Improving efficiency of cardiac magnetic resonance imaging for children with pulmonary hypertension
Year: 2026
Type: preprint
Abstract: Background Right ventricular (RV) failure is an important cause of morbidity and mortality in pulmonary hypertension (PH). However, access to pediatric CMR – the gold standard for RV assessment – can be limited by sedation needs, tolerance of prolonged exams, and intravenous access for contrast. We hypothesize that a focused PH-specific CMR protocol could address these limitations and standardize image acquisition at our institution. Methods We performed a retrospective (1/2018-12/2025) single-center study of pediatric PH patients referred for CMR. Patient and CMR characteristics were collected via chart review. A PH CMR protocol was implemented in late 2022 with additional clinician education in 1/2024. Outcomes were compared across three eras: pre-protocol implementation (era 1), post-protocol implementation (era 2), and after additional clinical education (era 3). Results We identified 129 CMR examinations in 57 PH patients (era 1: ~10 exams/year, era 2: 28 exams/year, era 3: ~26 exams/year). Despite increasing patient complexity and center volume, exam duration decreased after protocol implementation (era 1: 40 minutes [IQR 33–50] vs. era 3: 32 minutes [IQR 27–36], p = 0.003), reflecting shortened first-time CMR duration and decreased number of extraneous sequences. Contrast administration decreased (era 1: 26/48 [54.2%] vs. era 3:16/53 [30.2%], p = 0.007) but anesthesia use remained consistent across eras. Conclusions A focused PH CMR protocol was associated with shorter exam duration, improved image acquisition standardization, and reduced contrast administration despite increasing patient complexity and center volume. These findings support indication-specific CMR protocols in pediatric PH. Follow-up is needed to determine whether focused protocols reduce anesthesia use in younger children.
Source: Research Square
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225799531