Radiol Cardiothorac Imaging. 2026 Jun;8(3):e250395. doi: 10.1148/ryct.250395.
ABSTRACT
Purpose To evaluate the impact of dual-phase three-dimensional (3D) modified Dixon (mDixon) steady-state MR angiography (MRA) on phase-dependent image quality and vessel measurements in pediatric patients with congenital heart disease (CHD). Materials and Methods In this retrospective single-center study, pediatric patients with CHD underwent cardiac MRI at 3 T, including free-breathing dual-phase 3D mDixon steady-state MRA with respiratory navigator gating and interleaved acquisition of diastolic and systolic images. Vessel diameters were measured independently by two readers. Overall image quality, including vessel border delineation and breathing-, motion-, flow-, and susceptibility-related artifacts, was evaluated using a five-point Likert scale (1 = nondiagnostic; 5 = excellent). Paired t tests or Wilcoxon signed rank tests were used for phase comparisons. Results A total of 47 patients (mean age, 6.4 years ± 3.5 [SD]) were included. Arterial vessel diameters were larger in systole than in diastole (eg, main pulmonary artery: mean, 23.2 mm ± 5.3 [SD] vs 19.1 mm ± 3.9; P < .01). Systolic image quality was higher for coronary arteries and pulmonary veins (eg, pulmonary veins: median, 5.00 [IQR, 4.00-5.00] vs 4.00 [IQR, 3.00-4.00]; P < .01), whereas diastolic image quality was higher for most other vessels (eg, main pulmonary artery: median, 5.00 [IQR, 4.00-5.00] vs 3.00 [IQR, 2.00-4.00]; P < .01). In two (4%) of 47 patients with nondiagnostic diastolic image quality due to arrhythmia or high heart rate variability, systolic imaging yielded diagnostic image quality. Conclusion Dual-phase 3D mDixon steady-state MRA enabled phase-dependent assessment of vessel dimensions and image quality in pediatric CHD. Additional systolic imaging improved diagnostic adequacy and visualization of selected structures within a single acquisition. Keywords: Pediatric Congenital Heart Disease, Modified Dixon MR Angiography Supplemental material is available for this article. © RSNA, 2026.
PMID:42165742 | DOI:10.1148/ryct.250395