Ferumoxytol-enhanced Ultrashort Echo Time MRI of Cardiovascular Stents in Patients with Congenital Heart Disease: A Feasibility Study

Purpose To investigate the potential of using a three-dimensional (3D) ultrashort echo time (UTE) cardiovascular MRI sequence in conjunction with ferumoxytol for imaging extracardiac vascular stents. Materials and Methods Children and young adults with extracardiac vascular stents (<i>n</i> = 30) who underwent cardiovascular MRI were recruited for this prospective study. Ferumoxytol, a T1-shortening blood pool contrast agent with purely intravascular distribution, was used to acquire 3D whole-heart images with both the clinical standard 3D balanced-steady state free precession (bSSFP) and the 3D UTE sequences. Image quality was evaluated using a three-point scale, and the apparent contrast-to-noise ratio (aCNR) was calculated. Statistical analysis was performed to determine the significance of differences in image quality scores and aCNR between the two sequences. Results The 3D UTE sequence provided significantly better image quality for stent visualization compared with the 3D bSSFP sequence, with reviewer 1 scoring it as a mean (±SD) of 2.3 ± 0.6 versus 1.3 ± 0.5 and reviewer 2 scoring it as 2.5 ± 0.6 versus 1.3 ± 0.5 (both <i>P</i> < .01). However, interreviewer agreement on image quality was low for both sequences, with κ values indicating only slight agreement. The aCNR within the stent region for the 3D UTE sequence was also significantly higher than the 3D bSSFP sequence (median, 37.1 vs 12.9; <i>P</i> < .01). Conclusion The 3D UTE sequence was effective in depicting stents and reducing stent-related artifacts compared with the clinical standard 3D bSSFP sequence. It may serve as a valuable complementary tool for imaging extracardiac vascular stents in clinical practice. <b>Keywords:</b> 3D bSSFP, 3D UTE, Cardiovascular Magnetic Resonance, Cardiovascular Stents, Ferumoxytol <i>Supplemental material is available for this article.</i> © RSNA, 2026.