Utility of a High-Resolution 3D MRI Sequence (3D-SPACE) for Evaluation of Congenital Heart Disease

The purpose of this study was to evaluate the role of a high-resolution 3D dark-blood turbo spin echo sequence with variable flip angles (3D-SPACE) in evaluation of congenital heart disease. SPACE sequence was performed in 20 patients (mean age, 17.6 ± 12.6 years, range 9 months-57 years, M: 13) with either unrepaired (N = 3) or post-repair (n = 17) congenital heart disease. All scans were performed on 1.5 T Aera scanners (Siemens). Two separate observers with expertise in cardiovascular imaging scored the quality of the images for blood suppression and definition of key anatomical structures in a blinded fashion using a 5 grade scoring system. Mean of average overall quality scores for two observers was 4 ± 0.62. All overall quality scores were greater than 3. None of the studies were deemed nondiagnostic. Mean length of the SPACE acquisition time was 12.7 min (4-21 min). There was no significant correlation between image quality and duration of scans. Lack of blood suppression was the limiting factor in image quality with the most common place being ascending aorta in nine patients. However, overall blood suppression score was very good with score of 3.9 ± 0.43. There was very good overall agreement between observers in rating the image quality (85.6 % agreement, kappa 0.5, standard error 0.04, p < 0.0001). The 3D-SPACE dark-blood sequence with near-isotropic spatial resolution coupled with respiratory and cardiac gating can be feasibly performed in all age groups with diagnostic image quality in all cases in this study.