Congenital heart disease: Cardiovascular MR imaging by using an intravascular blood pool contrast agent

Purpose: To compare the image quality and diagnostic performance of a contrast agent-specific inversion-recovery(IR) steady-state free precession (SSFP) magnetic resonance (MR) imaging sequence performed by using an intravascular contrast agent (gadofosveset trisodium) with those of a commonly used T2-prepared SSFP sequence performed by using an extravascular(gadopentetate dimeglumine) and an intravascular(gadofosveset trisodium) contrast agent in patients with congenital heart disease (CHD). Materials and Methods: The local ethics committee and the United Kingdom Medicines and Healthcare products Regulatory Agency approved this study. Patient informed consent was obtained. Twenty-three patients with CHD were examined by using a 1.5-T MR imaging unit and a 32-channel coil. Gadopentetate dimeglumine and gadofosveset trisodium were used in the same patient on consecutive days. Vessel wall sharpness, contrast-to-noise ratios(CNRs), image quality, and diagnostic performance achieved by using the IR SSFP sequence with gadofosveset trisodium were compared with those achieved by using the T2-prepared SSFP sequence with gadopentetate dimeglumine and gadofosveset trisodium and with those achieved at respective contrast material-enhanced MR angiographic examinations. The Wilcoxon rank sum test was used to compare categoric variables; t tests were used to compare continuous variables. Results: Use of the IR SSFP sequence with gadofosveset trisodium significantly improved vessel wall sharpness, CNRs, and image quality(P<.05 for all) for all investigated intra-and extracardiac structures compared with the T2-prepared SSFP sequence with gadopentetate dimeglumine and gadofosveset trisodium and the respective contrast-enhanced MR angiographic examinations. With use of the IR SSFP sequence with gadofosveset trisodium, new, unsuspected diseases(five [22%] of 23) were diagnosed, while other diseases could be excluded(15 [65%] of 23). Information available from echocardiography(n = 23), conventional angiography (n = 4), and/or surgery(n = 1) confirmed all diagnoses. Conclusion: IR SSFP with gadofosveset trisodium improved image quality and diagnostic performance, allowing a more accuRate and complete assessment of cardiovascular anatomy in patients with CHD compared with T2-prepared SSFP with gadopentetate dimeglumine and gadofosveset trisodium and respective contrast-enhanced MR angiographic examinations.