Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Feasibility and Safety of Regadenoson Stress Perfusion Protocol in Pediatric Transplant Patients under General Anesthesia.","authors":"Nikkan Das, Eric L Vu, Andrada Popescu, Defne Magnetta, Cynthia K Rigsby, Joshua D Robinson, Simon Lee, Nazia Husain","doi":"10.1016/j.jocmr.2025.101880","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101880","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance with myocardial stress perfusion (stress CMR) is a non-invasive technique that offers assessment of myocardial function, perfusion, and viability. Regadenoson is a selective cardiac adenosine A2 receptor agonist with fewer side effects than adenosine and a favorable safety profile in older pediatric heart transplant recipients (PHTR). There are limited studies evaluating the hemodynamic response of regadenoson in pediatric patients under general anesthesia (GA).</p><p><strong>Methods: </strong>We reviewed our experience with regadenoson stress CMR in PHTR under GA from 2020-2024 and compared to a non-GA group of PHTR who underwent regadenoson stress CMR from 2015-2022. Demographic and clinical data were recorded. Hemodynamic response and adverse events were reviewed. CMRs were reviewed for perfusion abnormalities and semi-quantitative analysis was performed using myocardial perfusion reserve index (MPRI).</p><p><strong>Results: </strong>Forty-six PHTR underwent 53 stress CMRs under GA over the study period (mean age 7.8 years; range 3-19 years). All patients received endotracheal intubation and sevoflurane and were monitored during and after regadenoson administration per institutional protocol. Heart rate (HR) prior to regadenoson administration was 84±12 beats/min with a peak of 109±14 beats/min and average mean blood pressure (BP) was 63±12mmHg with a nadir of 45±8mmHg. Transient hypotension was observed in 33 (77%) scans, which resolved with phenylephrine. There were no other adverse events. Phenylephrine was used in 48 CMRs (91%) for blood pressure support at the discretion of anesthesia. Thirty-eight PHTR underwent 48 stress CMRs without sedation. CMRs were matched by time-since-transplant. The non-GA group was significantly older (mean age 15.8 years; p<0.001). GA patients had a larger percent decrease in mean BP compared to non-GA patients (27±17% vs 15±17%; p <0.001) with no difference in HR change. There were no significant differences in rates of qualitative perfusion defects, (11% vs 4%, p=0.18), late gadolinium enhancement or MPRI values between the two groups.</p><p><strong>Conclusion: </strong>Regadenoson stress CMR is safe and feasible in PHTR under GA. While hypotension was frequently seen, it improved in all cases with phenylephrine. Semi-quantitative myocardial perfusion analysis by MPRI is feasible in these young patients, however further studies are needed to assess its clinical utility in this population.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101880"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and Sex-Related Outcomes in CMR Versus CT-Guided TAVR: A Secondary Analysis of a Randomized Clinical Trial.","authors":"Ivan Lechner, Fritz Oberhollenzer, Christina Tiller, Magdalena Holzknecht, Alex Kaser, Ronald K Binder, Can Gollmann-Tepeköylü, Gert Klug, Agnes Mayr, Axel Bauer, Bernhard Metzler, Martin Reindl, Sebastian J Reinstadler","doi":"10.1016/j.jocmr.2025.101882","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101882","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is the preferred treatment for older patients with severe aortic stenosis with outcomes influenced by age and sex. Computed tomography (CT) is the reference imaging modality for TAVR planning, while cardiac magnetic resonance (CMR) is an emerging alternative for this indication. The aim of this study was to evaluate the impact of age and sex on implantation success in patients undergoing CT- or CMR-guided TAVR.</p><p><strong>Methods: </strong>This was a secondary analysis of the randomized TAVR-CMR trial comparing TAVR planning by CT or CMR (NCT03831087). Patients were categorized according to the median age (82 years) and sex. Implantation success, defined using the Valve Academic Research Consortium-2 definition (absence of procedural mortality, correct positioning of a single prosthetic valve, and proper prosthetic valve performance), was compared at hospital discharge between age groups and sex for each imaging strategy. All-cause mortality at 6 months was compared between imaging strategies across age groups and sex.</p><p><strong>Results: </strong>A total of 267 patients (median age 82 [IQR 80-85] years, 50% female) underwent TAVR at two heart centers in Austria between September 2017 and December 2022. Implantation success did not differ significantly between imaging strategies across age and sex subgroups. For patients ≤82 years, success rates were 92.1% (CT) vs. 94.7% (CMR) (p=0.524), and for those >82 years, 89.4% (CT) vs. 91.9% (CMR) (p=0.622). Among female patients, success rates were 84.7% (CT) vs. 93.2% (CMR) (p=0.113), and among male patients, 95.7% (CT) vs. 93.8% (CMR) (p=0.610). All-cause mortality at 6 months did not differ significantly between imaging strategies across age and sex subgroups. Mortality rates for patients ≤82 and >82 years were 4.8% vs. 5.3% (p=0.839) and 9.1% vs. 12.9% (p=0.490) for CT and CMR, respectively. Similarly, female and male patients had comparable mortality rates (10.2% vs. 8.1%, p=0.680; 4.3% vs. 9.4%, p=0.240).</p><p><strong>Conclusions: </strong>In this secondary analysis of the TAVR-CMR trial, CMR-guided TAVR was associated with similar outcomes compared with CT-guided TAVR irrespective of age and sex.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101882"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic handgrip exercise for the detection of myocardial ischemia using fast Strain-ENCoded CMR.","authors":"Andreas Ochs, Michael Nippes, Janek Salatzki, Lukas D Weberling, Nael Osman, Johannes Riffel, Hugo A Katus, Matthias G Friedrich, Norbert Frey, Marco M Ochs, Florian André","doi":"10.1016/j.jocmr.2025.101879","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101879","url":null,"abstract":"<p><strong>Background: </strong>Previous data suggests dynamic handgrip exercise (DHE) as a potential physiological, needle-free stressor feasible for cardiovascular magnetic resonance (CMR) conditions. DHE-fast Strain-ENCoded imaging (fSENC) is potentially cost-saving, ultra-fast and avoids pharmacological side effects thereby targeting the drawbacks of conventional pharmacological stress CMR.</p><p><strong>Objectives: </strong>To assess the diagnostic accuracy of DHE-fSENC for detecting ischemia-related wall motion abnormalities in suspected obstructive coronary artery disease (CAD).</p><p><strong>Methods: </strong>Patients with known or suspected obstructive CAD referred for CMR stress testing were prospectively enrolled. Diagnostic accuracy was assessed in comparison to pharmacological stress CMR and in a subgroup, compared to invasive coronary angiography (ICA). The CMR protocol was extended by both-handed DHE with 80 repetitions per minute over 2minutes followed by fSENC short-axis acquisition before pharmacological stress testing. Stress-induced impairment of regional longitudinal strain was graded suspicious for obstructive CAD.</p><p><strong>Results: </strong>Two-hundred sixty individuals with cardiovascular high-risk profile (64±13 years, 75% male) were enrolled. DHE-fSENC provided a sensitivity of 79% (95% CI: 64-89) and specificity of 87% (95% CI 82-91) compared to pharmacological stress CMR. In a subgroup of 105 patients with recent ICA, high diagnostic accuracy was found for the detection of obstructive CAD (sensitivity 82% (95% CI: 67-92), specificity 89% (95% CI: 78-95)). Exam duration of DHE-fSENC was significantly reduced compared to conventional CMR stress protocols (DHE-fSENC 207±69sec vs. adenosine-perfusion 287±82sec vs. dobutamine-cine 1132±294sec, all p< 0.001).</p><p><strong>Conclusions: </strong>DHE-fSENC allows for a reliable and fast detection of obstructive CAD, thereby expanding the applicability of needle-free CMR stress testing.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101879"},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the Society for Magnetic Resonance Angiography 2024 Conference.","authors":"Claudia Prieto, Mahmud Mossa-Basha, Anthony Christodoulou, Calder D Sheagren, Yin Guo, Aleksandra Radjenovic, Xihai Zhao, Jeremy D Collins, René M Botnar, Oliver Wieben","doi":"10.1016/j.jocmr.2025.101878","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101878","url":null,"abstract":"<p><p>The 36th Annual International Meeting of the Society for Magnetic Resonance Angiography (SMRA), held from November 12-15, 2024, in Santiago de Chile, marked a milestone as the first SMRA conference in Latin America. Themed \"The Ever-Changing Landscape of MRA\", the event highlighted the rapid advancements in magnetic resonance angiography (MRA), including cutting-edge developments in contrast-enhanced MRA, contrast-free techniques, dynamic, multi-parametric, and multi-contrast MRA, 4D flow, low-field solutions and AI-driven technologies, among others. The program featured 174 attendees from 15 countries, including 43 early-career scientists and 30 industry representatives. The conference offered a rich scientific agenda, with 12 plenary talks, 24 educational talks, 98 abstract presentations, a joint SMRA-MICCAI challenge on intracranial artery lesion detection and segmentation and a joint session with the Society for Cardiovascular Magnetic Resonance (SCMR) emphasizing accessibility, low-field MRI, and AI's transformative role in cardiac imaging. The meeting's single-track format fostered engaging discussions on interdisciplinary research and highlighted innovations spanning various vascular beds. This paper summarizes the conference's key themes, emphasizing the collaborative efforts driving the future of MRA, while reflecting on SMRA's vision to advance research, education, and clinical practice globally.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101878"},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of Cardiac Magnetic Resonance in Clinical Application and Scientific Research: A National Survey in China.","authors":"Huaying Zhang, Mengdi Jiang, Wenjing Yang, Di Zhou, Yining Wang, Leyi Zhu, Qiang Zhang Oxford, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao, Xiaohu Li, Xinxiang Zhao, Hui Liu, Hongjie Hu, Min Liu, Yi He, Qi Yang, Yining Wang, Yingkun Guo, Minwen Zheng, Fuhua Yan, Minjie Lu","doi":"10.1016/j.jocmr.2025.101877","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101877","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is rapidly expanding in China, yet comprehensive national data on its clinical application and research status are limited. This study aims to evaluate the current landscape of CMR across the country.</p><p><strong>Methods: </strong>An electronic survey was conducted targeting two groups: physicians trained at the Fuwai Fellowship Program and members of the Chinese Society of Radiology. The survey encompassed details on CMR equipment, clinical practices, and research activities.</p><p><strong>Results: </strong>Of 248 hospitals responded to the survey, 98.0% were tertiary centers. The number of scanners distributed unevenly across geographic regions, with Central South China leading with 5.89/center. Siemens, Philips and GE were top three scanner vendors. Most centers initiated CMR program post-2015. Coronary artery disease was the primary indication for CMR. The median annual volume was 120/center. High-volume centers unevenly concentrated most CMR cases. The weighted average waiting period was 14.2 days, while scan durations ranged from 40 to 60minutes. Two thirds of hospitals used post-processing software to analyze imaging. Half of responding centers included T1 and T2 mapping in clinical routine, but stress perfusion was underutilized in both clinic and research. Approximately one-third of centers had published CMR-related research. The majority of physicians were confident about the development of CMR. Major barriers to CMR development included long scan times, high costs, insufficient equipment, and limited training.</p><p><strong>Conclusions: </strong>CMR is experiencing rapid growth in China but faces significant regional disparities in access to technology and expertise. Efforts to reduce costs, improve training, and expand access to advanced techniques are crucial for balanced development.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101877"},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Quantification of Aortic Regurgitation with Direct Regurgitant Jet Measurement by 4D Flow CMR in Complex Congenital Heart Disease.","authors":"Brynn S Connor, Makoto Takei, Daniel E Clark, Shiraz A Maskatia","doi":"10.1016/j.jocmr.2025.101876","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101876","url":null,"abstract":"<p><strong>Background: </strong>Due to the presence of complex flow states and significant jet eccentricity in patients with congenital heart disease (CHD), accurate quantification of aortic regurgitation (AR) using standard echocardiographic or conventional cardiac magnetic resonance (CMR) imaging measures remains challenging. Four-dimensional flow (4DF) CMR permits transvalvular flow quantification under non-laminar flow states, although has not been well validated for AR quantification in CHD.</p><p><strong>Methods: </strong>In 186 patients with moderate or complex CHD, we evaluated the agreement between different methods of AR quantification by 4DF CMR when compared to volumetry. Regurgitant flow volumes were measured (1) conventionally on time-resolved, velocity-encoded 4DF sequences at the aortic annulus, sinotubular junction (STJ), and ascending aorta (AAo), and via (2) direct regurgitant jet quantification 5mm proximal to the vena contracta.</p><p><strong>Results: </strong>Moderate overall agreement in AR quantification was observed between study methods (ρ=0.58-0.73). Compared with conventional flow quantification at the annulus, STJ, and AAo, direct regurgitant jet measurements showed improved correlation with volumetry (ρ=0.76), especially in patients with significant aortic dilation (r=0.95-0.97). In this latter group, regurgitant flow quantification at all other aortic levels resulted in AR severity classifications that were nearly a full grade lower (mean aortic regurgitant fraction difference: 7-12% ± 10-12%; p<0.001).</p><p><strong>Conclusions: </strong>4DF CMR permits AR quantification in complex CHD with comparable accuracy to volumetry. Under non-laminar or complex flow states, as observed with significant aortic dilation, direct regurgitant jet measurements may be preferable to regurgitant flow quantification at all other aortic levels.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101876"},"PeriodicalIF":4.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coprime dual-VENC for extended velocity dynamic range in 4D Flow MRI.","authors":"Marta Beghella Bartoli, Sara Boccalini, David Chechin, Loic Boussel, Philippe Douek, Damien Garcia, Monica Sigovan","doi":"10.1016/j.jocmr.2025.101871","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101871","url":null,"abstract":"<p><strong>Background: </strong>In the field of cardiovascular imaging, 4D flow MRI provides non-invasive assessment of blood flow. Dual velocity encoding (dual-VENC) strategies have emerged to obtain quantitative information on both low and high blood flow velocities simultaneously. However, these strategies often encounter difficulties in coping with large velocity ranges. This work presents a dual-VENC 4D flow MRI sequence that utilizes the coprime rule to define the VENC ratio.</p><p><strong>Methods: </strong>A dual-VENC 4D flow MRI sequence and reconstruction algorithm were developed and validated in vitro at two different field strengths, using a flow phantom generating realistic complex flow patterns. A digital twin of the phantom allowed comparison of the MRI measurements with computational fluid dynamics (CFD) simulations. Three patients with different cardiac pathologies were scanned in order to evaluate the in vivo feasibility of the proposed method.</p><p><strong>Results: </strong>The results of the in vitro acquisitions demonstrated significant improvement in velocity-to-noise ratio (VNR) with respect to single-VENC acquisitions (110  ±  3%) and conventional dual-VENC de-aliasing approach (75  ±  3%). Furthermore, the effectiveness of aliasing correction was demonstrated even when both sets of images from the dual-VENC acquisition presented velocity aliasing artifacts. We observed a high degree of agreement between the measured and simulated velocity fields.</p><p><strong>Conclusion: </strong>The strength of this approach lies in the fact that, unlike the conventional de-aliasing method, no data is discarded. The final image is obtained by a weighted average of the VENC_low and VENC_high datasets. Consequently, setting the value of the VENC_high to prevent aliasing is no longer necessary, and higher VNR gains are possible.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101871"},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction Techniques for Accelerating Dynamic Cardiac MRI.","authors":"Andrew Phair, René Botnar, Claudia Prieto","doi":"10.1016/j.jocmr.2025.101873","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101873","url":null,"abstract":"<p><p>Achieving sufficient spatial and temporal resolution for dynamic applications in cardiac MRI is a challenging task due to the inherently slow nature of MR imaging. In order to accelerate scans and allow improved resolution, much research over the past three decades has been aimed at developing innovative reconstruction methods that can yield high-quality images from reduced amounts of k-space data. In this review, we describe the evolution of these reconstruction techniques, with a particular focus on those advances that have shifted the dynamic reconstruction paradigm as it relates to cardiac MRI. This review discusses and explains the fundamental ideas behind the success of modern reconstruction algorithms, including parallel imaging, spatio-temporal redundancies, compressed sensing, low-rank methods and machine learning.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101873"},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Image Quality in Fetal Cardiac Cine MRI Using Doppler US Gating:A Multicenter Study.","authors":"Thomas M Vollbrecht, Luis F Goncalves, Dianna M E Bardo, Christopher Hart, Heide Boeth, Alex J Barker, Richard M Friesen, Julian A Luetkens","doi":"10.1016/j.jocmr.2025.101875","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101875","url":null,"abstract":"<p><strong>Background: </strong>Fetal cardiac cine MRI is an emerging technique for evaluating the fetal heart in conditions such as congenital heart disease, but limited evidence on factors affecting image quality restricts its clinical potential. This study investigated key determinants of image quality in a multicenter cohort.</p><p><strong>Methods: </strong>This study analyzed fetal cardiac MRI scans from April 2021 to July 2023 at three centers (University Hospital Bonn, Children's Hospital Colorado, Phoenix Children's Hospital). Cine image quality was assessed using a 5-point Likert scale (1=non-diagnostic to 5=excellent) across three criteria: contour sharpness, blood-to-structure contrast, and artifacts. Overall image quality scores were calculated by the average of all criteria. Apparent signal-to-noise (aSNR) and contrast-to-noise ratios (aCNR) were measured. Nine parameters were evaluated for their impact on image quality: gestational age, body mass index (BMI), fetal motion, patient positioning, gating signal stability, breathing technique, field strength, slice thickness, and flip angle. Comparisons were conducted using the Mann-Whitney U test.</p><p><strong>Results: </strong>A total of 98 scans were analyzed. Higher overall image quality, aSNR, and aCNR were observed in participants with BMI <30kg/m², gestational age ≥32 weeks, low fetal motion severity, and stable gating signals (e.g., overall image quality for BMI <30kg/m² vs ≥30kg/m²: 4.4 ± 0.7 vs. 4.1 ± 0.7, p <0.001). Supine positioning resulted in better overall image quality compared to the left lateral position (4.5 ± 0.5 vs. 4.2 ± 0.8, p = 0.001). Breath-holds provided similar overall image quality but improved contour sharpness and reduced artifacts compared to free breathing (5 [4-5] vs. 4 [4-5], p = 0.042; and 4 [3-5] vs. 4 [3-5], p = 0.014, respectively). At 1.5T field strength, higher contrast and fewer artifacts were observed compared to 3T (5 [4-5] vs. 5 [4-5], p = 0.041; and 4 [4-5] vs. 4 [3-5], p = 0.010, respectively). Slice thickness showed no significant impact on image quality.</p><p><strong>Conclusions: </strong>Various factors (e.g. BMI) influence fetal cardiac cine MRI image quality. Understanding these factors may help achieving reliable examinations and better exploit the potential of fetal cardiac MRI in clinical routine.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101875"},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilatation of the main pulmonary artery in patients with isolated pulmonary stenosis: Arteriopathy or hemodynamic consequence?","authors":"Pietro Paolo Tamborrino, Michela Miglianti, Dario Freitas, Camelia Demetrescu, Christopher Rush, Claudia Montanaro, Alessandra Frigiola","doi":"10.1016/j.jocmr.2025.101874","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101874","url":null,"abstract":"<p><strong>Background: </strong>Main pulmonary artery (mPA) dilatation has been reported in patients with isolated pulmonary valve (PV) stenosis. The aim of our study was to detect the incidence of mPA dilatation and aneurysm in patients with isolated PV stenosis and the association with PV function.</p><p><strong>Methods: </strong>In this single-centre retrospective observational study all patients with a diagnosis of isolated PV stenosis referred to our centre were enrolled. Patients were divided into two groups (children and adults) according to age. Echocardiography, cardiac magnetic resonance imaging (MRI) and computed tomography (CT) were reviewed. MPA dilatation was defined as ≥2 Z-Score in children and ≥30mm diameters in adults, while giant (aneurysmal) mPA dilatation was defined as ≥4 Z-Score in children and ≥40mm in adults.</p><p><strong>Results: </strong>Out of 197 patients (41.6% males, 51.8% children), 67.2% presented mPA dilatation and 16.8% giant dilatation of the mPA. The majority were adults (p<0.001). There was an underestimation of the mPA with echocardiography in 11% of patients with mPA dilatation and 50% with giant mPA. The diameter did not correlate with sex and the degree of PV stenosis. About 44% of cohort under follow-up presented a progression in mPA dilatation, however no rupture or cardiac-related death was reported.</p><p><strong>Conclusions: </strong>There is a very high incidence of mPA dilatation in both adults and paediatric patients with isolated PV stenosis. Nevertheless, there were not recorded dissections even in patients with the largest diameters suggesting a more benign lesion. Echocardiography often underestimates the mPA measurement compared to MRI/CT which might be indicated in selected patients as a baseline 3D cross-sectional imaging evaluation, even in the presence of mild PV disease, especially when the mPA is not well visualised.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101874"},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}