Congenital heart disease (CHD) is the most common congenital defect affecting approximately 1% of live births. Initially developed and optimized for adults, cardiovascular MRI (CMR) is increasingly used in pediatric CHD patients to complement echocardiography and invasive angiography for anatomical and functional evaluation of the heart and blood vessels. For children, the non-invasiveness, unrestricted field of view, lack of contrast nephrotoxicity and absence of ionizing radiation make MRI an attractive imaging modality, as many of the patients will likely need sequential imaging and follow-up in the long term. However, current CMR is limited by the breath-holding period, the need to capture the first-pass of a gadolinium (Gd) bolus and relatively thick 2D slices in cardiac cine MRI. Consequently, despite yielding exquisitely detailed information on extra-cardiac vascular anatomy, current CMR methods fall short of providing comparable definition of dynamic intra-cardiac anatomy, such as the cardiac chambers, valves, coronary arteries, and other pulsatile blood vessels, despite the fact that the status of these structures often determines the basis for treatment planning. We propose a new paradigm of CMR in pediatric CHD to address these issues. Completion of the project will result in the clinical deployment of a set of MRI pulse sequences, image acquisition and reconstruction strategies CMR in pediatric CHD patients, and successful validation in a cohort of patients of its diagnostic value.

Public Health Relevance

Cardiovascular MRI (CMR) plays an important role in diagnosis and treatment planning of congenital heart disease. However, current CMR is limited in many aspects, which prevent CMR from achieving its full potential. The current proposal develops a new paradigm of CMR for pediatric congenital heart disease that can potentially change how CMR is practiced in pediatric congenital heart disease, boost the value of CMR in managing pediatric CHD, and reduce invasive diagnostic cardiac catheterization in these patients.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL127153-02
Application #
9105399
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (82)S)
Program Officer
Baldwin, Tim
Project Start
2015-07-15
Project End
2021-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
2
Fiscal Year
2017
Total Cost
$702,158
Indirect Cost
$225,353
Name
University of California Los Angeles
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
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