Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. 78-83 (doi:10.1542/peds.2006-3305)
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ARTICLE

Three-Tesla Cardiac Magnetic Resonance Imaging for Preterm Infants

Adrienne M. Foran, MDa,b, Julie A. Fitzpatrick, BSb,c, Joanna Allsop, BSb,c, Stephan Schmitz, PhDb,c, Jamie Franklin, BSb,c, Constandinos Pamboucas, MDb,c, Declan O'Regan, FRCRb,c, Jo V. Hajnal, PhDb,c and A. David Edwards, FMedScia,b,c

a Departments of Paediatrics
b Imaging Sciences, Imperial College, London, England
c Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, England

OBJECTIVES. We aimed to establish the feasibility of acquiring 3.0-T cardiac MRIs without sedation, anesthesia, or breath-holding for preterm infants and to obtain preliminary quantitative data on left ventricular function in this population.

METHODS. Twelve preterm infants underwent 3.0-T cardiac MRI without sedation or breath-holding. The median gestational age was 29 weeks (range: 26–33 weeks), the median birth weight was 1240 g (range: 808–2200 g), and the median postconceptional age at the time of cardiac MRI was 33 weeks (range: 31–40 weeks). Anatomic images were acquired with T2-weighted spin-echo sequences, and ventricular function was assessed with balanced steady-state free precession cine sequences. We assessed left ventricular function by using the area-length ejection fraction method on horizontal long-axis images and the volumetric Sergeant's discs method of analysis on short-axis images.

RESULTS. Imaging was successful for 10 of 12 infants. For those 10, the area-length ejection fraction method in the horizontal long-axis plane estimated median stroke volume at 2.9 mL, cardiac output at 0.4 L/minute, end-diastolic volume at 3.8 mL, end-systolic volume at 0.3 mL, and ejection fraction at 74.6%. Short-axis volumetric estimations were made for 4 infants. With this approach, the median stroke volume was 2.4 mL, cardiac output 0.35 L/minute, end-diastolic volume 4.3 mL, end-systolic volume 2.1 mL, and ejection fraction 56%.

CONCLUSIONS. Three-tesla cardiac MRI is feasible for preterm infants without sedation, anesthesia, or breath-holding and has the potential to provide a wide range of precise quantitative data that may be of great value for the investigation of cardiac function in preterm infants.

Key Words: cardiac magnetic resonance imaging • area-length ejection fraction • Sergeant's discs • preterm • newborn • patent ductus arteriosus • left ventricular function

Abbreviations: CMRI—cardiac MRI • ALEF—area-length ejection fraction • PDA—patent ductus arteriosus • b-SSFP—balanced steady-state free precession

Accepted Mar 1, 2007.


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