that 4DFlow CMR usually provides a comprehensive assessment of CHD in adults and children. A learning curve exists for children and the investigation remains challenging in neonates.
BACKGROUND: Cardiac magnetic resonance (CMR) imaging with velocity encoding along all three directions of flow, known as 4DFlow CMR, provides both anatomical and functional information. Few data are available on the usefulness of 4DFlow CMR in everyday practice. Here, our objective was to investigate the usefulness of 4DFlow CMR for assessing congenital heart disease (CHD) in everyday practice. METHODS: From 2017 to 2019, consecutive patients who underwent 4DFlow CMR were included prospectively at a single high-volume centre. The parameters recommended by an expert's consensus statement for each diagnosis (congenital valvulopathy, septal defect, complex CHD, tetralogy of Fallot, aortic abnormalities) were assessed by two blinded experienced readers. 4DFlow CMRs that provided all recommended parameters were considered successful. Inter-observer and intra-observer agreement were investigated. RESULTS: We included 187 adults and 60 children covering broad ranges of weight (4.5-142 kg) and age (0.1-67 years). 4DFlow CMR was always the second-line imaging modality, after inconclusive echocardiography, and was successful in 231/247 (91%) patients, with no significant difference between children and adults (54/60, 90%; and 177/187, 95%; respectively; p = .13). Longer time using 4DFlow CMR at our centre was associated with success; in children, older age was also associated with exam success. There was an about 12-month learning curve in children. The success rate was lowest in neonates. Inter-observer and intra-observer agreement were substantial. CONCLUSION: Our results suggest that 4DFlow CMR usually provides a comprehensive assessment of CHD in adults and children. A learning curve exists for children and the investigation remains challenging in neonates.
Authors: Takashi Fujiwara; Haben Berhane; Michael B Scott; Erin K Englund; Michal Schäfer; Brian Fonseca; Alexander Berthusen; Joshua D Robinson; Cynthia K Rigsby; Lorna P Browne; Michael Markl; Alex J Barker Journal: J Magn Reson Imaging Date: 2021-11-18 Impact factor: 5.119