For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution (~2.5mm × 2.5mm) and temporal resolution (~40ms), to produce high-quality real-time cine MR images that could be applied clinically for wall motion assessment and measurement of left ventricular (LV) function. In this work, we present an 8-fold accelerated real-time cardiac cine MRI pulse sequence using a combination of compressed sensing and parallel imaging (k-t SPARSE-SENSE). Compared with reference, breath-hold cine MRI, our 8-fold accelerated real-time cine MRI produced significantly worse qualitative grades (1–5 scale), but its image quality and temporal fidelity scores were above 3.0 (adequate) and artifacts and noise scores were below 3.0 (moderate), suggesting that acceptable diagnostic image quality can be achieved. Additionally, both 8-fold accelerated real-time cine and breath-hold cine MRI yielded comparable LV function measurements, with coefficient of variation < 10% for LV volumes. Our proposed 8-fold accelerated real-time cine MRI with k-t SPARSE-SENSE is a promising modality for rapid imaging of myocardial function.

This study was designed to test the hypothesis that non‐ambulatory patients with spastic quadriplegia will have reduced bone mass which worsens with increasing age. Forty‐eight patients (age 5 to 48 years, median age 15 years; 19 females and 29 males) were studied. Anticonvulsants were used in 29 patients (60.4%). Lumbar spine bone mineral density (LS‐BMD) was markedly reduced compared with age‐and sex‐matched control individuals with a z score of ‐2.37±0.21. Twenty‐eight (58%) had z scores of less than ‐2. A history of documented previous fracture was present in 19 patients (39%). Patients with a history of fracture had significantly lower (p=0.05) LS‐BMD z scores (‐2.81±0.29) compared with those without a history of fracture (‐2.11±0.26). Mean serum 25‐OH vitamin D was 29.6±1.9ng/mL (normal 9 to 37.6ng/mL) with three patients having serum 25‐OH vitamin D levels less than 15ng/mL. These findings indicate that BMD is markedly reduced in non‐ambulatory children and adults with neuromuscular disease. Reductions in bone mass put them at greater risk for non‐traumatic fractures.

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Rotational angiography (RA) has proven to be an excellent method for evaluating congenital disease (CHD) in the cardiac cath lab, permitting acquisition of 3D datasets with superior spatial resolution. This technique has not been routinely implemented for 3D printing in CHD. We describe our case series of models printed from RA and validate our technique. All patients with models printed from RA were selected. RA acquisitions from a Toshiba Infinix-I system were postprocessed and printed with a Stratasys Eden 260. Two independent observers measured 5-10 points of interest on both the RA and the 3D model. Bland Altman plot was used to compare the measurements on rotational angiography to the printed model. Models were printed from RA in 5 patients (age 2 months-1 year). Diagnoses included (a) coronary artery aneurysm, (b) Glenn shunt, (c) coarctation of the aorta, (d) tetralogy of Fallot with MAPCAs, and (e) pulmonary artery stenosis. There was no significant measurement difference between RA and the printed model (r = 0.990, p < 0.01, Bland Altman p = 0.987). There was also no significant inter-observer variability. The MAPCAs model was referenced by the surgeon intraoperatively and was accurate. Rotational angiography can generate highly accurate 3D models in congenital heart disease, including in small vascular structures. These models can be extremely useful in patient evaluation and management.