PMID- 23223637 OWN - NLM STAT- MEDLINE DCOM- 20130305 LR - 20211021 IS - 1942-0080 (Electronic) IS - 1941-9651 (Linking) VI - 6 IP - 1 DP - 2013 Jan 1 TI - Detection and grading of coronary allograft vasculopathy in children with contrast-enhanced magnetic resonance imaging of the coronary vessel wall. PG - 91-8 LID - 10.1161/CIRCIMAGING.112.975797 [doi] AB - BACKGROUND: Coronary allograft vasculopathy is the leading cause of late death after heart transplantation in children. It is poorly detected by conventional angiography. Intravascular ultrasound is invasive and costly. This study shows that magnetic resonance imaging (MRI) late gadolinium enhancement (LGE) of the coronary vessel wall can detect and grade coronary allograft vasculopathy. METHODS AND RESULTS: Twenty-four children (10 male; age range, 9-17 years) underwent coronary angiography, intravascular ultrasound, and MRI. Maximal intimal thickness and mean intimal index were recorded. MRI included coronary magnetic resonance angiogram and LGE vessel wall imaging with 1.5 T (n=12) and 3.0 T (n=12). Ten healthy control subjects also underwent LGE MRI. Mean time posttransplantation was 5.5 years (range, 0.25-14 years). Seven patients had Stanford grade IV coronary allograft vasculopathy on intravascular ultrasound, 3 of whom had angiographic disease. Maximal intimal thickness and mean intimal index were 0.73+/-0.50 mm and 20.9+/-10.6%, respectively. On MRI, mean diameter of enhancement of vessel wall was 6.57+/-4.91 mm, and mean enhancement index (indexed to vessel lumen size) was 1.10+/-1.72. The control group showed little or no LGE. Correlation of LGE with maximal intimal thickness using the Pearson coefficient was 0.80 (P<0.001) and with mean intimal index was 0.92 (P<0.001). An MRI diameter >7.5 mm gave 86% sensitivity and 93% specificity. CONCLUSIONS: LGE scores correlate well with traditional intravascular ultrasound measures. These promising early results encourage larger-scale clinical studies to investigate whether LGE MRI will allow closer follow-up and better prevention of coronary allograft vasculopathy in children. FAU - Hussain, Tarique AU - Hussain T AD - King's College London, London, UK. Tarique@doctors.org.uk FAU - Fenton, Matthew AU - Fenton M FAU - Peel, Sarah A AU - Peel SA FAU - Wiethoff, Andrea J AU - Wiethoff AJ FAU - Taylor, Andrew AU - Taylor A FAU - Muthurangu, Vivek AU - Muthurangu V FAU - Razavi, Reza AU - Razavi R FAU - Botnar, Rene M AU - Botnar RM FAU - Burch, Michael AU - Burch M FAU - Greil, Gerald F AU - Greil GF LA - eng GR - SRF/01/018/DH_/Department of Health/United Kingdom GR - PG/12/5/29350/BHF_/British Heart Foundation/United Kingdom GR - FS/08/012/24454/BHF_/British Heart Foundation/United Kingdom GR - PG/10/44/28343/BHF_/British Heart Foundation/United Kingdom GR - RG/12/1/29262/BHF_/British Heart Foundation/United Kingdom GR - PG/11/98/29201/BHF_/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20121205 PL - United States TA - Circ Cardiovasc Imaging JT - Circulation. Cardiovascular imaging JID - 101479935 RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 1BJ477IO2L (gadobutrol) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adolescent MH - Child MH - Child, Preschool MH - *Contrast Media MH - Coronary Artery Disease/*diagnosis MH - Coronary Vessels/*pathology MH - Female MH - Follow-Up Studies MH - Gadolinium MH - Graft Rejection/*diagnosis MH - *Heart Transplantation MH - Humans MH - Infant MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - *Organometallic Compounds MH - Reproducibility of Results MH - Transplantation, Homologous EDAT- 2012/12/12 06:00 MHDA- 2013/03/06 06:00 CRDT- 2012/12/11 06:00 PHST- 2012/12/11 06:00 [entrez] PHST- 2012/12/12 06:00 [pubmed] PHST- 2013/03/06 06:00 [medline] AID - CIRCIMAGING.112.975797 [pii] AID - 10.1161/CIRCIMAGING.112.975797 [doi] PST - ppublish SO - Circ Cardiovasc Imaging. 2013 Jan 1;6(1):91-8. doi: 10.1161/CIRCIMAGING.112.975797. Epub 2012 Dec 5.