Which MRI sequence provides the most accurate estimate of branch pulmonary artery size in children with single ventricle?
Bibliographic record
Abstract
Accurate evaluation of branch pulmonary artery size in children with single ventricle is important for surgical planning and has prognostic implications after Fontan surgery. Various cardiac MRI sequences are employed to evaluate these sometimes hypoplastic pulmonary arteries, which increases imaging time in anesthetised children. The aim of this study was to evaluate which MRI sequence(s) correlate with angiography measurements of pulmonary artery size made at cardiac catheterization in children with single ventricle. Twenty children (age: 21±30 months, weight 10±7kg) with single ventricle who underwent cardiac catheterization with pulmonary angiography, and cardiac MRI (Siemens 1.5T) within 43±29 days were included at any surgical stage. Pulmonary arteries were measured within the hilum, proximal to the first branch in both MRI and catheterization angiography. We used 4 different MRI sequences to assess pulmonary artery size: 1) Axial black blood (HASTE or TSE), 2) Axial cine, 3) Phase contrast (PC) through plane flow, and 4) 3D contrast-enhanced MRA images. The maximum diameter was measured in mid-systole for cines. For MRA images, the long axis of each pulmonary artery was reconstructed using multiplanar reformatting (MPR) and diameters in 2 dimensions were measured (RPA: axial and coronal, LPA: axial and sagittal-oblique). Cross-sectional areas and diameters were measured from MRA and through plane flow images. Pearson's correlation and linear regression with 95% confidence intervals were used to compare MRI with the "gold" standard catheterization angiography measurements (p<0.05). For the RPA, all MRA measured dimensions correlated well with catheterization angiography (axial r=0.81, coronal r=0.89, cross-sectional area r=0.81, p<0.0001), with axial dark blood (r=0.65, p=0.02) and cine diameters (r=0.67, p=0.03) showing modest correlations. In contrast, LPA through plane PC area correlated best (r=0.73, p=0.02), with modest correlations for axial dark blood (r=0.54, p=0.04), MRA axial diameter (r=0.55, p=0.02), and MRA cross-sectional area (r=0.48, p=0.05). In children with single ventricle, MPR contrast enhanced MRA measurements showed the best correlate of RPA size compared to catheterization angiography. However, LPA cross-sectional area from PC flow measurements, and not MRA, were the best correlate of LPA measurements. Selection of the most appropriate sequence will provide a more accurate pre-operative evaluation of pulmonary artery size to aid the surgical strategy in this population. Knowledge of this will help tailor protocols to study pulmonary artery size in this population and imaging time may be shortened with this in mind.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".