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Background <p>The main pulmonary artery (MPA) and branch pulmonary arteries (PAs) are commonly affected in congenital heart diseases, with residual postoperative abnormalities, a leading cause of reintervention.</p> Objective <p>To establish normative mean diameters, area and corresponding Z-scores for the MPA and branch PAs in teenagers, utilizing respiratory-navigated non-contrast ECG-gated 3D balanced steady-state free precession (3D bSSFP) magnetic resonance imaging (MRI) in systole.</p> Materials and methods <p>This retrospective study included patients with pectus excavatum deformity who underwent cardiac MRI between January and August 2023, excluding patients with aortopathies. Measurements of the PAs were obtained from non-contrast multiplanar reformatted 3D bSSFP datasets. Mean diameters and cross-sectional areas were calculated. Relationships between each vascular measurement and patient characteristics (age, height, and body surface area (BSA)) were assessed individually using weighted linear regression with inverse-density-based weights to account for data distribution. Additionally, Z-scores were calculated.</p> Results <p>The study included 112 patients (91 males [81%]; mean age, 14.3±1.7&#xa0;years; mean BSA, 1.63±0.2 m<sup>2</sup>). All vessel measurements showed a positive trend with body size (height and BSA). Across categorical age groups, however, they did not exhibit a monotonic increase with age. Across all models, BSA was a statistically significant independent predictor of PA dimensions (<i>p</i>&lt;0.01), with stronger associations observed for cross-sectional area than for diameter. Height contributed minimally and was not an independent predictor. Branch PA measurements—particularly right pulmonary artery, and to a lesser extent left pulmonary artery—exhibited slightly better model fit than the MPA.</p> Conclusion <p>We report normative reference values for mean diameters and cross-sectional areas of the MPA and branch PAs in children 10-18&#xa0;years, obtained using respiratory-navigated ECG-gated non-contrast-enhanced 3D bSSFP MRI technique in systole.</p> Graphical Abstract <p></p>

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Reference values for mean diameter and cross-sectional area of the pulmonary arteries in teenagers using ECG-gated 3D balanced steady‑state free precession MRI

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Sara Kattainen,
  • Cara E. Morin,
  • Shixuan Wang,
  • Amol S. Pednekar,
  • Murat Kocaoglu

摘要

Background

The main pulmonary artery (MPA) and branch pulmonary arteries (PAs) are commonly affected in congenital heart diseases, with residual postoperative abnormalities, a leading cause of reintervention.

Objective

To establish normative mean diameters, area and corresponding Z-scores for the MPA and branch PAs in teenagers, utilizing respiratory-navigated non-contrast ECG-gated 3D balanced steady-state free precession (3D bSSFP) magnetic resonance imaging (MRI) in systole.

Materials and methods

This retrospective study included patients with pectus excavatum deformity who underwent cardiac MRI between January and August 2023, excluding patients with aortopathies. Measurements of the PAs were obtained from non-contrast multiplanar reformatted 3D bSSFP datasets. Mean diameters and cross-sectional areas were calculated. Relationships between each vascular measurement and patient characteristics (age, height, and body surface area (BSA)) were assessed individually using weighted linear regression with inverse-density-based weights to account for data distribution. Additionally, Z-scores were calculated.

Results

The study included 112 patients (91 males [81%]; mean age, 14.3±1.7 years; mean BSA, 1.63±0.2 m2). All vessel measurements showed a positive trend with body size (height and BSA). Across categorical age groups, however, they did not exhibit a monotonic increase with age. Across all models, BSA was a statistically significant independent predictor of PA dimensions (p<0.01), with stronger associations observed for cross-sectional area than for diameter. Height contributed minimally and was not an independent predictor. Branch PA measurements—particularly right pulmonary artery, and to a lesser extent left pulmonary artery—exhibited slightly better model fit than the MPA.

Conclusion

We report normative reference values for mean diameters and cross-sectional areas of the MPA and branch PAs in children 10-18 years, obtained using respiratory-navigated ECG-gated non-contrast-enhanced 3D bSSFP MRI technique in systole.

Graphical Abstract