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3.0T Pediatric cardiac - OHSU, Portland, USA

ExamCard
Silberbach, Michael Portland, Ore., Oregon Health & Science University (OHSU) USA
de Kok, Wendy Philips Healthcare Philips Global

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ExamCard purpose

This Release 2 ExamCard consists of sequences for pediatric cardiac MR at 3.0T used at Doernbecher Children's Hospital, Oregon Health & Science University (OHSU, Portland, USA). The protocols were developed by Michael Silberbach, M.D. and Michael Jerosch-Herold, Ph.D.

 

ExamCard overview

OHSU Pediatric cardiac
Scan 1SURVEY
Scan 2Ref SENSE Cardiac
Scan 3SINGLE PHASE FFE Anatomy Ax
Scan 4SINGLE PHASE FFE Anatomy Sag
Scan 5SINGLE PHASE FFE anatomy Cor
Scan 6FFE CINE Ax
Scan 7FFE CINE Sag
Scan 8FFE CINE Cor
Scan 9REAL TIME TFE
Scan 101st PASS PERFUSION
Scan 113D CE ANGIO
Scan 12DELAYED CE (Viability)
Scan 13Q-FLOW THRUPLANE
Scan 14ALTERNATIVE DCE (for older patients)

ExamCard images

FFE CINE Ax Multi-slice multi-phase sequence, to give an overview of anatomy and function.FFE CINE Cor Multi-slice multi-phase sequence, to give an overview of anatomy and function.FFE Cine Sag Multi-slice multi-phase sequence, to give an overview of anatomy and function.
FFE CINE Ax
FFE CINE Cor
FFE Cine Sag
Multi-slice multi-phase sequence, to give an overview of anatomy and function.
Multi-slice multi-phase sequence, to give an overview of anatomy and function.
Multi-slice multi-phase sequence, to give an overview of anatomy and function.
1st pass perfusion Dynamic TFE using saturation recovery pre-pulse.3D CE Angio CE angiogram of the great vessels.
1st pass perfusion
3D CE Angio
Dynamic TFE using saturation recovery pre-pulse.
CE angiogram of the great vessels.

Patient preparation

The protocols in this ExamCard are typically used on sedated patients. The number of averages (NSA) is therefore larger than 1, to average out breathing motion. If breath hold is required in one or more of the sequences, NSA is reduced to 1.

 

The SENSE Cardiac coil is used. For children up to about 2 years old, the SENSE Flex-M coil can be used instead, with the two loops of the coil (slightly overlapping) positioned on the chest of the child.

ExamCard / protocol description

The examination usually starts with the acquisition of the FFE CINE scans (multi-slice multi-phase) in three orthogonal planes, to get an overview of anatomy and function in patients with congenital defects. Single PHASE FFE can be acquired instead of FFE CINE, again in three orthogonal planes for a quick assessment of the anatomy.

 

This is typically followed by phase contrast velocity measurements (Q-FLOW THRUPLANE) in the pulmonary artery and in the aorta.

 

In patients with suspected ischemia, perfusion studies are performed, both at rest and during maximal vasodilation with adenosine, using a 0.03 mmol/kg bolus of contrast agent. (1st PASS PERFUSION). Usually 2 - 3 slices per heartbeat are acquired. SENSE is used, but the reduction factor should not exceed 2 for best image quality.

REAL TIME TFE is a sinlge-slice perfusion protocol.

 

Contrast-enhanced 3D angiography (3D CE ANGIO) of the great vessels is acquired in nearly all pediatric cardiac patients. BolusTrak is not used in very young patients, because of the 2-3 second delay. A timing sequence is used instead.

 

Finally, in patients with a history of ischemia, a sequence is run to look at the delayed contrast enhancement. (Delayed CE). The shot interval in this sequence can be one or two heart beats. Two heart beats are recommended for patients with heart reates of 80 beats per minute or more for best contrast to visualize non-viable myocardium.

The dose used is 0.1 mmol/kg of gadolinium-based contrast agent.



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Sep 13, 2007

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ExamCard
Achieva 3.0T
Release 2
Quasar, Quasar Dual
3T, Cardiac, Pediatric
 

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