Non contrast versus contrast enhanced MRI of the great thoracic vessels in pediatric congenital heart disease: A quantitative and qualitative analysis

Aim: To compare 3D steady-state free-precession (SSFP) non-contrast magnetic resonance angiography (NC-MRA) with contrast-enhanced MRA (CE-MRA) for quantitative and qualitative analysis of thoracic arteries in pediatric patients with congenital heart disease. Methodology: Forty patients with thoracic vascular anomalies (22 boys & 18 girls) ranging in age between 6 months and 14 years (mean age 4.58 ± 4.5) were included in this prospective study. Measurements of the thoracic arteries were taken by 3D SSFP NC-MRA & CE-MRA. Image quality was assessed using a four-point score. Pearson's and Spearman's Correlation Coefficients were calculated for correlation analysis while Student's t and Mann-Whitney U tests were used for comparative analysis, Bland-Altman plots were employed to demonstrate the level of agreement between the 2 techniques. Results: Measurements from NC-CMRA images were comparable to those from CE-MRA. All measures highly correlated (r > 0.9), 3D SSFP NC-MRA exhibited a significantly higher image quality score than contrast- enhanced MRA, the mean difference was significantly lower than that of the 3D SSFP; (p-value <0.0001). Conclusion: NC-MRA produced similar and comparable measurements of the thoracic arteries with superior image quality when compared to contrast- enhanced MRA in pediatric congenital heart defects.