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Title: Improved passive catheter tracking with positive contrast for CMR-guided cardiac catheterization using partial saturation (pSAT).
Authors: Velasco Forte, Mari Nieves
Pushparajah, Kuberan
Schaeffter, Tobias
Valverde Perez, Israel
Rhode, Kawal
Ruijsink, Bram
Alhrishy, Mazen
Byrne, Nicholas
Chiribiri, Amedeo
Ismail, Tevfik
Hussain, Tarique
Razavi, Reza
Roujol, Sébastien
Keywords: Cardiac catheterization;Congenital heart disease;Device tracking;Interventional CMR
metadata.dc.subject.mesh: Adolescent
Cardiac Catheterization
Cardiac Catheters
Case-Control Studies
Contrast Media
Feasibility Studies
Heart Defects, Congenital
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging, Interventional
Organometallic Compounds
Predictive Value of Tests
Issue Date: 15-Aug-2017
Abstract: 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. 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. 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. 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.
metadata.dc.identifier.doi: 10.1186/s12968-017-0368-0
Appears in Collections:Producción 2020

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