Application of first-pass contrast bolus tracking sequence for the assessment of morphology and flow dynamics in cardiac MRI

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Pediatric Cardiology

Background:

• First-pass perfusion imaging is established for myocardial ischemia and tumor vascularity.
• Cardiac magnetic resonance imaging (MRI) and contrast-enhanced magnetic resonance angiography (CE-MRA) are primary tools for cardiac anatomy.
• There is a need for dynamic flow evaluation in complex congenital and acquired heart diseases.

Purpose of the Study:

• To evaluate the utility of a first-pass contrast bolus tracking sequence (FPCBTS) for diagnosing congenital and acquired heart and great vessel diseases.
• To assess FPCBTS in cases unrelated to typical indications like myocardial ischemia or tumor vascularity.

Main Methods:

• 35 patients (1 day to 66 years) with suspected heart and great vessel disease underwent cardiac MRI and FPCBTS.
• 20 patients also underwent CE-MRA for complementary anatomic assessment.
• FPCBTS was used for dynamic flow evaluation, while MRI and CE-MRA provided anatomic details.

Main Results:

• FPCBTS successfully detected various congenital heart diseases including truncus arteriosus, tetralogy of Fallot, and septal defects.
• Complex pathologies such as aortic rupture, cardiac hydatid cyst, and interrupted aorta were diagnosed.
• Dynamic evaluation using FPCBTS easily identified shunt gaps, flow direction, aortic wall defects, and paracardiac mass relationships.

Conclusions:

• First-pass contrast bolus tracking sequence (FPCBTS) is a valuable addition to cardiac MRI and CE-MRA.
• FPCBTS provides crucial dynamic flow information complementing static anatomic imaging.
• This technique enhances diagnostic capabilities for a wide range of pediatric and adult cardiovascular conditions.