Delayed three-dimensional inversion recovery-prepared fast low-angle shot for airway imaging in children: More than myocardial fibrosis assessment

Laura Acosta Izquierdo; Romina Dsouza; Ankavipar Saprungruang; Afsaneh Amirabadi; Mike Seed; Shi-Joon Yoo; Christopher Z. Lam

Journal of Cardiovascular Magnetic Resonance (Jan 2024)

Delayed three-dimensional inversion recovery-prepared fast low-angle shot for airway imaging in children: More than myocardial fibrosis assessment

Laura Acosta Izquierdo,
Romina Dsouza,
Ankavipar Saprungruang,
Afsaneh Amirabadi,
Mike Seed,
Shi-Joon Yoo,
Christopher Z. Lam

Affiliations

Laura Acosta Izquierdo: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
Romina Dsouza: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
Ankavipar Saprungruang: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Afsaneh Amirabadi: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
Mike Seed: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Shi-Joon Yoo: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Christopher Z. Lam: Department of Diagnostic and Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Corresponding author. Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1x8, Canada.

Journal volume & issue: Vol. 26, no. 2
p. 101110

Abstract

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ABSTRACT: Background: To investigate the ability of a delayed respiratory-navigated, electrocardiographically-gated three-dimensional inversion recovery-prepared fast low-angle shot (3D IR FLASH) sequence to evaluate the lower airways in children undergoing routine cardiovascular magnetic resonance (CMR). Methods: This retrospective study included pediatric patients (0–18 years) who underwent clinical CMR where a delayed 3D IR FLASH sequence was performed between July 2020 and April 2021. The airway image quality and extent of lower airway visibility were graded by two blinded readers using a four-point ordinal scale (0–3). Lower airway anatomical variants and abnormalities were recorded. Results: One hundred and eighty patients were included with a median age of 11.7 (4.6–15.3) years. Fifty-one of 180 (28%) were under general anesthesia. Overall, the median grading of airway image quality was 3 (2–3) and the extent of lower airway visibility was 3 (3–3). Interrater agreement was almost perfect (κ = 0.867 and κ = 0.956, respectively). Image quality correlated with extent of lower airway visibility (r = 0.62, p < 0.01). Delayed 3D IR FLASH was able to characterize the segmental bronchi in 137/180 (76%) and lobar bronchi in 172/180 (96%) of patients. Lower airway abnormalities were identified in 37/180 (21%) of patients and 33/129 (26%) with congenital heart disease (CHD). Identified abnormalities included tracheobronchial branching anomalies in 6/180 (3%), abnormal tracheobronchial situs in 6/180 (3%), and extrinsic vascular compression in 25/180 (14%). Conclusion: Delayed 3D IR FLASH has excellent performance for evaluation of the lower airway anatomy and can simultaneously assess for myocardial late gadolinium enhancement. Lower airway abnormalities are not infrequently seen in children undergoing routine CMR for CHD.

Published in Journal of Cardiovascular Magnetic Resonance

ISSN: 1097-6647 (Print); 1532-429X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-cardiovascular-magnetic-resonance

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