Congenital Heart Disease Clinical Trial
Official title:
Improved Diagnosis of Congenital Heart Disease by Magnetic Resonance Imaging Using Vasovist
Magnetic Resonance Imaging (MRI) is an effective and radiation free method of diagnosing Congenital Heart Disease (CHD). MRI works by taking images of the anatomy and physiology. These images also provide information on the hearts function and blood flow. The clarity of these images is enhanced by the use of contrast agents (dyes). However these agents only stay in the blood vessels for a short time and therefore limit the time in which the better quality images can be obtained. This study aims to determine whether MRI using Vasovist (a dye that stays in the vessels for a prolonged period of time) can improve the diagnosis of Congenital Heart Disease (CHD) by allowing more areas to be imaged and the improved assessment of various parameters (anatomy, volumes, flow) as well as vastly improving image quality.
We planned an intra-individual study, where 20 adult patients with CHD (e.g. Fallot
Tetralogy, s/p corrective surgery, single ventricle s/p Fontan operation, aortic and
pulmonary artery stenosis) will undergo two examinations. Both scans are aimed to assess
different diagnostic parameter like angiography, cardiac anatomy, ventricular volume and
flow.
The first clinically indicated scan in our clinically established imaging protocol is
performed using a standard contrast agent. The second scan is performed using a new protocol
with Vasovist within the next seven days. Informed consent for the additional second scan
will be obtained. In order to optimise the scan protocol for Vasovist we plan a pilot phase
using three patients. Dosage of the two contrast agents will be within the approved dose.
Any adverse events will be immediately reported. The following diagnostic parameters will be
assessed and compared between standard Gadolinium (Gd) agent and Vasovist.
1. MR-Angiography (MRA): assessment of the MRA quality of the large systemic and the
pulmonary vessel (arterial and venous) by measuring the Contrast-to-Noise Ratio (CNR)
and the vessel sharpness. In addition, the overall image-quality will be scored by
three independent readers (scale: excellent, good, ok, bad).
2. Cardiac Anatomy: assessment of image quality of the cardiac anatomy from 3D single/dual
phase MRI by measuring Signal-to-Noise Ratio (SNR) and CNR as well as assessing the
overall image quality by three independent readers (scale: excellent, good, ok, bad).
3. Ventricular Volumes: comparison of systolic and diastolic volumes measured from
multi-slice 2D short axis cine MRI, two single phases 3D whole heart MRI (diastole and
systole).
4. Flow: the different flow values will be measured in the large vessels using the Phase
Contrast Angio (PCA) data. Furthermore, the flow reproducibility will be determined by
using two scans. The overall scan-time to assess all these parameter will be
approximately 40 minutes. The intra-individual study allows a direct comparison of the
different parameters in a number of vascular territories.
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Primary Purpose: Diagnostic
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