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J Cardiovasc Magn Reson. 2017 Aug 15;19(1):60. doi: 10.1186/s12968-017-0368-0.

Improved passive catheter tracking with positive contrast for CMR-guided cardiac catheterization using partial saturation (pSAT).

Author information

1
Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas' Hospital, 3rd Floor Lambeth Wing, Westminster Bridge Road, London, SE1 7EH, UK.
2
Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
3
Cardiovascular Pathology Unit, Institute of Biomedicine of Seville, IBIS, Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain.
4
Department of Medical Physics, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
5
Dept. of Pediatrics, University of Texas Southwestern Medical Center, 1935 Medical District Drive, Dallas, USA.
6
Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas' Hospital, 3rd Floor Lambeth Wing, Westminster Bridge Road, London, SE1 7EH, UK. sebastien.roujol@kcl.ac.uk.

Abstract

BACKGROUND:

Cardiac catheterization is a common procedure in patients with congenital heart disease (CHD). Although cardiovascular magnetic resonance imaging (CMR) represents a promising alternative approach to fluoroscopy guidance, simultaneous high contrast visualization of catheter, soft tissue and the blood pool remains challenging. In this study, a novel passive tracking technique is proposed for enhanced positive contrast visualization of gadolinium-filled balloon catheters using partial saturation (pSAT) magnetization preparation.

METHODS:

The proposed pSAT sequence uses a single shot acquisition with balanced steady-state free precession (bSSFP) readout preceded by a partial saturation pre-pulse. This technique was initially evaluated in five healthy subjects. The pSAT sequence was compared to conventional bSSFP images acquired with (SAT) and without (Non-SAT) saturation pre-pulse. Signal-to-noise ratio (SNR) of the catheter balloon, blood and myocardium and the corresponding contrast-to-noise ratio (CNR) are reported. Subjective assessment of image suitability for CMR-guidance and ideal pSAT angle was performed by three cardiologists. The feasibility of the pSAT sequence is demonstrated in two adult patients undergoing CMR-guided cardiac catheterization.

RESULTS:

The proposed pSAT approach provided better catheter balloon/blood contrast and catheter balloon/myocardium contrast than conventional Non-SAT sequences. It also resulted in better blood and myocardium SNR than SAT sequences. When averaged over all volunteers, images acquired with a pSAT angle of 20° to 40° enabled simultaneous visualization of the catheter balloon and the cardiovascular anatomy (blood and myocardium) and were found suitable for CMR-guidance in >93% of cases. The pSAT sequence was successfully used in two patients undergoing CMR-guided diagnostic cardiac catheterization.

CONCLUSIONS:

The proposed pSAT sequence offers real-time, simultaneous, enhanced contrast visualization of the catheter balloon, soft tissues and blood. This technique provides improved passive tracking capabilities during CMR-guided catheterization in patients.

KEYWORDS:

Cardiac catheterization; Congenital heart disease; Device tracking; Interventional CMR

PMID:
28806996
PMCID:
PMC5556659
DOI:
10.1186/s12968-017-0368-0
[Indexed for MEDLINE]
Free PMC Article

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