Purpose/ Objective

Kawasaki disease (KD) is an acute idiopathic form of childhood vasculitis that can result in coronary artery aneurysms.  Although it is one of the leading cause of acquired heart disease in children, KD sequelae can be difficult to assess by standard non-invasive imaging techniques. Takeyasu arteritis is also an idiopathic form of inflammatory vasculitis that more commonly affects larger arteries and is also difficult to assess by standard imaging techniques. CMR can improve the clinician’s understanding of coronary artery and vascular wall anatomy in patients with KD or vasculitis such as Takeyasu arteritis, particularly with regards to later sequelae of disease. Following this session, learners will better understand, what are the most common types of vascular diseases in children, how to assess coronary arteries by CMR in subjects with a history of Kawasaki Disease, and what are CMR characteristics of the vessel wall in Kawasaki Disease and in Takayasu arteritis.

Purpose/ Objective

Volumetric imaging of the whole heart and the great vessels is very important for surgical planning and clinical decision making, particularly in complex congenital heart diseases. However, volumetric imaging is challenging due to presence of respiratory and cardiac motion. Gadolinium contrast injection is still a concern for patients with severe renal impairment and contrast allergy, as well as the need for intravenous cannulation. With use of a navigator 3D SSFP sequence, volumetric bright blood imaging can be achieved without the need for contrast injection. However, this sequence is still limited by the intrinsic limitations of SSFP sequences (e.g. presence of dephasing artifacts in regions with turbulence) and the need for additional scanning time due to dual gating. Volumetric imaging of the whole heart and the great vessels is very important for surgical planning and clinical decision making, particularly in complex congenital heart diseases. However, as the heart is beating and the diaphragms are moving, respiratory and ECG navigation must be performed to minimize motion artifacts. With use of a balanced SSFP sequence, bright blood imaging can be achieved without the need for contrast injection.

Planners

Kenneth Cheung and Christopher Lam

Disclosure of Commercial Support

SCMR received no funding to support this activity.

Bibliography

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