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Background <p>Cardiac magnetic resonance (CMR) is the gold standard for assessing cardiac anatomy and function. However, long acquisition times and multiple breath-holds pose significant challenges in pediatric imaging.</p> Objective <p>To perform a non-inferiority analysis comparing a novel 3-dimensional (D) ultrafast CMR protocol against the conventional 2-dimensional (D) gold standard for evaluating cardiac function, strain, and tissue characterization in adolescents.</p> Materials and methods <p>Thirty-nine adolescents (mean age 12.2±2.6&#xa0;years) underwent both a standard 2-D protocol and a 3-D ultrafast protocol at 3-T. The 3-D protocol comprised enhanced sensitivity encoding by static outer volume subtraction (ESSOS) cine and 3-D late gadolinium enhancement. Image quality and diagnostic confidence were compared. A pre-specified non-inferiority margin (Δ) was used to assess functional and strain parameters. Agreement was evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICCs).</p> Results <p>The total scan time was significantly shorter for the 3-D protocol compared to the 2-D protocol (75.8±10.0&#xa0;s vs. 734.4±19.6&#xa0;s, <i>P</i>&lt;0.05). Image quality scores were comparable between protocols (median score 4.0, <i>P</i>=0.74). The 3-D protocol demonstrated statistical non-inferiority for all functional and strain metrics. Bland–Altman analysis showed minimal bias for key parameters, and the 95% confidence intervals for differences met the pre-specified non-inferiority margins. Intraclass correlation coefficients (ICCs) indicated good to excellent agreement for all parameters (<i>n</i>=39).</p> Conclusion <p>The novel 3-D ultrafast CMR protocol is non-inferior to the conventional 2-D gold standard for quantitative assessment of cardiac function and strain in adolescents. It offers comparable image quality with significantly reduced acquisition times, potentially improving clinical feasibility in pediatric populations.</p> Graphical abstract <p></p>

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Validation of a novel three-dimensional ultrafast cardiac magnetic resonance imaging protocol in adolescents: a non-inferiority study compared with the two-dimensional gold standard

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月21日

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  • Wei Chen,
  • Shuo Liu,
  • Wei Li,
  • Hui Wang,
  • Shuang Li,
  • Yike Zhao,
  • Xinyan Tao,
  • Jianxiu Lian,
  • Rui Wang,
  • Lei Xu

摘要

Background

Cardiac magnetic resonance (CMR) is the gold standard for assessing cardiac anatomy and function. However, long acquisition times and multiple breath-holds pose significant challenges in pediatric imaging.

Objective

To perform a non-inferiority analysis comparing a novel 3-dimensional (D) ultrafast CMR protocol against the conventional 2-dimensional (D) gold standard for evaluating cardiac function, strain, and tissue characterization in adolescents.

Materials and methods

Thirty-nine adolescents (mean age 12.2±2.6 years) underwent both a standard 2-D protocol and a 3-D ultrafast protocol at 3-T. The 3-D protocol comprised enhanced sensitivity encoding by static outer volume subtraction (ESSOS) cine and 3-D late gadolinium enhancement. Image quality and diagnostic confidence were compared. A pre-specified non-inferiority margin (Δ) was used to assess functional and strain parameters. Agreement was evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICCs).

Results

The total scan time was significantly shorter for the 3-D protocol compared to the 2-D protocol (75.8±10.0 s vs. 734.4±19.6 s, P<0.05). Image quality scores were comparable between protocols (median score 4.0, P=0.74). The 3-D protocol demonstrated statistical non-inferiority for all functional and strain metrics. Bland–Altman analysis showed minimal bias for key parameters, and the 95% confidence intervals for differences met the pre-specified non-inferiority margins. Intraclass correlation coefficients (ICCs) indicated good to excellent agreement for all parameters (n=39).

Conclusion

The novel 3-D ultrafast CMR protocol is non-inferior to the conventional 2-D gold standard for quantitative assessment of cardiac function and strain in adolescents. It offers comparable image quality with significantly reduced acquisition times, potentially improving clinical feasibility in pediatric populations.

Graphical abstract