Background:In congenital heart disease(CHD)patients,detailed three-dimensional anatomy depiction plays a pivotal role for diagnosis and therapeutical decision making.Hence,the present study investigated the applicabil...Background:In congenital heart disease(CHD)patients,detailed three-dimensional anatomy depiction plays a pivotal role for diagnosis and therapeutical decision making.Hence,the present study investigated the applicability of an advanced cardiovascular magnetic resonance(CMR)whole heart imaging approach utilizing nonselective excitation and compressed sensing for anatomical assessment and interventional guidance of CHD patients in comparison to conventional dynamic CMR angiography.Methods:86 consecutive pediatric patients and adults with congenital heart disease(age,1 to 74 years;mean,35 years)underwent CMR imaging including a freebreathing,ECG-triggered 3D nonselective SSFP whole heart acquisition using compressed SENSE(nsWHcs).Anatomical assessability and signal intensity ratio(SIR)measurements were compared with conventional dynamic 3D-/4D-MR angiography.Results:The most frequent diagnoses were partial anomalous pulmonary venous drainage(17/86,20%),transposition of the great arteries(15/86,17%),tetralogy of Fallot(12/86,14%),and a single ventricle(7/86,8%).Image quality of nsWHcs was rated as excellent/good in 98%of patients.nsWHcs resulted in a reliable depiction of all large thoracic vessels(anatomic assessability,99%–100%)and the proximal segments of coronary arteries and coronary sinus(>90%).nsWHcs achieved a homogenously distributed SIR in all cardiac cavities and thoracic vessels without a significant difference between pulmonary and systemic circulation(10.9±3.5 and 10.6±3.4;p=0.15),while 3D angiography showed significantly increased SIR for targeted vs.non-targeted circulation(PA-angiography,15.2±8.1 vs.5.8±3.6,p<0.001;PV-angiography,7.0±3.9 vs.17.3±6.8,p<0.001).Conclusions:The proposed nsWHcs imaging approach provided a consistently high image quality and a homogeneous signal intensity distribution within the pulmonary and systemic circulation in pediatric patients and adults with a wide spectrum of congenital heart diseases.nsWHcs enabled detailed anatomical assessment and three-dimensional reconstruction of all cardiac cavities and large thoracic vessels and can be regarded particularly useful for preprocedural planning and interventional guidance in CHD patients.展开更多
BACKGROUND Congenital heart disease(CHD)is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus.In children with CHD,abnormalities in the development and function of the nerv...BACKGROUND Congenital heart disease(CHD)is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus.In children with CHD,abnormalities in the development and function of the nervous system are common.At present,there is a lack of research on the preoperative neurological development and injury in young children with non-cyanotic CHD.AIM To determine the changes in white matter,gray matter,and cerebrospinal fluid(CSF)by magnetic resonance imaging(MRI)in children with non-cyanotic CHD as compared with healthy controls.METHODS Children diagnosed with non-cyanotic CHD on ultrasonography(n=54)and healthy control subjects(n=35)were included in the study.All the subjects were aged 1-3 years.Brain MRI was performed prior to surgery for CHD.The SPM v12 software was used to calculate the volumes of the gray matter,white matter,CSF,and the whole brain(sum of the gray matter,white matter,and CSF volumes).Volume differences between the two groups were analyzed.Voxel-based morphometry was used to compare specific brain regions with statistically significant atrophy.RESULTS Compared with the control group,the study group had significantly reduced whole-brain white matter volume(P<0.05),but similar whole-brain gray matter,CSF,and whole-brain volumes(P>0.05).As compared with the healthy controls,children with non-cyanotic CHD had mild underdevelopment in the white matter of the anterior central gyrus,the posterior central gyrus,and the pulvinar.CONCLUSION Children with non-cyanotic CHD show decreased white matter volume before surgery,and this volume reduction is mainly concentrated in the somatosensory and somatic motor nerve regions.展开更多
Objective To assess the effectiveness of magnetic resonance imaging (MRI) and cine magnetic resonance imaging (cine MRI) in the diagnosis of infantile congenital heart disease Methods A total of 34 cases were stud...Objective To assess the effectiveness of magnetic resonance imaging (MRI) and cine magnetic resonance imaging (cine MRI) in the diagnosis of infantile congenital heart disease Methods A total of 34 cases were studied with MRI and cine MRI The data were analyzed and compared with those of two dimensional echocardiography (2DE), cardioangiography (CAG) and surgery Results The size of the defect or its caliber obtained from MRI in 6 patients with left to right shunt congenital heart disease was compatible with that observed in surgery ( P =0 924) Comparison of cine MRI and CAG in 28 patients with complicated congenital heart disease showed that the diagnosis of 27 cases by cine MRI was the same as that by CAG Conclusion Both MRI and cine MRI play an important role in diagnosing infantile congenital heart disease展开更多
Congenital aortic arch anomalies occur most commonly in children. The disease can be classified into three types： ① obstructive congenital abnormalities, including coarctation of aorta （CoA） and interruption of ao...Congenital aortic arch anomalies occur most commonly in children. The disease can be classified into three types： ① obstructive congenital abnormalities, including coarctation of aorta （CoA） and interruption of aortic arch （IAA）; ② nonobstructive congenital abnormalities, including double aortic arch and others; ③ congenital shunt abnormalities, including different types of patent ductus arteriosus （PDA）. Management of patients with congenital aortic arch anomalies relies on imaging. Routine imaging modalities, such as conventional X-ray plain film and transthoracic echocardiography （TTE）, have been recently complemented by magnetic resonance imaging （MRI）.展开更多
目的分析双时相三维稳态进动快速成像序列(3DSSFP)对先天性心脏(CHD)大血管畸形的诊断价值。方法对我院近两年(2015年12月-2017年12月)收治的经超声诊断为CHD的46例患者先心病患者在术前或术后均采用胸部双时相3DSSFP成像及传统对比剂...目的分析双时相三维稳态进动快速成像序列(3DSSFP)对先天性心脏(CHD)大血管畸形的诊断价值。方法对我院近两年(2015年12月-2017年12月)收治的经超声诊断为CHD的46例患者先心病患者在术前或术后均采用胸部双时相3DSSFP成像及传统对比剂增强磁共振血管成像(CE-MRA)技术,比较两种MR检查获得的先心病患者大血管图像质量及测得的大血管直径,分析评估双时相3DSSFP成像技术在先天性心脏(CHD大血管畸形中的诊断效能。结果两种MR检查获得的先心病患者大血管图像质量无显著差异(P>0.05);3DSSFP收缩期、舒张期及CE-MRA测得的主动脉、左肺动脉、右肺动脉直径差异显著(P<0.05),肺总动脉及下腔静脉直径无显著差异(P>0.05),3DSSFP收缩期测得的主动脉、肺总动脉、右肺动脉直径显著大于舒张期(P<0.05),左肺动脉及下腔静脉直径与舒张期无显著差异(P>0.05)。结论 3D SSFP成像技术能清晰显示先天性心脏病患者的大血管形态变化,且能准确测量不同心动时期大血管直径,有助于临床制定合理的治疗方案,提高CHD患者的治疗效果。展开更多
文摘Background:In congenital heart disease(CHD)patients,detailed three-dimensional anatomy depiction plays a pivotal role for diagnosis and therapeutical decision making.Hence,the present study investigated the applicability of an advanced cardiovascular magnetic resonance(CMR)whole heart imaging approach utilizing nonselective excitation and compressed sensing for anatomical assessment and interventional guidance of CHD patients in comparison to conventional dynamic CMR angiography.Methods:86 consecutive pediatric patients and adults with congenital heart disease(age,1 to 74 years;mean,35 years)underwent CMR imaging including a freebreathing,ECG-triggered 3D nonselective SSFP whole heart acquisition using compressed SENSE(nsWHcs).Anatomical assessability and signal intensity ratio(SIR)measurements were compared with conventional dynamic 3D-/4D-MR angiography.Results:The most frequent diagnoses were partial anomalous pulmonary venous drainage(17/86,20%),transposition of the great arteries(15/86,17%),tetralogy of Fallot(12/86,14%),and a single ventricle(7/86,8%).Image quality of nsWHcs was rated as excellent/good in 98%of patients.nsWHcs resulted in a reliable depiction of all large thoracic vessels(anatomic assessability,99%–100%)and the proximal segments of coronary arteries and coronary sinus(>90%).nsWHcs achieved a homogenously distributed SIR in all cardiac cavities and thoracic vessels without a significant difference between pulmonary and systemic circulation(10.9±3.5 and 10.6±3.4;p=0.15),while 3D angiography showed significantly increased SIR for targeted vs.non-targeted circulation(PA-angiography,15.2±8.1 vs.5.8±3.6,p<0.001;PV-angiography,7.0±3.9 vs.17.3±6.8,p<0.001).Conclusions:The proposed nsWHcs imaging approach provided a consistently high image quality and a homogeneous signal intensity distribution within the pulmonary and systemic circulation in pediatric patients and adults with a wide spectrum of congenital heart diseases.nsWHcs enabled detailed anatomical assessment and three-dimensional reconstruction of all cardiac cavities and large thoracic vessels and can be regarded particularly useful for preprocedural planning and interventional guidance in CHD patients.
文摘BACKGROUND Congenital heart disease(CHD)is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus.In children with CHD,abnormalities in the development and function of the nervous system are common.At present,there is a lack of research on the preoperative neurological development and injury in young children with non-cyanotic CHD.AIM To determine the changes in white matter,gray matter,and cerebrospinal fluid(CSF)by magnetic resonance imaging(MRI)in children with non-cyanotic CHD as compared with healthy controls.METHODS Children diagnosed with non-cyanotic CHD on ultrasonography(n=54)and healthy control subjects(n=35)were included in the study.All the subjects were aged 1-3 years.Brain MRI was performed prior to surgery for CHD.The SPM v12 software was used to calculate the volumes of the gray matter,white matter,CSF,and the whole brain(sum of the gray matter,white matter,and CSF volumes).Volume differences between the two groups were analyzed.Voxel-based morphometry was used to compare specific brain regions with statistically significant atrophy.RESULTS Compared with the control group,the study group had significantly reduced whole-brain white matter volume(P<0.05),but similar whole-brain gray matter,CSF,and whole-brain volumes(P>0.05).As compared with the healthy controls,children with non-cyanotic CHD had mild underdevelopment in the white matter of the anterior central gyrus,the posterior central gyrus,and the pulvinar.CONCLUSION Children with non-cyanotic CHD show decreased white matter volume before surgery,and this volume reduction is mainly concentrated in the somatosensory and somatic motor nerve regions.
文摘Objective To assess the effectiveness of magnetic resonance imaging (MRI) and cine magnetic resonance imaging (cine MRI) in the diagnosis of infantile congenital heart disease Methods A total of 34 cases were studied with MRI and cine MRI The data were analyzed and compared with those of two dimensional echocardiography (2DE), cardioangiography (CAG) and surgery Results The size of the defect or its caliber obtained from MRI in 6 patients with left to right shunt congenital heart disease was compatible with that observed in surgery ( P =0 924) Comparison of cine MRI and CAG in 28 patients with complicated congenital heart disease showed that the diagnosis of 27 cases by cine MRI was the same as that by CAG Conclusion Both MRI and cine MRI play an important role in diagnosing infantile congenital heart disease
文摘Congenital aortic arch anomalies occur most commonly in children. The disease can be classified into three types： ① obstructive congenital abnormalities, including coarctation of aorta （CoA） and interruption of aortic arch （IAA）; ② nonobstructive congenital abnormalities, including double aortic arch and others; ③ congenital shunt abnormalities, including different types of patent ductus arteriosus （PDA）. Management of patients with congenital aortic arch anomalies relies on imaging. Routine imaging modalities, such as conventional X-ray plain film and transthoracic echocardiography （TTE）, have been recently complemented by magnetic resonance imaging （MRI）.
文摘目的分析双时相三维稳态进动快速成像序列(3DSSFP)对先天性心脏(CHD)大血管畸形的诊断价值。方法对我院近两年(2015年12月-2017年12月)收治的经超声诊断为CHD的46例患者先心病患者在术前或术后均采用胸部双时相3DSSFP成像及传统对比剂增强磁共振血管成像(CE-MRA)技术,比较两种MR检查获得的先心病患者大血管图像质量及测得的大血管直径,分析评估双时相3DSSFP成像技术在先天性心脏(CHD大血管畸形中的诊断效能。结果两种MR检查获得的先心病患者大血管图像质量无显著差异(P>0.05);3DSSFP收缩期、舒张期及CE-MRA测得的主动脉、左肺动脉、右肺动脉直径差异显著(P<0.05),肺总动脉及下腔静脉直径无显著差异(P>0.05),3DSSFP收缩期测得的主动脉、肺总动脉、右肺动脉直径显著大于舒张期(P<0.05),左肺动脉及下腔静脉直径与舒张期无显著差异(P>0.05)。结论 3D SSFP成像技术能清晰显示先天性心脏病患者的大血管形态变化,且能准确测量不同心动时期大血管直径,有助于临床制定合理的治疗方案,提高CHD患者的治疗效果。
