For MRI, cine images using balanced steady-state free precession were obtained in axial, sagittal, and/or coronal planes, as needed. Using a four-point Likert scale (1 for non-diagnostic, 4 for good image quality), the overall picture quality was assessed. Using both imaging approaches, an independent analysis of 20 fetal cardiovascular features with abnormalities was conducted. Postnatal examination results provided the reference point for the comparison. Differences in sensitivities and specificities were determined via a random-effects modeling approach.
Among the participants of the study, 23 had an average age of 32 years and 5 months (standard deviation), and an average gestational age of 36 weeks and 1 day. In every participant, a fetal cardiac MRI scan was performed. The median image quality observed in DUS-gated cine imaging was 3; the interquartile range was 25-4. In a cohort of 23 participants, 21 (91%) were correctly assessed for underlying congenital heart disease (CHD) utilizing fetal cardiac MRI. Employing MRI alone, a correct diagnosis was reached in a case involving situs inversus and congenitally corrected transposition of the great arteries. find more Sensitivity figures differ substantially (918% [95% CI 857, 951] while the other is 936% [95% CI 888, 962]).
A set of ten distinct sentences, each a reflection of the initial thought, but with different structural patterns, highlighting the nuances of wording and sentence arrangement. Specificities measured nearly identically: 999% [95% CI 992, 100] and 999% [95% CI 995, 100].
More than ninety-nine percent. When assessing abnormal cardiovascular features, MRI and echocardiography exhibited comparable diagnostic accuracy.
Fetal cine cardiac MRI, gated by Doppler ultrasound, demonstrated diagnostic accuracy on par with fetal echocardiography for the detection of intricate fetal congenital heart defects.
Cardiac MRI, fetal MRI (MR-Fetal), fetal imaging, congenital heart disease, congenital conditions, prenatal, pediatrics, heart imaging, clinical trial registration number. The meticulously documented study NCT05066399 warrants further analysis.
The 2023 RSNA proceedings contain a supplementary commentary by Biko and Fogel, which is essential reading.
Fetal cardiac MRI, using DUS gating, produced diagnostic accuracy comparable to fetal echocardiography in complex congenital heart disease cases. This article's accompanying materials for NCT05066399 can be accessed. The RSNA 2023 abstract book includes a commentary by Biko and Fogel, a perspective to consider.
Photon-counting detector (PCD) CT will be utilized to develop and evaluate a low-volume contrast media protocol for thoracoabdominal CT angiography.
This prospective study, conducted between April and September 2021, included participants who underwent CTA with PCD CT of the thoracoabdominal aorta and a prior CTA with an energy-integrating detector (EID) CT, at the same radiation levels. PCD CT reconstructions created virtual monoenergetic images (VMI) at 5-keV energy intervals from 40 keV up to and including 60 keV. Two independent readers performed subjective image quality assessments and measured the attenuation of the aorta, image noise, and contrast-to-noise ratio (CNR). For the initial cohort of participants, a consistent contrast medium protocol guided both imaging sessions. The reference standard for reducing contrast media volume in the second group was the improvement in computed tomography contrast-to-noise ratio (CNR) from PCD CT, in contrast to EID CT. Using a noninferiority analysis framework, the image quality of the low-volume contrast media protocol was compared against PCD CT to determine its noninferiority.
The study cohort consisted of 100 participants, with a mean age of 75 years and 8 months (standard deviation), including 83 men. In the primary assemblage,
Regarding the best balance between objective and subjective image quality, VMI at 50 keV achieved a 25% greater contrast-to-noise ratio (CNR) than EID CT. The second group's contrast media volume is a significant element to observe.
Starting with 60, a 25% reduction (525 mL) was implemented. Mean differences in image quality assessment (CNR and subjective) between EID CT and PCD CT at a 50 keV energy level significantly exceeded the pre-defined non-inferiority thresholds of -0.54 [95% CI -1.71, 0.62] and -0.36 [95% CI -0.41, -0.31] respectively.
The use of PCD CT for aortography yielded a higher CNR, allowing for a reduced contrast media protocol while maintaining image quality that was non-inferior to EID CT at the same radiation dose.
CT angiography, including CT spectral, vascular, and aortic studies, as assessed in the 2023 RSNA report, involve intravenous contrast agents. See the commentary by Dundas and Leipsic in the same issue.
Aorta CTA by PCD CT produced a higher CNR, enabling a lower contrast medium protocol with image quality not inferior to the EID CT protocol while maintaining the same radiation dose. Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment RSNA, 2023. Refer to Dundas and Leipsic's commentary in this issue.
Using cardiac MRI, this study investigated the relationship between prolapsed volume and regurgitant volume (RegV), regurgitant fraction (RF), and left ventricular ejection fraction (LVEF) in individuals with mitral valve prolapse (MVP).
Between 2005 and 2020, patients with mitral valve prolapse (MVP) and mitral regurgitation who underwent cardiac MRI were identified via a retrospective search of the electronic record. relative biological effectiveness The difference between left ventricular stroke volume (LVSV) and aortic flow is RegV. Left ventricular end-systolic volume (LVESV) and stroke volume (LVSV) were obtained from volumetric cine imaging. Employing both included (LVESVp, LVSVp) and excluded (LVESVa, LVSVa) prolapsed volumes, two estimations were generated for regional volume (RegVp, RegVa), ejection fraction (RFp, RFa), and left ventricular ejection fraction (LVEFa, LVEFp). Microscopes Intraclass correlation coefficient (ICC) analysis was used to ascertain the degree of interobserver concordance regarding LVESVp. Mitral inflow and aortic net flow phase-contrast imaging measurements served as the benchmark (RegVg), enabling independent calculation of RegV.
Nineteen patients were enrolled in the study; their average age was 28 years, with a standard deviation of 16, including 10 male participants. The interobserver concordance for LVESVp was substantial, with an ICC of 0.98 (95% CI, 0.96–0.99). Inclusion of the prolapsed volume manifested in a higher LVESV (LVESVp 954 mL 347 compared to LVESVa 824 mL 338).
The probability of this outcome is less than 0.001%. LVSVp (1005 mL, 338) demonstrated a diminished LVSV value when contrasted with LVSVa (1135 mL, 359).
Analysis revealed a p-value of less than 0.001, suggesting that the results are highly improbable if the null hypothesis is true. LVEF decreased (LVEFp 517% 57, in contrast to LVEFa 586% 63;)
The probability is less than 0.001. When prolapsed volume was excluded, the magnitude of RegV was greater (RegVa 394 mL 210 versus RegVg 258 mL 228).
A statistically significant result (p = .02) was observed. Analysis of prolapsed volume (RegVp 264 mL 164) revealed no significant difference when contrasted with the reference group (RegVg 258 mL 228).
> .99).
Prolapsed volume measurements demonstrated the strongest correlation with mitral regurgitation severity, but incorporating this volume resulted in a lower left ventricular ejection fraction.
The cardiac MRI findings, presented at the 2023 RSNA, are further interpreted and discussed by Lee and Markl in this issue.
The severity of mitral regurgitation was most closely associated with measurements that encompassed prolapsed volume, although incorporating this measure produced a lower left ventricular ejection fraction.
To evaluate the clinical efficacy of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence in adult congenital heart disease (ACHD).
In the course of this prospective study, participants with ACHD who underwent cardiac MRI between July 2020 and March 2021 were subjected to scans utilizing both the clinical T2-prepared balanced steady-state free precession sequence and the proposed MTC-BOOST sequence. Cardiologists, using a four-point Likert scale, assessed diagnostic confidence for each sequential segment of images acquired during each series. The Mann-Whitney test was utilized to assess the correlation between scan times and diagnostic confidence. Measurements of coaxial vascular dimensions at three anatomical locations were undertaken, and the concordance between the research sequence and the corresponding clinical sequence was evaluated using Bland-Altman analysis.
A study population of 120 participants (average age 33 years, standard deviation 13; with 65 male participants) was examined. The conventional clinical sequence's mean acquisition time was significantly longer than the mean acquisition time of the MTC-BOOST sequence, which was 9 minutes and 2 seconds, in contrast to the 14 minutes and 5 seconds required by the conventional approach.
The probability of occurrence was less than 0.001. Diagnostic confidence was significantly higher for the MTC-BOOST sequence (39.03) than for the clinical sequence (34.07).
A result with a probability of less than 0.001 was obtained. A high degree of agreement, with a mean bias of less than 0.08 cm, was ascertained between the research and clinical vascular measurements.
The three-dimensional whole-heart imaging produced by the MTC-BOOST sequence in ACHD patients was efficient, high-quality, and contrast-agent-free. Its advantages included a shorter, more predictable acquisition time and an enhanced degree of diagnostic confidence compared with the gold standard clinical sequence.
Cardiac imaging using magnetic resonance angiography.
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