Asthma, Cystic Fibrosis, Heart Disease
Conditions
Keywords
pediatrics, Heart Disease, Cystic Fibrosis, Severe Asthma, Magnetic Resonance Imaging
Brief summary
The primary objective of this study is to determine if quantitative Dynamic contrast-enhanced magnetic resonance (DCE MR) perfusion imaging accurately quantifies right and left pulmonary artery blood flow as compared with phase contrast flow velocity mapping (PC), the current gold standard of flow volume measurements.
Detailed description
Many conditions of the heart or the lungs lead to differences in how the blood is pumped to the lungs. Specifically, some areas of the lung may receive less blood supply than others. We would like to do a research study in children and adolescents who have a heart condition or a chronic or stable lung condition. We are doing this study to see if measuring the circulation of blood in the lungs in children is possible using magnetic resonance imaging (MRI) with a special dye (contrast medium) injection called Magnevist®.
Interventions
PROCEDUREPhase contrast flow velocity mapping (PC)
An MRI is done using the phase contrast flow velocity mapping (PC)technique. Using PC, an imaging slice is prescribed perpendicular to the vessel's course. Within the pulmonary circulation, PC can quantify total pulmonary blood flow and the right / left distribution of the lung blood flow volume.
PROCEDUREDynamic contrast-enhanced magnetic resonance imaging
Dynamic contrast-enhanced magnetic resonance (DCE MR) perfusion imaging imaging is a non-invasive method to quantify regional pulmonary blood flow. A bolus of gadolinium-containing contrast medium is injected and its passage through the pulmonary circulation traced using a repetitive rapid three-dimensional (3D) T1 weighted angiography sequence.
Sponsors
The Hospital for Sick Children
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Cardiac Patients: 1. Patients \> 6 years of age 2. Patients with suspected or confirmed congenital or acquired heart disease 3. Who undergo a clinically indicated MRI scan, including gadolinium (MRI contrast medium) 4. And receive gadolinium (= MRI contrast medium) as part of their clinical investigation Pulmonary Patients: 1. Patients \> 6 years of age 2. Patients with a chronic and stable lung condition, such as cystic fibrosis, severe asthma.
Exclusion criteria
1. Children under the age of 6 will be excluded as they are routinely scanned under general anesthesia 2. Patients in whom MRI is contraindicated (e.g. pacemaker, ocular metal, claustrophobia, tattoos) 3. Patients with a known allergy to gadolinium. 4. Patients with a history of allergic disposition or have anaphylactic reactions 5. Moderate-to-severe renal impairment (defined as having a GFR/ eGFR \< 60 mL/min) 6. Have Sickle Cell anemia 7. Known pregnancy, or breast feeding 8. Patient is uncooperative during a MRI without sedation or anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pulmonary blood flow | 1 hour | Pulmonary blood flow as measured with DCE MRI perfusion imaging will be compared to MRI phase contrast imaging, which is the gold standard of non-invasive flow measurements. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perfusion defects detected | 1 hour | Perfusion defects (number and location) will be compared to images of lung morphology and correlated with pathology within the lung parenchyma and central airways. |
| Quantitative results from dynamic contrast-enhanced magnetic resonance perfusion imaging | 1 hour | Quantitative results from DCE MRI perfusion imaging (including mean transit time, pulmonary blood flow, pulmonary blood volume) will be correlated with the results of pulmonary perfusion tests, where clinically available. |
Countries
Canada
Outcome results
None listed