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, the presence of 20 fetal cardiovascular irregularities was individually evaluated. Results of postnatal examinations were the defining standard. Quantifying the variations in sensitivities and specificities was accomplished through the application of a random-effects model.
The study group comprised 23 participants, averaging 32 years and 5 months of age (standard deviation), and having a mean gestational age of 36 weeks and 1 day. All participants underwent a fetal cardiac MRI examination. The average image quality, measured by the median, of DUS-gated cine images was 3 (IQR, 25-4). A significant 91% (21 of 23) of participants' underlying congenital heart disease (CHD) was correctly diagnosed through fetal cardiac MRI. Only with the assistance of MRI was a precise diagnosis of situs inversus and congenitally corrected transposition of the great arteries made. check details Sensitivities were notably different (918% [95% CI 857, 951] versus 936% [95% CI 888, 962]).
Reframing the original sentence ten times, resulting in a list of unique and structurally different sentences that retain the original meaning. The degree of specificity was virtually indistinguishable (999% [95% CI 992, 100] compared to 999% [95% CI 995, 100]).
At least ninety-nine percent completion. The detection of abnormal cardiovascular features was found to be equally precise using MRI and echocardiography.
The diagnostic performance of DUS-gated fetal cardiac MRI cine sequences was on a par with fetal echocardiography in assessing complex congenital heart disease in fetuses.
Fetal MRI (MR-Fetal), cardiac MRI, prenatal assessment of congenital heart disease, pediatric cardiac and heart imaging, congenital conditions, fetal imaging, clinical trial registration number. The clinical trial, NCT05066399, merits detailed investigation.
The RSNA 2023 conference features a commentary by Biko and Fogel, which is worth reviewing.
Fetal cine cardiac MRI, gated by Doppler ultrasound, exhibited comparable diagnostic accuracy to fetal echocardiography for complex congenital heart defects in fetuses. Supplementary information pertinent to NCT05066399 is included with this article. Within the RSNA 2023 journal, delve into the commentary by Biko and Fogel.
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, encompassing consecutive participants (April-September 2021), involved participants who had undergone prior CTA with energy-integrating detector (EID) CT followed by CTA with PCD CT of the thoracoabdominal aorta, all at identical radiation doses. Virtual monoenergetic images (VMI) in PCD CT were reconstructed at 5 keV intervals, spanning from 40 keV to 60 keV. Quantifying aortic attenuation, image noise, and contrast-to-noise ratio (CNR), along with subjective assessments of image quality by two independent readers. Participants in the first group were subjected to the identical contrast media protocol for both imaging. To establish the optimal contrast media reduction in the second group, the CNR differences between PCD and EID computed tomography scans served as a benchmark. In order to confirm the noninferiority of the image quality, a noninferiority analysis method was used comparing low-volume contrast media protocol with PCD CT imaging.
Of the 100 participants in the study, 75 years 8 months was the average age (standard deviation), and 83 were men. In the primary assemblage,
VMI at 50 keV delivered the superior compromise between objective and subjective image quality, resulting in a 25% higher contrast-to-noise ratio (CNR) as opposed to EID CT. An analysis of contrast media volume in the second group is necessary.
A volume of 60 was decreased by 25%, leading to a new volume of 525 mL. The comparative analysis at 50 keV of EID CT and PCD CT demonstrated that the mean differences in CNR and subjective image quality values were above the pre-defined non-inferiority limits, -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.
A 2023 RSNA technology assessment focuses on CT angiography, including CT spectral, vascular, and aortic evaluations, utilizing intravenous contrast agents. Refer to Dundas and Leipsic's commentary in this publication.
A high CNR, resultant from CTA of the aorta employing PCD CT, enabled a low-volume contrast media protocol, exhibiting non-inferior image quality compared to EID CT protocols at identical radiation doses. Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment RSNA, 2023. See also the commentary by Dundas and Leipsic in this issue.
Cardiac MRI analysis explored the influence of prolapsed volume on the metrics of regurgitant volume (RegV), regurgitant fraction (RF), and left ventricular ejection fraction (LVEF) in patients presenting with mitral valve prolapse (MVP).
Retrospectively, the electronic record was examined to identify patients who had undergone cardiac MRI between 2005 and 2020 and had both mitral valve prolapse (MVP) and mitral regurgitation. check details Aortic flow, when subtracted from left ventricular stroke volume (LVSV), yields RegV. From volumetric cine imaging, left ventricular end-systolic volume (LVESV) and left ventricular stroke volume (LVSV) were calculated. Separate estimates for regional volume (RegVp, RegVa), ejection fraction (RFp, RFa), and left ventricular ejection fraction (LVEFa, LVEFp) were achieved using prolapsed volume included (LVESVp, LVSVp) and excluded (LVESVa, LVSVa) data. check details Interobserver reliability of LVESVp was determined through calculation of the intraclass correlation coefficient (ICC). Measurements from mitral inflow and aortic net flow phase-contrast imaging, designated as RegVg, were employed to independently calculate RegV.
From the study group, 19 patients were selected, exhibiting an average age of 28 years with a standard deviation of 16, and 10 of these patients were male. The interobserver concordance for LVESVp was substantial, with an ICC of 0.98 (95% CI, 0.96–0.99). Prolapsed volume inclusion caused a heightened LVESV, specifically LVESVp (954 mL 347) in contrast to LVESVa (824 mL 338).
The observed result is astronomically rare, with a probability below 0.001. LVSVp, having a volume of 1005 mL and 338 units, exhibited a lower LVSV than LVSVa, which held a volume of 1135 mL and a count of 359.
The probability of the observed outcome occurring by chance, given the null hypothesis, was less than one-thousandth of a percent (less than 0.001). LVEF decreased (LVEFp 517% 57, in contrast to LVEFa 586% 63;)
The probability is less than 0.001. RegV's magnitude was larger when prolapsed volume was not included in the calculation (RegVa 394 mL 210, RegVg 258 mL 228).
The observed phenomena exhibited a statistically significant result, corresponding to a p-value of .02. Analysis of prolapsed volume (RegVp 264 mL 164) revealed no significant difference when contrasted with the reference group (RegVg 258 mL 228).
> .99).
Precise measurements of mitral regurgitation severity were linked most closely to those that also included prolapsed volume, but this inclusion resulted in a diminished left ventricular ejection fraction.
The 2023 RSNA meeting featured a cardiac MRI presentation, which is further examined in the commentary by Lee and Markl in this journal.
Mitral regurgitation severity was best correlated with measurements encompassing prolapsed volume, but integrating this metric led to a decreased left ventricular ejection fraction.
A study on the clinical applications of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) technique for adult congenital heart disease (ACHD) was performed.
Participants in this prospective study, who had ACHD and underwent cardiac MRI between July 2020 and March 2021, were scanned with both the clinical T2-prepared balanced steady-state free precession sequence and the suggested MTC-BOOST sequence. Four cardiologists used a four-point Likert scale to measure their diagnostic confidence for each sequential segment analyzed from images obtained by each imaging sequence. A comparison of scan durations and the confidence levels in diagnoses was carried out using the Mann-Whitney test. Dimensional assessment of coaxial vasculature at three anatomical markers was conducted, and the agreement between the research protocol and the clinical procedure was evaluated using Bland-Altman analysis.
The study cohort comprised 120 individuals, with an average age of 33 years (standard deviation 13; 65 being male). The mean acquisition time for the MTC-BOOST sequence was significantly less than that of the conventional clinical sequence, demonstrating a difference of 5 minutes and 3 seconds, with the MTC-BOOST sequence taking 9 minutes and 2 seconds and the conventional sequence requiring 14 minutes and 5 seconds.
The data indicated a probability of less than 0.001 for this outcome. 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. Research and clinical vascular measurements exhibited a narrow margin of agreement, with a mean bias of less than 0.08 cm.
The MTC-BOOST sequence in ACHD cases yielded efficient, high-quality, and contrast-agent-free three-dimensional whole-heart imaging. This was accompanied by a shorter and more predictable acquisition time, leading to increased diagnostic confidence when compared to the reference standard clinical sequence.
MR angiography, a method to image the heart's vasculature.
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