Free-breathing multi-parametric SASHA (mSASHA) mapping provides reliable non-contrast myocardial characterization in a pediatric and adult congenital population

Abstract

Parametric mapping has become a standard of care technique for the non-invasive assessment of myocardial edema and fibrosis. Conventional MOLLI-based T1 mapping is susceptible to many confounding effects particularly in the pediatric population. The requirement for compliant breath holds is a major limitation for younger or more ill patients. The advent of free-breathing SASHA-based multi-parametric mapping with motion correction therefore offers a significant advantage in pediatric cohorts. With IRB approval and consent/assent, children and adults with congenital heart disease underwent both conventional breath-held MOLLI-based T1 and T2 TrueFISP mapping as well as free-breathing multi-parametric SASHA assessment in the context of a clinically indicated study on a 1.5T magnet. A total of 71 subjects with mean age of 19.3 ± 8.6 years were scanned. Free-breathing multiparametric SASHA T1 and T2 values were moderately correlated with breath-held MOLLI/T2p-bSSFP (r = 0.52). Importantly free-breathing SASHA-based T1 maps were able to discriminate between patients with late gadolinium enhancement with a statistically significant difference in mean T1 values (p = 0.03). Free-breathing multiparametric SASHA allows for reliable myocardial characterization with moderate correlation to conventional breath-held T1 and T2 mapping techniques in a small and heterogenous sample of pediatric and congenital cardiac subjects.

Keywords: Free-breathing; Parametric mapping; Pediatric cardiology; SASHA.