The acquisition of balanced steady-state free precession cine MRI images encompassed axial planes, and selectively, sagittal and/or coronal planes. The quality of the overall image was judged using a four-point Likert scale, graded from a minimum of 1 (non-diagnostic) to a maximum of 4 (good image quality). The 20 fetal cardiovascular abnormalities were each independently evaluated by utilizing both imaging techniques. The standard against which all others were measured was postnatal examination results. Differences in sensitivities and specificities were established through the use of a random-effects model.
Among the participants of the study, 23 had an average age of 32 years and 5 months (standard deviation), and an average gestational age of 36 weeks and 1 day. In every participant, a fetal cardiac MRI scan was performed. For DUS-gated cine images, the median overall image quality score was 3 (interquartile range, 25-4). In a study involving 23 participants, fetal cardiac MRI correctly diagnosed underlying congenital heart disease (CHD) in 21 (91%). MRI scans alone allowed for the correct identification of situs inversus and congenitally corrected transposition of the great arteries in one instance. Devimistat The sensitivity levels demonstrated a stark contrast (918% [95% CI 857, 951] differing from 936% [95% CI 888, 962]).
A set of ten distinct sentences, each a reflection of the initial thought, but with different structural patterns, highlighting the nuances of wording and sentence arrangement. The specificity figures were nearly identical, 999% [95% CI 992, 100] contrasted with 999% [95% CI 995, 100].
A percentage exceeding ninety-nine percent. Comparative analysis indicated that the detection of abnormal cardiovascular features was equivalent between MRI and echocardiography.
The diagnostic performance of DUS-gated fetal cardiac MRI cine sequences was on a par with fetal echocardiography in assessing complex congenital heart disease in fetuses.
Cardiac MRI, fetal MRI (MR-Fetal), fetal imaging, congenital heart disease, congenital conditions, prenatal, pediatrics, heart imaging, clinical trial registration number. A research project, NCT05066399, is essential to scrutinize.
The RSNA 2023 publication includes a commentary by Biko and Fogel, which should be examined in conjunction with this paper.
DUS-gated fetal cine cardiac MRI demonstrated diagnostic equivalence to fetal echocardiography in diagnosing complex fetal congenital heart defects. Additional material related to NCT05066399 is furnished with this article. To complement the RSNA 2023 content, readers should review the commentary offered by Biko and Fogel.

A low-volume contrast media protocol for thoracoabdominal CT angiography (CTA) with photon-counting detector (PCD) CT will be developed and its effectiveness rigorously evaluated.
Consecutive participants, enrolled in this prospective study between April and September 2021, had previously undergone CTA with EID CT and subsequently underwent CTA with PCD CT of the thoracoabdominal aorta, all with the same radiation dosage. PCD CT processing involved reconstructing virtual monoenergetic images (VMI) using 5 keV steps within the energy range of 40 keV to 60 keV. The attenuation of the aorta, image noise levels, and contrast-to-noise ratio (CNR) were determined, with two independent readers rating the subjective quality of the images. The identical contrast media protocol was applied to each scan in the first participant group. The contrast media volume reduction strategy in the second group was calibrated based on the difference in CNR between PCD and EID computed tomography scans. Noninferiority analysis was employed to ascertain if the image quality of the low-volume contrast media protocol in PCD CT scans fell below an acceptable threshold for noninferiority.
Included in the study were 100 participants, whose average age was 75 years and 8 months (standard deviation), and 83 of whom were male. In the initial grouping,
Employing VMI at 50 keV, a 25% enhancement in CNR over EID CT was observed, signifying the best compromise between objective and subjective image quality. In the second group, the amount of contrast media used merits attention.
The original volume of 60 was reduced by 25%, which is equivalent to 525 mL. The comparative analysis of CNR and subjective image quality between EID CT and PCD CT at 50 keV demonstrated mean differences exceeding the predefined non-inferiority margins (-0.54 [95% CI -1.71, 0.62] and -0.36 [95% CI -0.41, -0.31], respectively).
With PCD CT aortography, a higher contrast-to-noise ratio was achieved, which in turn supported a contrast media protocol of reduced volume and maintained non-inferior image quality compared to EID CT at the same radiation dose.
2023's RSNA technology assessment of CT angiography, CT spectral imaging, vascular, and aortic imaging incorporates the use of intravenous contrast agents. The Dundas and Leipsic commentary is also relevant.
High CNR from PCD CT aorta CTA allowed for a lower volume contrast media protocol, demonstrating non-inferior image quality to the EID CT protocol at the same radiation dose. Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment RSNA, 2023. See the commentary by Dundas and Leipsic in this issue.

In a cardiac MRI study of patients with mitral valve prolapse (MVP), the relationship between prolapsed volume and regurgitant volume (RegV), regurgitant fraction (RF), and left ventricular ejection fraction (LVEF) was investigated.
The electronic record was searched retrospectively for patients with mitral valve prolapse (MVP) and mitral regurgitation, who had cardiac MRI scans between 2005 and 2020. Devimistat The disparity between left ventricular stroke volume (LVSV) and aortic flow constitutes RegV. Left ventricular end-systolic volume (LVESV) and left ventricular stroke volume (LVSV) were derived from volumetric cine images, factoring in both prolapsed volume (LVESVp, LVSVp) and excluded volume (LVESVa, LVSVa), generating two independent assessments of regional volume (RegVp, RegVa), ejection fraction (RFp, RFa), and left ventricular ejection fraction (LVEFa, LVEFp). Devimistat To determine the concordance of LVESVp measurements across observers, the intraclass correlation coefficient (ICC) was applied. Measurements from mitral inflow and aortic net flow phase-contrast imaging, designated as RegVg, were employed to independently calculate RegV.
Involving 19 patients (average age, 28 years; standard deviation, 16); 10 of these were male, the study was conducted. The interobserver reliability of LVESVp measurements was exceptionally high, as evidenced by an ICC of 0.98 (95% confidence interval: 0.96–0.99). Prolapsed volume inclusion caused a heightened LVESV, specifically LVESVp (954 mL 347) in contrast to LVESVa (824 mL 338).
The results are highly improbable, with a probability less than 0.001. LVSVp (1005 mL, 338) demonstrated a lower value for LVSV compared to LVSVa (1135 mL, 359).
Results indicated a negligible effect, with a p-value falling below 0.001. LVEF decreased (LVEFp 517% 57, in contrast to LVEFa 586% 63;)
The event's occurrence is extremely improbable, with a probability below 0.001. Excluding prolapsed volume, RegV exhibited a larger magnitude (RegVa 394 mL 210 compared to RegVg 258 mL 228).
Analysis revealed a statistically significant outcome, corresponding to a p-value of .02. Prolapsed volume (RegVp 264 mL 164) and the control group (RegVg 258 mL 228) demonstrated no variation between each other.
> .99).
While measurements including prolapsed volume provided the most precise reflection of mitral regurgitation severity, the subsequent inclusion of this volume resulted in a lower left ventricular ejection fraction.
The 2023 RSNA conference showcased a cardiac MRI, and this issue's commentary by Lee and Markl elaborates further on this important topic.
Among the various measurements, those encompassing prolapsed volume were the most indicative of mitral regurgitation severity, but their incorporation led to a smaller left ventricular ejection fraction.

In adult congenital heart disease (ACHD), the clinical performance of the three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence was evaluated.
Participants in this prospective study, who had ACHD and underwent cardiac MRI between July 2020 and March 2021, were scanned with both the clinical T2-prepared balanced steady-state free precession sequence and the suggested MTC-BOOST sequence. Four cardiologists assessed their diagnostic confidence, graded on a four-point Likert scale, for the sequential segmental analysis performed on images captured by each sequence. A comparison of scan durations and the confidence levels in diagnoses was carried out using the Mann-Whitney test. Dimensional assessment of coaxial vasculature at three anatomical markers was conducted, and the agreement between the research protocol and the clinical procedure was evaluated using Bland-Altman analysis.
A study population of 120 participants (average age 33 years, standard deviation 13; with 65 male participants) was examined. A statistically significant difference in mean acquisition time was observed between the MTC-BOOST sequence and the conventional clinical sequence, with the MTC-BOOST sequence requiring 9 minutes and 2 seconds, considerably less than the 14 minutes and 5 seconds needed by the conventional sequence.
The observed event had a probability significantly less than 0.001. The MTC-BOOST sequence exhibited a superior diagnostic confidence compared to the clinical sequence, with average scores of 39.03 versus 34.07 respectively.
Statistically, the probability is below 0.001. The research and clinical vascular measurements demonstrated substantial similarity, characterized by a mean bias of less than 0.08 cm.
The MTC-BOOST sequence produced three-dimensional whole-heart imaging of high quality, efficiency, and contrast-agent-free character in ACHD patients, resulting in shorter, more predictable scan times and an increase in diagnostic confidence when compared with the standard clinical reference sequence.
MR angiography of the heart.
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