Application of high-resolution 3D MR angiography (MRA) in small children with congenital heart disease (CHD) is challenging and generally requires contrast agent administration. In a cohort of pediatric CHD patients (median age: 4 years), non-contrast-enhanced free-breathing gated 3D mDixon REACT-MRA provided comparable overall image quality to contrast-enhanced free-breathing 3D mDixon steady-state MRA for assessment of the thoracic vasculature. REACT-MRA allowed for accurate and reliable vessel size measurements. Although fat-water separation artifacts were observed, they could be extenuated by reconstruction of in- and out-of-phase images. Gated REACT-MRA allows for a contrast-free assessment of the thoracic vasculature in small children with CHD.
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