ArticlePediatric radiology2026
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.
Article in Pediatric radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundCardiac 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.
objectiveTo 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
methodsThirty-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).
resultsThe 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).
conclusionThe 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.
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