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3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence.
Int J Cardiovasc Imaging. 2019 Aug; 35(8):1453-1463.IJ

Abstract

To compare contrast-enhanced magnetic resonance angiography (ceMRA) and 3D steady-state free precession (SSFP) during systole and diastole for assessment of the right ventricle outflow tract (RVOT) in patients considered for percutaneous pulmonary valve implantation (PPVI) after tetralogy of Fallot (TOF) repair. We retrospectively evaluated 89 patients (male: 45, mean age 19 ± 8 years), who underwent cardiac-MRI after surgical TOF-repair. Datasets covering the whole heart in systole and diastole were acquired using ECG-gated 3D SSFP and non-gated ceMRA. Measurements were performed in SSFP-sequences and in ceMRA in the narrowest region of the RVOT to obtain the minimum, maximum and effective diameter. Invasive balloon sizing as the gold standard was available in 12 patients. The minimum diameter in diastolic SSFP, systolic SSFP and ceMRA were 21.4 mm (± 6.1 mm), 22.6 mm (± 6.2 mm) and 22.6 mm (± 6.0 mm), respectively. Maximum diameter was 29.9 mm (± 9.5 mm), 30.0 mm (± 7.0 mm) and 28.8 mm (± 8.1 mm) respectively. The effective diameter was 23.2 mm (± 5.7 mm), 27.4 mm (± 6.7 mm) and 24.4 mm (± 6.2 mm), differing significantly between diastole and systole (p < 0.0001). Measurements in ECG-gated SSFP showed a better inter- and intraobserver variability compared to measurements in non-ECG-gated ceMRA. Comparing invasive balloon sizing with our analysis, we found the highest correlation coefficients for the maximum and effective diameter measured in systolic SSFP (R = 0.99 respectively). ECG-gated 3D SSFP enables the identification and characterization of a potential landing zone for PPVI. The maximum and effective systolic diameter allow precise sizing for PPVI. Patients with TOF-repair could benefit from cardiac MRI before PPVI.

Authors+Show Affiliations

Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany. sebastian.ebel@icloud.com.Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany.Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany. Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany.Department of Pediatric Cardiology and Congenital Heart Disease, University of Leipzig - Heart Centre, Leipzig, Germany.Department of Pediatric Cardiology and Congenital Heart Disease, University of Leipzig - Heart Centre, Leipzig, Germany.Department of Pediatric Radiology, University of Leipzig, Leipzig, Germany.Department of Cardiology, University of Leipzig - Heart Centre, Leipzig, Germany.Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany.Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30937683

Citation

Ebel, Sebastian, et al. "3D-assessment of RVOT Dimensions Prior Percutaneous Pulmonary Valve Implantation: Comparison of Contrast-enhanced Magnetic Resonance Angiography Versus 3D Steady-state Free Precession Sequence." The International Journal of Cardiovascular Imaging, vol. 35, no. 8, 2019, pp. 1453-1463.
Ebel S, Gottschling S, Buzan MTA, et al. 3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence. Int J Cardiovasc Imaging. 2019;35(8):1453-1463.
Ebel, S., Gottschling, S., Buzan, M. T. A., Grothoff, M., Dähnert, I., Wagner, R., Gräfe, D., Lurz, P., Gutberlet, M., & Lücke, C. (2019). 3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence. The International Journal of Cardiovascular Imaging, 35(8), 1453-1463. https://doi.org/10.1007/s10554-019-01578-w
Ebel S, et al. 3D-assessment of RVOT Dimensions Prior Percutaneous Pulmonary Valve Implantation: Comparison of Contrast-enhanced Magnetic Resonance Angiography Versus 3D Steady-state Free Precession Sequence. Int J Cardiovasc Imaging. 2019;35(8):1453-1463. PubMed PMID: 30937683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence. AU - Ebel,Sebastian, AU - Gottschling,Sebastian, AU - Buzan,Maria T A, AU - Grothoff,Matthias, AU - Dähnert,Ingo, AU - Wagner,Robert, AU - Gräfe,Daniel, AU - Lurz,Philipp, AU - Gutberlet,Matthias, AU - Lücke,Christian, Y1 - 2019/04/01/ PY - 2018/12/24/received PY - 2019/03/05/accepted PY - 2019/4/3/pubmed PY - 2019/8/14/medline PY - 2019/4/3/entrez KW - Magnetic resonance angiography KW - Preprocedural imaging KW - Pulmonary valve Insufficiency KW - Pulmonary valve stenosis KW - Tetralogy of Fallot SP - 1453 EP - 1463 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 35 IS - 8 N2 - To compare contrast-enhanced magnetic resonance angiography (ceMRA) and 3D steady-state free precession (SSFP) during systole and diastole for assessment of the right ventricle outflow tract (RVOT) in patients considered for percutaneous pulmonary valve implantation (PPVI) after tetralogy of Fallot (TOF) repair. We retrospectively evaluated 89 patients (male: 45, mean age 19 ± 8 years), who underwent cardiac-MRI after surgical TOF-repair. Datasets covering the whole heart in systole and diastole were acquired using ECG-gated 3D SSFP and non-gated ceMRA. Measurements were performed in SSFP-sequences and in ceMRA in the narrowest region of the RVOT to obtain the minimum, maximum and effective diameter. Invasive balloon sizing as the gold standard was available in 12 patients. The minimum diameter in diastolic SSFP, systolic SSFP and ceMRA were 21.4 mm (± 6.1 mm), 22.6 mm (± 6.2 mm) and 22.6 mm (± 6.0 mm), respectively. Maximum diameter was 29.9 mm (± 9.5 mm), 30.0 mm (± 7.0 mm) and 28.8 mm (± 8.1 mm) respectively. The effective diameter was 23.2 mm (± 5.7 mm), 27.4 mm (± 6.7 mm) and 24.4 mm (± 6.2 mm), differing significantly between diastole and systole (p < 0.0001). Measurements in ECG-gated SSFP showed a better inter- and intraobserver variability compared to measurements in non-ECG-gated ceMRA. Comparing invasive balloon sizing with our analysis, we found the highest correlation coefficients for the maximum and effective diameter measured in systolic SSFP (R = 0.99 respectively). ECG-gated 3D SSFP enables the identification and characterization of a potential landing zone for PPVI. The maximum and effective systolic diameter allow precise sizing for PPVI. Patients with TOF-repair could benefit from cardiac MRI before PPVI. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/30937683/3D_assessment_of_RVOT_dimensions_prior_percutaneous_pulmonary_valve_implantation:_comparison_of_contrast_enhanced_magnetic_resonance_angiography_versus_3D_steady_state_free_precession_sequence_ L2 - https://doi.org/10.1007/s10554-019-01578-w DB - PRIME DP - Unbound Medicine ER -