Three-dimensional magnetic resonance angiography of vascular lesions in children

Abstract

We applied three-dimensional (3D) magnetic resonance (MR) angiography to vascular lesions in children and evaluated the clinical usefulness of this technique. Ten patients, whose ages ranged from 1 month to 16 years, underwent 3D MR angiography for 12 vascular lesions, including lesions in seven pulmonary arteries, two thoracic aortae, a pair of renal arteries, and one iliac artery. Three-dimensional MR angiography was performed with body-or pelvic-phased array coils on a 1.5-T scanner using fast spoiled gradient echo sequence. Data were acquired with the following parameters: TE, 1.9 ms; TR, 10.1 ms; flip angle, 20-60 degrees ; 1 or 2 NEX; field of view, 24-48 x 18-40 cm; matrix, 256 or 512 x 128 or 256; slice thickness, 1.2-7.5 mm; and 12, 28, or 60 partitions. Vascular imaging was enhanced with 20% gadolinium-diethylenetriaminepentaacetic acid. The examination was performed under breath-holding in six patients and with shallow breathing in four patients. In a comparative study with other noninvasive methods, 3D MR angiography was superior in seven of nine cases to other noninvasive examinations and in two cases, all methods evaluated the lesions. Furthermore, six cases were compared with conventional angiography. In five of the six cases, both methods depicted the lesions similarly, and in one case, MR angiography was more effective. A quantitative comparison of vascular diameter in the MR image was made with that in the conventional angiographic image. The correlation between them was excellent: y = 1.145x-2.090 (r = 0.987; P < 0.0001), where x is the diameter in the conventional angiographic images, y is the diameter in the MR images, and r is the correlation coefficient. In conclusion, 3D MR angiography is useful for depicting peripheral vascular lesions in children.

Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review

“…16,26 Recently three-dimensional magnetic resonance angiography was demonstrated to be useful for revealing this malformation and generally for depicting peripheral vascular lesions in children. 27 We reviewed the age, the associated malformation, and the surgical procedure employed in patients with AOLPA in the 40 reports found in the literature (Table 2). Almost 52% (35/67, in 6 cases the patients' age was not reported) of patients were under 6 months of age at operation.…”

Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, subaortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries

“…7,10,[21][22][23][24] Other imaging modalities such as cineangiography, 21,22,25 or magnetic resonance angiography have also been utilised. 26 Due to the rapid development of irreversible pulmonary vascular disease in infancy and associated high mortality in the patients presenting with AOPA, re-implantation of the pulmonary artery is an operation that needs to be performed within the first year of life. 2,3,8,10,27 …”

Magnetic Resonance Imaging Predictors of Coarctation Severity

“…A practical advantage of these findings is that both 3D MRA of the thoracic aorta and PVC-MRI flow analysis are established MRI techniques, are commonly used in clinical practice, and require relatively short acquisition and imageprocessing times. 9,[13][14][15][16][23][24][25][26] Moreover, both techniques have been evaluated in patients with CoA and were found to reliably assess aortic morphology and collateral vessels and to accurately quantify flow in the descending aorta. 9,13 Assessment of coarctation severity presents a clinical challenge.…”