Non-Contrast-Enhanced CMR Is Sufficient!
Anastasia Fotaki1
1King's College London, London, United Kingdom

Synopsis

Keywords: Cardiovascular: Cardiovascular

Cardiac Magnetic Resonance Imaging plays a fundamental role in the care of patients with congenital heart disease. Current clinical protocols might necessitate the administration of contrast agents, particularly for anatomical imaging and tissue characterisation. This talk discusses emerging approaches for contrast-agent free CMR protocols, with the hope to motivate further application of these techniques for efficient, contrast-agent free imaging in CHD.

Cardiac Magnetic Resonance Imaging plays a fundamental role in the diagnosis, pre-procedural planning, and follow-up of patients with congenital heart disease (CHD)1,2. Current clinical protocols recommend 2D bSSFP imaging for quantification of ventricular volumes and function and 2D phase contrast imaging for flow and shunt assessment1,2. For anatomical description MRA and 3D whole-heart imaging is utilised, frequently requiring administration of contrast-agents3. Additionally, tissue characterisation techniques for prognostication might necessitate the administration of contrast agents too4,5,6.
Several recent advances in MRI acquisition and reconstruction enable contrast-free approaches in 3D cine, 4D flow, 3D anatomical imaging and tissue characterisation7,8,9. Despite the prolific literature, clinical uptake is lacking or limited to specialised centres only. This talk discusses current approaches for contrast-free CMR protocols for assessment of cardiac function, volumes and flows; along with emerging contrast-free techniques for myocardial tissue characterisation. Acknowledging that not some of the approaches presented are ready for clinical uptake, while others necessitate further validation; the hope is to motivate further application of these techniques for efficient, contrast-agent free imaging in CHD.

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Acknowledgements

No acknowledgement found.

References

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2.Fratz, S., Chung, T., Greil, G.F. et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson 15, 51 (2013). https://doi.org/10.1186/1532-429X-15-51.

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7.Velasco C, Cruz G, Lavin B, Hua A, Fotaki A, Botnar R, et al. Simultaneous T1, T2, and T1rho cardiac magnetic resonance fingerprinting for contrast agent-free myocardial tissue characterization. Magn Reson Med. (2022) 87:1992–2002. doi: 10.1002/mrm.29091.

8.Qi H, Bustin A, Cruz G, Jaubert O, Chen H, Botnar R, et al. Free-running simultaneous myocardial T1/T2 mapping and cine imaging with 3D whole-heart coverage and isotropic spatial resolution. Magn Reson Imaging. (2019) 63:159–69. doi: 10.1016/j.mri.2019.08.008.

9. Seeger, A., Fenchel, M.C., Greil, G.F. et al. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease. Pediatr Radiol 39, 1333–1342 (2009). https://doi.org/10.1007/s00247-009-1390-7.

Proc. Intl. Soc. Mag. Reson. Med. 31 (2023)