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The International Journal of Cardiovascular Imaging

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Open Access 01-08-2019 | Angiography | Original Paper

3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence

Authors: Sebastian Ebel, Sebastian Gottschling, Maria T. A. Buzan, Matthias Grothoff, Ingo Dähnert, Robert Wagner, Daniel Gräfe, Philipp Lurz, Matthias Gutberlet, Christian Lücke

Published in: The International Journal of Cardiovascular Imaging | Issue 8/2019

Abstract

To compare contrast-enhanced magnetic resonance angiography (ceMRA) and 3D steady-state free precession (SSFP) during systole and diastole for assessment of the right ventricle outflow tract (RVOT) in patients considered for percutaneous pulmonary valve implantation (PPVI) after tetralogy of Fallot (TOF) repair. We retrospectively evaluated 89 patients (male: 45, mean age 19 ± 8 years), who underwent cardiac-MRI after surgical TOF-repair. Datasets covering the whole heart in systole and diastole were acquired using ECG-gated 3D SSFP and non-gated ceMRA. Measurements were performed in SSFP-sequences and in ceMRA in the narrowest region of the RVOT to obtain the minimum, maximum and effective diameter. Invasive balloon sizing as the gold standard was available in 12 patients. The minimum diameter in diastolic SSFP, systolic SSFP and ceMRA were 21.4 mm (± 6.1 mm), 22.6 mm (± 6.2 mm) and 22.6 mm (± 6.0 mm), respectively. Maximum diameter was 29.9 mm (± 9.5 mm), 30.0 mm (± 7.0 mm) and 28.8 mm (± 8.1 mm) respectively. The effective diameter was 23.2 mm (± 5.7 mm), 27.4 mm (± 6.7 mm) and 24.4 mm (± 6.2 mm), differing significantly between diastole and systole (p < 0.0001). Measurements in ECG-gated SSFP showed a better inter- and intraobserver variability compared to measurements in non-ECG-gated ceMRA. Comparing invasive balloon sizing with our analysis, we found the highest correlation coefficients for the maximum and effective diameter measured in systolic SSFP (R = 0.99 respectively). ECG-gated 3D SSFP enables the identification and characterization of a potential landing zone for PPVI. The maximum and effective systolic diameter allow precise sizing for PPVI. Patients with TOF-repair could benefit from cardiac MRI before PPVI.

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Title: 3D-assessment of RVOT dimensions prior percutaneous pulmonary valve implantation: comparison of contrast-enhanced magnetic resonance angiography versus 3D steady-state free precession sequence
Authors: Sebastian Ebel
Sebastian Gottschling
Maria T. A. Buzan
Matthias Grothoff
Ingo Dähnert
Robert Wagner
Daniel Gräfe
Philipp Lurz
Matthias Gutberlet
Christian Lücke
Publication date: 01-08-2019
Publisher: Springer Netherlands
Keywords: Angiography
Pulmonary Valve Insufficiency
Tetralogy of Fallot
Tetralogy of Fallot
Published in: The International Journal of Cardiovascular Imaging / Issue 8/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-019-01578-w

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