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60-S Retrogated Compressed Sensing 2D Cine of the Heart: Sharper Borders and Accurate Quantification. J Clin Med 2021; 10:jcm10112417. [PMID: 34072464 PMCID: PMC8199407 DOI: 10.3390/jcm10112417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/28/2022] Open
Abstract
Background and objective: Real-time compressed sensing cine (CSrt) provides reliable quantification for both ventricles but may alter image quality. The aim of this study was to assess image quality and the accuracy of left (LV) and right ventricular (RV) volumes, ejection fraction and mass quantifications based on a retrogated segmented compressed sensing 2D cine sequence (CSrg). Methods: Thirty patients were enrolled. Each patient underwent the reference retrogated segmented steady-state free precession cine sequence (SSFPref), the real-time CSrt cine and the segmented retrogated prototype CSrg sequence providing the same slices. Functional parameters quantification and image quality rating were performed on SSFPref and CSrg images sets. The edge sharpness, which is an estimate of the edge spread function, was assessed for the three sequences. Results: The mean scan time was: SSFPref = 485.4 ± 83.3 (SD) s (95% CI: 454.3–516.5) and CSrg = 58.3 ± 15.1 (SD) s (95% CI: 53.7–64.2) (p < 0.0001). CSrg subjective image quality score (median: 4; range: 2–4) was higher than the one provided by CSrt (median: 3; range: 2–4; p = 0.0008) and not different from SSFPref overall quality score (median: 4; range: 2–4; p = 0.31). CSrg provided similar LV and RV functional parameters to those assessed with SSFPref (p > 0.05). Edge sharpness was significantly better with CSrg (0.083 ± 0.013 (SD) pixel−1; 95% CI: 0.078–0.087) than with CSrt (0.070 ± 0.011 (SD) pixel−1; 95% CI: 0.066–0.074; p = 0.0004) and not different from the reference technique (0.075 ± 0.016 (SD) pixel−1; 95% CI: 0.069–0.081; p = 0.0516). Conclusions: CSrg cine provides in one minute an accurate quantification of LV and RV functional parameters without compromising subjective and objective image quality.
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Kocaoglu M, Pednekar AS, Wang H, Alsaied T, Taylor MD, Rattan MS. Breath-hold and free-breathing quantitative assessment of biventricular volume and function using compressed SENSE: a clinical validation in children and young adults. J Cardiovasc Magn Reson 2020; 22:54. [PMID: 32713347 PMCID: PMC7384228 DOI: 10.1186/s12968-020-00642-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/29/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although the breath-hold cine balanced steady state free precession (bSSFP) imaging is well established for assessment of biventricular volumes and function, shorter breath-hold times or no breath-holds are beneficial in children and severely ill or sedated patients. METHODS Clinical cardiovascular magnetic resonance (CMR) examinations from September 2019 to October 2019 that included breath-hold (BH) and free-breathing (FB) cine bSSFP imaging accelerated using compressed sensitivity encoding (C-SENSE) factor of 3 in addition to the clinical standard BH cine bSSFP imaging using SENSE factor of 2 were analyzed retrospectively. Patients with structurally normal hearts who could perform consistent BHs were included. Aortic flow measured by phase contrast acquisition was used as a reference for the left ventricular (LV) stroke volume. Comparative analysis was performed for evaluation of biventricular volumes and function, imaging times, quantitative image quality, and qualitative image scoring. RESULTS There were 26 patients who underwent all three cine scans during the study period (16.7 ± 6.4 years, body surface area (BSA) 1.6 ± 0.4 m2, heart rate 83 ± 7 beats/min). BH durations of 8 ± 1 s with C-SENSE = 3 were significantly shorter (p < 0.001) by 33% compared to 12 ± 1 s with SENSE = 2. Actual scan time for BH SENSE (4.9 ± 1.2 min) was comparable to that with FB C-SENSE (5.2 ± 1.5 min; p= NS). Biventricular stroke volume and ejection fraction, and LV mass computed using all three sequences were comparable. There was a small but statistically significant (p < 0.05) difference in LV end-diastolic volume (- 3.0 ± 6.8 ml) between BH SENSE and FB C-SENSE. There was a small but statistically significant (p < 0.005) difference in end-diastolic LV (- 5.0 ± 7.7 ml) and RV (- 6.0 ± 8.5 ml) volume and end-systolic LV (- 3.2 ± 4.3 ml) and RV(- 4.2 ± 6.8 ml) volumes between BH C-SENSE and FB C-SENSE. The LV stroke volumes from all three sequences had excellent correlations (r = 0.96, slope = 0.98-1.02) with aortic flow, with overestimation by 2.7 (5%) to 4.6 (8%) ml/beat. The image quality score was Excellent (16 of 26) to Good (10 of 26) with BH SENSE, Excellent (13 of 26) to Good (13 of 26) with BH C-SENSE, and Excellent (3 of 26) to Good (21 of 26) to Adequate (2 of 26) with FB C-SENSE. CONCLUSIONS Image quality and ventricular volumetric and functional indices using either BH or FB C-SENSE cine bSSFP imaging were comparable to standard BH SENSE cine bSSFP imaging while maintaining nominally identical spatio-temporal resolution. This accelerated image acquisition provides an alternative to accommodate patients with impaired BH capacity.
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Affiliation(s)
- Murat Kocaoglu
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Amol S. Pednekar
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Hui Wang
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
- MR Clinical Science, Philips Healthcare, Cincinnati, OH USA
| | - Tarek Alsaied
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Michael D. Taylor
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Mantosh S. Rattan
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
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Wang J, Li X, Lin L, Dai JW, Schmidt M, Forman C, An J, Jin ZY, Wang YN. Diagnostic efficacy of 2-shot compressed sensing cine sequence cardiovascular magnetic resonance imaging for left ventricular function. Cardiovasc Diagn Ther 2020; 10:431-441. [PMID: 32695623 DOI: 10.21037/cdt-20-135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Cardiac magnetic resonance cine images are conventionally acquired in breath-hold with a segmented balanced steady-state free precession (bSSFP) sequence, which requires a relatively long acquisition time and high patient cooperation. The single-shot compressed sensing (ss CS) cine sequence is a real-time sequence that has reasonable spatial and temporal resolution and can be applied during free breathing. However, the contrast between the myocardium and surrounding soft tissue is relatively reduced, and the epicardial delineation results are not as accurate with the ss CS cine sequence compared with the bSSFP sequence. In this study, we evaluated the use of a 2-shot CS cine technique in quickly acquiring high-quality images and accurately assessing cardiac function in clinical practice. Methods The patients enrolled in the study underwent cardiovascular magnetic resonance (CMR) on a 3T scanner from Jul. to Dec. 2018. Cine imaging was performed with 3 different methods: a standard segment cine sequence, a real-time ss CS cine sequence, and a 2-shot CS cine sequence prototype. Quantitative analysis of image quality was performed using a 0-4 scoring system, and also edge sharpness was measured, and cardiac function analysis was performed for all 3 types of cine images. Results Thirty-eight patients underwent imaging with the three types of cine sequences. The average scan time of the standard cine sequence was 101±20 s, the average scan time of the ss CS cine sequence was 20±4 s, and the average scan time of the 2-shot CS cine sequence was 30±6 s. The standard cine sequence image score was 3.68±0.64 and edge sharpness was (2.47±0.18) mm, the ss CS cine sequence image score was 3.13±0.35 and edge sharpness was (4.69±0.02) mm, and the 2-shot cine sequence image score was 3.54±0.51 and the edge sharpness was (2.51±0.13) mm. In terms of the quantitative study of cardiac function, the differences between the standard cine sequence and the ss CS cine sequence were not statistically significant, except for those of the imaging score and LV mass. There were no significant differences in the cardiac function parameters between the standard cine sequence and the 2-shot cine sequence. There was a strong correlation between the standard cine and ss CS cine sequences and between the standard cine and 2-shot CS cine sequences (P<0.01) of all the cardiac function parameters. Conclusions The 2-shot CS cine sequence can acquire images with a level of quality comparable to that of the standard cine sequence in a significantly shorter period of time. The functional parameters are similar between the 2-shot CS cine sequence and the standard cine sequence.
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Affiliation(s)
- Jian Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lu Lin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing-Wen Dai
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi-Ning Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Reindl M, Eitel I, Reinstadler SJ. Role of Cardiac Magnetic Resonance to Improve Risk Prediction Following Acute ST-Elevation Myocardial Infarction. J Clin Med 2020; 9:E1041. [PMID: 32272692 PMCID: PMC7231095 DOI: 10.3390/jcm9041041] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiac magnetic resonance (CMR) imaging allows comprehensive assessment of myocardial function and tissue characterization in a single examination after acute ST-elevation myocardial infarction. Markers of myocardial infarct severity determined by CMR imaging, especially infarct size and microvascular obstruction, strongly predict recurrent cardiovascular events and mortality. The prognostic information provided by a comprehensive CMR analysis is incremental to conventional risk factors including left ventricular ejection fraction. As such, CMR parameters of myocardial tissue damage are increasingly recognized for optimized risk stratification to further ameliorate the burden of recurrent cardiovascular events in this population. In this review, we provide an overview of the current impact of CMR imaging on optimized risk assessment soon after acute ST-elevation myocardial infarction.
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Affiliation(s)
- Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria;
| | - Ingo Eitel
- University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Ratzeburger Allee 160, D-23538 Lübeck, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, D-23538 Lübeck, Germany
| | - Sebastian Johannes Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria;
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Compressed SENSE single-breath-hold and free-breathing cine imaging for accelerated clinical evaluation of the left ventricle. Clin Radiol 2019; 74:325.e9-325.e17. [DOI: 10.1016/j.crad.2018.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
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Real-time cardiac magnetic resonance cine imaging with sparse sampling and iterative reconstruction for left-ventricular measures: Comparison with gold-standard segmented steady-state free precession. Magn Reson Imaging 2017; 38:138-144. [PMID: 28065694 DOI: 10.1016/j.mri.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/18/2016] [Accepted: 01/04/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Segmented cine imaging with a steady-state free-precession sequence (Cine-SSFP) is currently the gold standard technique for measuring ventricular volumes and mass, but due to multi breath-hold (BH) requirements, it is prone to misalignment of consecutive slices, time consuming and dependent on respiratory capacity. Real-time cine avoids those limitations, but poor spatial and temporal resolution of conventional sequences has prevented its routine application. We sought to examine the accuracy and feasibility of a newly developed real-time sequence with aggressive under-sampling of k-space using sparse sampling and iterative reconstruction (Cine-RT). METHODS Stacks of short-axis cines were acquired covering both ventricles in a 1.5T system using gold standard Cine-SSFP and Cine-RT. Acquisition parameters for Cine-SSFP were: acquisition matrix of 224×196, temporal resolution of 39ms, retrospective gating, with an average of 8 heartbeats per slice and 1-2 slices/BH. For Cine-RT: acquisition matrix of 224×196, sparse sampling net acceleration factor of 11.3, temporal resolution of 41ms, prospective gating, real-time acquisition of 1 heart-beat/slice and all slices in one BH. LV contours were drawn at end diastole and systole to derive LV volumes and mass. RESULTS Forty-one consecutive patients (15 male; 41±17years) in sinus rhythm were successfully included. All images from Cine-SSFP and Cine-RT were considered to have excellent quality. Cine-RT-derived LV volumes and mass were slightly underestimated but strongly correlated with gold standard Cine-SSFP. Inter- and intra-observer analysis presented similar results between both sequences. CONCLUSIONS Cine-RT featuring sparse sampling and iterative reconstruction can achieve spatial and temporal resolution equivalent to Cine-SSFP, providing excellent image quality, with similar precision measurements and highly correlated and only slightly underestimated volume and mass values.
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Kido T, Kido T, Nakamura M, Watanabe K, Schmidt M, Forman C, Mochizuki T. Compressed sensing real-time cine cardiovascular magnetic resonance: accurate assessment of left ventricular function in a single-breath-hold. J Cardiovasc Magn Reson 2016; 18:50. [PMID: 27553656 PMCID: PMC4995641 DOI: 10.1186/s12968-016-0271-0] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/29/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cardiovascular cine magnetic resonance (CMR) accelerated by compressed sensing (CS) is used to assess left ventricular (LV) function. However, it is difficult for prospective CS cine CMR to capture the complete end-diastolic phase, which can lead to underestimation of the end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), compared to retrospective standard cine CMR. This prospective study aimed to evaluate the diagnostic quality and accuracy of single-breath-hold full cardiac cycle CS cine CMR, acquired over two heart beats, to quantify LV volume in comparison to multi-breath-hold standard cine CMR. METHODS Eighty-one participants underwent standard segmented breath-hold cine and CS real-time cine CMR examinations to obtain a stack of eight contiguous short-axis images with same high spatial (1.7 × 1.7 mm(2)) and temporal resolution (41 ms). Two radiologists independently performed qualitative analysis of image quality (score, 1 [i.e., "nondiagnostic"] to 5 [i.e., "excellent"]) and quantitative analysis of the LV volume measurements. RESULTS The total examination time was 113 ± 7 s for standard cine CMR and 24 ± 4 s for CS cine CMR (p < 0.0001). The CS cine image quality was slightly lower than standard cine (4.8 ± 0.5 for standard vs. 4.4 ± 0.5 for CS; p < 0.0001). However, all image quality scores for CS cine were above 4 (i.e., good). No significant differences existed between standard and CS cine MR for all quantitative LV measurements. The mean differences with 95 % confidence interval (CI), based on Bland-Altman analysis, were 1.3 mL (95 % CI, -14.6 - 17.2) for LV end-diastolic volume, 0.2 mL (95 % CI, -9.8 to10.3) for LV end-systolic volume, 1.1 mL (95 % CI, -10.5 to 12.7) for LV stroke volume, 1.0 g (95 % CI, -11.2 to 13.3) for LV mass, and 0.4 % (95 % CI, -4.8 - 5.6) for LV ejection fraction. The interobserver and intraobserver variability for CS cine MR ranged from -4.8 - 1.6 % and from -7.3 - 9.3 %, respectively, with slopes of the regressions ranging 0.88-1.0 and 0.86-1.03, respectively. CONCLUSIONS Single-breath-hold full cardiac cycle CS real-time cine CMR could evaluate LV volume with excellent accuracy. It may replace multi-breath-hold standard cine CMR.
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Affiliation(s)
- Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Masashi Nakamura
- Department of Radiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Kouki Watanabe
- Department of Cardiology, Saiseikai Matsuyama Hospital, 880-2, Yamanishi, Matsuyama, Ehime 791-8026 Japan
| | - Michaela Schmidt
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Christoph Forman
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
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Goebel J, Nensa F, Bomas B, Schemuth HP, Maderwald S, Gratz M, Quick HH, Schlosser T, Nassenstein K. Real-time SPARSE-SENSE cardiac cine MR imaging: optimization of image reconstruction and sequence validation. Eur Radiol 2016; 26:4482-4489. [PMID: 26960537 DOI: 10.1007/s00330-016-4301-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/25/2015] [Accepted: 02/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Improved real-time cardiac magnetic resonance (CMR) sequences have currently been introduced, but so far only limited practical experience exists. This study aimed at image reconstruction optimization and clinical validation of a new highly accelerated real-time cine SPARSE-SENSE sequence. METHODS Left ventricular (LV) short-axis stacks of a real-time free-breathing SPARSE-SENSE sequence with high spatiotemporal resolution and of a standard segmented cine SSFP sequence were acquired at 1.5 T in 11 volunteers and 15 patients. To determine the optimal iterations, all volunteers' SPARSE-SENSE images were reconstructed using 10-200 iterations, and contrast ratios, image entropies, and reconstruction times were assessed. Subsequently, the patients' SPARSE-SENSE images were reconstructed with the clinically optimal iterations. LV volumetric values were evaluated and compared between both sequences. RESULTS Sufficient image quality and acceptable reconstruction times were achieved when using 80 iterations. Bland-Altman plots and Passing-Bablok regression showed good agreement for all volumetric parameters. CONCLUSIONS 80 iterations are recommended for iterative SPARSE-SENSE image reconstruction in clinical routine. Real-time cine SPARSE-SENSE yielded comparable volumetric results as the current standard SSFP sequence. Due to its intrinsic low image acquisition times, real-time cine SPARSE-SENSE imaging with iterative image reconstruction seems to be an attractive alternative for LV function analysis. KEY POINTS • A highly accelerated real-time CMR sequence using SPARSE-SENSE was evaluated. • SPARSE-SENSE allows free breathing in real-time cardiac cine imaging. • For clinically optimal SPARSE-SENSE image reconstruction, 80 iterations are recommended. • Real-time SPARSE-SENSE imaging yielded comparable volumetric results as the reference SSFP sequence. • The fast SPARSE-SENSE sequence is an attractive alternative to standard SSFP sequences.
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Affiliation(s)
- Juliane Goebel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany.
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Bettina Bomas
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Haemi P Schemuth
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Marcel Gratz
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany.,High Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Harald H Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany.,High Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Thomas Schlosser
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Kai Nassenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
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Three-dimensional cardiac cine imaging using the kat ARC acceleration: Initial experience in clinical adult patients at 3T. Magn Reson Imaging 2015; 33:911-7. [PMID: 25936683 DOI: 10.1016/j.mri.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 03/02/2015] [Accepted: 04/18/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Three-dimensional cardiac cine imaging has demonstrated promising clinical 1.5-Tesla results; however, its application to 3T scanners has been limited because of the higher sensitivity to off-resonance artifacts. The aim of this study was to apply 3D cardiac cine imaging during a single breath hold in clinical patients on a 3T scanner using the kat ARC (k- and adaptive-t auto-calibrating reconstruction for Cartesian sampling) technique and to evaluate the interchangeability between 2D and 3D cine imaging for cardiac functional analysis and detection of abnormalities in regional wall motion. METHODS Following institutional review board approval, we obtained 2D cine images with an acceleration factor of two during multiple breath holds and 3D cine images with a net scan acceleration factor of 7.7 during a single breath hold in 20 patients using a 3T unit. Two readers independently evaluated the wall motion of the left ventricle (LV) using a 5-point scale, and the consistency in the detection of regional wall motion abnormality between 2D and 3D cine was analyzed by Cohen's kappa test. The LV volume was calculated at end-diastole and end-systole (LVEDV, LVESV); the ejection fraction (LVEF) and myocardial weight (LVmass) were also calculated. The relationship between functional parameters calculated for 2D and 3D cine images was analyzed using Pearson's correlation analysis. The bias and 95% limit of agreement (LA) were calculated using Bland-Altman plots. In addition, a qualitative evaluation of image quality was performed with regard to the myocardium-blood contrast, noise level and boundary definition. RESULTS Despite slight degradation in image quality for 3D cine, excellent agreement was obtained for the detection of wall motion abnormalities between 2D and 3D cine images (κ=0.84 and 0.94 for each reader). Excellent correlations between the two imaging methods were shown for the evaluation of functional parameters (r>0.97). Slight differences in LVEDV, LVESV, LVEF and LVmass were observed, with average values of 1.6±8.9mL, -0.6±5.9mL, 1.4±3.6%, and 1.3±8.7g, respectively. CONCLUSIONS Images obtained using the kat ARC 3D and conventional 2D cine techniques were equivalent in the detection of regional wall motion abnormalities and the evaluation of cardiac functional parameters.
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Coppo S, Piccini D, Bonanno G, Chaptinel J, Vincenti G, Feliciano H, van Heeswijk RB, Schwitter J, Stuber M. Free-running 4D whole-heart self-navigated golden angle MRI: Initial results. Magn Reson Med 2014; 74:1306-16. [PMID: 25376772 DOI: 10.1002/mrm.25523] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/01/2014] [Accepted: 10/16/2014] [Indexed: 12/22/2022]
Abstract
PURPOSE To test the hypothesis that both coronary anatomy and ventricular function can be assessed simultaneously using a single four-dimensional (4D) acquisition. METHODS A free-running 4D whole-heart self-navigated acquisition incorporating a golden angle radial trajectory was implemented and tested in vivo in nine healthy adult human subjects. Coronary magnetic resonance angiography (MRA) datasets with retrospective selection of acquisition window width and position were extracted and quantitatively compared with baseline self-navigated electrocardiography (ECG) -triggered coronary MRA. From the 4D datasets, the left-ventricular end-systolic, end-diastolic volumes (ESV & EDV) and ejection fraction (EF) were computed and compared with values obtained from conventional 2D cine images. RESULTS The 4D datasets enabled dynamic assessment of the whole heart with isotropic spatial resolution of 1.15 mm(3). Coronary artery image quality was very similar to that of the ECG-triggered baseline scan despite some SNR penalty. A good agreement between 4D and 2D cine imaging was found for EDV, ESV, and EF. CONCLUSION The hypothesis that both coronary anatomy and ventricular function can be assessed simultaneously in vivo has been tested positive. Retrospective and flexible acquisition window selection allows to best visualize each coronary segment at its individual time point of quiescence.
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Affiliation(s)
- Simone Coppo
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Davide Piccini
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare IM BM PI, Lausanne, Switzerland
| | - Gabriele Bonanno
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jérôme Chaptinel
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Gabriella Vincenti
- Department of Cardiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Hélène Feliciano
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Juerg Schwitter
- Department of Cardiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Matthias Stuber
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Vincenti G, Monney P, Chaptinel J, Rutz T, Coppo S, Zenge MO, Schmidt M, Nadar MS, Piccini D, Chèvre P, Stuber M, Schwitter J. Compressed Sensing Single–Breath-Hold CMR for Fast Quantification of LV Function, Volumes, and Mass. JACC Cardiovasc Imaging 2014; 7:882-92. [DOI: 10.1016/j.jcmg.2014.04.016] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/28/2022]
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de Marvao A, Dawes TJW, Shi W, Minas C, Keenan NG, Diamond T, Durighel G, Montana G, Rueckert D, Cook SA, O’Regan DP. Population-based studies of myocardial hypertrophy: high resolution cardiovascular magnetic resonance atlases improve statistical power. J Cardiovasc Magn Reson 2014; 16:16. [PMID: 24490638 PMCID: PMC3914701 DOI: 10.1186/1532-429x-16-16] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 01/29/2014] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cardiac phenotypes, such as left ventricular (LV) mass, demonstrate high heritability although most genes associated with these complex traits remain unidentified. Genome-wide association studies (GWAS) have relied on conventional 2D cardiovascular magnetic resonance (CMR) as the gold-standard for phenotyping. However this technique is insensitive to the regional variations in wall thickness which are often associated with left ventricular hypertrophy and require large cohorts to reach significance. Here we test whether automated cardiac phenotyping using high spatial resolution CMR atlases can achieve improved precision for mapping wall thickness in healthy populations and whether smaller sample sizes are required compared to conventional methods. METHODS LV short-axis cine images were acquired in 138 healthy volunteers using standard 2D imaging and 3D high spatial resolution CMR. A multi-atlas technique was used to segment and co-register each image. The agreement between methods for end-diastolic volume and mass was made using Bland-Altman analysis in 20 subjects. The 3D and 2D segmentations of the LV were compared to manual labeling by the proportion of concordant voxels (Dice coefficient) and the distances separating corresponding points. Parametric and nonparametric data were analysed with paired t-tests and Wilcoxon signed-rank test respectively. Voxelwise power calculations used the interstudy variances of wall thickness. RESULTS The 3D volumetric measurements showed no bias compared to 2D imaging. The segmented 3D images were more accurate than 2D images for defining the epicardium (Dice: 0.95 vs 0.93, P<0.001; mean error 1.3 mm vs 2.2 mm, P<0.001) and endocardium (Dice 0.95 vs 0.93, P<0.001; mean error 1.1 mm vs 2.0 mm, P<0.001). The 3D technique resulted in significant differences in wall thickness assessment at the base, septum and apex of the LV compared to 2D (P<0.001). Fewer subjects were required for 3D imaging to detect a 1 mm difference in wall thickness (72 vs 56, P<0.001). CONCLUSIONS High spatial resolution CMR with automated phenotyping provides greater power for mapping wall thickness than conventional 2D imaging and enables a reduction in the sample size required for studies of environmental and genetic determinants of LV wall thickness.
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Affiliation(s)
- Antonio de Marvao
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
| | - Timothy JW Dawes
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
| | - Wenzhe Shi
- Department of Computing, Imperial College London, Kensington Campus, Exhibition Road, London SW7 2AZ, UK
| | - Christopher Minas
- Department of Mathematics, Imperial College London, South Kensington Campus, Exhibition Road, London SW7 2AZ, UK
| | - Niall G Keenan
- Department of Cardiology, Imperial College NHS Healthcare Trust, Du Cane Road, London W12 0HS, UK
| | - Tamara Diamond
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
| | - Giuliana Durighel
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
| | - Giovanni Montana
- Department of Mathematics, Imperial College London, South Kensington Campus, Exhibition Road, London SW7 2AZ, UK
| | - Daniel Rueckert
- Department of Computing, Imperial College London, Kensington Campus, Exhibition Road, London SW7 2AZ, UK
| | - Stuart A Cook
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
- Department of Cardiology, National Heart Centre Singapore, 17 Third Hospital Ave, Singapore 168752, Singapore
- Duke-NUS, 8 College Road, Singapore 169857, Singapore
| | - Declan P O’Regan
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK
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Jaroni J, Meier R, Beer A, Herrmann K, Settles M, Rummeny EJ, Huber A. Three-dimensional magnetic resonance imaging using single breath-hold k-t BLAST for assessment of global left ventricular functional parameters. Acad Radiol 2013; 20:987-94. [PMID: 23830604 DOI: 10.1016/j.acra.2013.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/04/2013] [Accepted: 03/17/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the accuracy of three-dimensional k-t broad-use linear acquisition speed-up technique (k-t BLAST) accelerated magnetic resonance imaging (MRI) for the assessment of left ventricular (LV) parameters compared to segmented multiple breath-hold cine imaging. METHODS A multislice cine (steady state free precession [SSFP]) sequence was performed with complete ventricular coverage during multiple breath-holds (temporal resolution 47 ms, voxel size 1.25 × 1.25 × 8 mm(3)). In addition, two k-t BLAST sequences with complete coverage were acquired, KT1 (temporal resolution 57 ms, voxel size 1.25 × 1.25 × 4 mm(3)) and k-t2 (temporal resolution 57 ms, voxel size 1.25 × 1.25 × 8 mm(3)), during a single breath-hold. For comparison of SSFP and k-t BLAST, LV parameters were determined: ejection fraction (EF), end-diastolic volume, end-systolic volume, and LV mass. RESULTS EF was underestimated by KT1 (47%) and KT2 (48%) compared to the SSFP sequence (53%). All parameters showed high correlation with the k-t BLAST sequences and the SSFP sequence (r = 0.88-0.98, P < .001). The mean relative difference for KT1/KT2 compared to the SSFP sequence was -0.11/-0.09 for the EF, -0.073/-0.086 for the EDV, 0.044/0.051 for the ESV, and 0.085/0.12 for the LV mass. CONCLUSIONS The use of three-dimensional k-t BLAST enabled a determination of the LV parameters with high correlation compared to the SSFP sequence. EF was slightly underestimated, and LV mass was slightly overestimated.
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Affiliation(s)
- Jennifer Jaroni
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
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Marshall I, Jansen MA, Tao Y, Merrifield GD, Gray GA. Application of kt-BLAST acceleration to reduce cardiac MR imaging time in healthy and infarcted mice. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 27:201-10. [PMID: 23836162 PMCID: PMC4042009 DOI: 10.1007/s10334-013-0392-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/20/2013] [Accepted: 06/20/2013] [Indexed: 11/29/2022]
Abstract
Object We evaluated the use of kt-broad-use linear acquisition speed-up technique (kt-BLAST) acceleration of mouse cardiac imaging in order to reduce scan times, thereby minimising physiological variation and improving animal welfare.
Materials and methods Conventional cine cardiac MRI data acquired from healthy mice (n = 9) were subsampled to simulate kt-BLAST acceleration. Cardiological indices (left ventricular volume, ejection fraction and mass) were determined as a function of acceleration factor. kt-BLAST threefold undersampling was implemented on the scanner and applied to a second group of mice (n = 6 healthy plus 6 with myocardial infarct), being compared with standard cine imaging (3 signal averages) and cine imaging with one signal average. Results In the simulations, sufficient accuracy was achieved for undersampling factors up to three. Cardiological indices determined from the implemented kt-BLAST scanning showed no significant differences compared with the values determined from the standard sequence, and neither did indices derived from the cine scan with only one signal average despite its lower signal-to-noise ratio. Both techniques were applied successfully in the infarcted hearts. Conclusion For cardiac imaging of mice, threefold undersampling of kt-space, or a similar reduction in the number of signal averages, are both feasible with subsequent reduction in imaging time.
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Affiliation(s)
- Ian Marshall
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK,
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Xu J, Kim D, Otazo R, Srichai MB, Lim RP, Axel L, Mcgorty KA, Niendorf T, Sodickson DK. Towards a five-minute comprehensive cardiac MR examination using highly accelerated parallel imaging with a 32-element coil array: feasibility and initial comparative evaluation. J Magn Reson Imaging 2013; 38:180-8. [PMID: 23197471 PMCID: PMC3615039 DOI: 10.1002/jmri.23955] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 10/11/2012] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate the feasibility and perform initial comparative evaluations of a 5-minute comprehensive whole-heart magnetic resonance imaging (MRI) protocol with four image acquisition types: perfusion (PERF), function (CINE), coronary artery imaging (CAI), and late gadolinium enhancement (LGE). MATERIALS AND METHODS This study protocol was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board-approved. A 5-minute comprehensive whole-heart MRI examination protocol (Accelerated) using 6-8-fold-accelerated volumetric parallel imaging was incorporated into and compared with a standard 2D clinical routine protocol (Standard). Following informed consent, 20 patients were imaged with both protocols. Datasets were reviewed for image quality using a 5-point Likert scale (0 = non-diagnostic, 4 = excellent) in blinded fashion by two readers. RESULTS Good image quality with full whole-heart coverage was achieved using the accelerated protocol, particularly for CAI, although significant degradations in quality, as compared with traditional lengthy examinations, were observed for the other image types. Mean total scan time was significantly lower for the Accelerated as compared to Standard protocols (28.99 ± 4.59 min vs. 1.82 ± 0.05 min, P < 0.05). Overall image quality for the Standard vs. Accelerated protocol was 3.67 ± 0.29 vs. 1.5 ± 0.51 (P < 0.005) for PERF, 3.48 ± 0.64 vs. 2.6 ± 0.68 (P < 0.005) for CINE, 2.35 ± 1.01 vs. 2.48 ± 0.68 (P = 0.75) for CAI, and 3.67 ± 0.42 vs. 2.67 ± 0.84 (P < 0.005) for LGE. Diagnostic image quality for Standard vs. Accelerated protocols was 20/20 (100%) vs. 10/20 (50%) for PERF, 20/20 (100%) vs. 18/20 (90%) for CINE, 18/20 (90%) vs. 18/20 (90%) for CAI, and 20/20 (100%) vs. 18/20 (90%) for LGE. CONCLUSION This study demonstrates the technical feasibility and promising image quality of 5-minute comprehensive whole-heart cardiac examinations, with simplified scan prescription and high spatial and temporal resolution enabled by highly parallel imaging technology. The study also highlights technical hurdles that remain to be addressed. Although image quality remained diagnostic for most scan types, the reduced image quality of PERF, CINE, and LGE scans in the Accelerated protocol remain a concern.
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Affiliation(s)
- Jian Xu
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
- PolyTechnic Institute of New York University, Brooklyn, New York, NY, USA
- Siemens Medical Solutions USA Inc., New York, NY, USA
| | - Daniel Kim
- Radiology, The University of Utah, Salt Lake City, Utah, USA
| | - Ricardo Otazo
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Monvadi B. Srichai
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Ruth. P. Lim
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Leon Axel
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Kelly Anne Mcgorty
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | | | - Daniel K. Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
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Biglands JD, Radjenovic A, Ridgway JP. Cardiovascular magnetic resonance physics for clinicians: Part II. J Cardiovasc Magn Reson 2012; 14:66. [PMID: 22995744 PMCID: PMC3533879 DOI: 10.1186/1532-429x-14-66] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 09/13/2012] [Indexed: 01/08/2023] Open
Abstract
This is the second of two reviews that is intended to cover the essential aspects of cardiovascular magnetic resonance (CMR) physics in a way that is understandable and relevant to clinicians using CMR in their daily practice. Starting with the basic pulse sequences and contrast mechanisms described in part I, it briefly discusses further approaches to accelerate image acquisition. It then continues by showing in detail how the contrast behaviour of black blood fast spin echo and bright blood cine gradient echo techniques can be modified by adding rf preparation pulses to derive a number of more specialised pulse sequences. The simplest examples described include T2-weighted oedema imaging, fat suppression and myocardial tagging cine pulse sequences. Two further important derivatives of the gradient echo pulse sequence, obtained by adding preparation pulses, are used in combination with the administration of a gadolinium-based contrast agent for myocardial perfusion imaging and the assessment of myocardial tissue viability using a late gadolinium enhancement (LGE) technique. These two imaging techniques are discussed in more detail, outlining the basic principles of each pulse sequence, the practical steps required to achieve the best results in a clinical setting and, in the case of perfusion, explaining some of the factors that influence current approaches to perfusion image analysis. The key principles of contrast-enhanced magnetic resonance angiography (CE-MRA) are also explained in detail, especially focusing on timing of the acquisition following contrast agent bolus administration, and current approaches to achieving time resolved MRA. Alternative MRA techniques that do not require the use of an endogenous contrast agent are summarised, and the specialised pulse sequence used to image the coronary arteries, using respiratory navigator gating, is described in detail. The article concludes by explaining the principle behind phase contrast imaging techniques which create images that represent the phase of the MR signal rather than the magnitude. It is shown how this principle can be used to generate velocity maps by designing gradient waveforms that give rise to a relative phase change that is proportional to velocity. Choice of velocity encoding range and key pitfalls in the use of this technique are discussed.
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Affiliation(s)
- John D Biglands
- Division of Medical Physics, University of Leeds, Leeds, UK
- Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, 1st Floor, Bexley Wing, St James's University Hospital, Leeds, LS9 7TF, UK
- Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - Aleksandra Radjenovic
- NIHR-Leeds Musculoskeletal Biomedical Research Unit and Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
- Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - John P Ridgway
- Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, 1st Floor, Bexley Wing, St James's University Hospital, Leeds, LS9 7TF, UK
- Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
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Makowski MR, Wiethoff AJ, Jansen CHP, Uribe S, Parish V, Schuster A, Botnar RM, Bell A, Kiesewetter C, Razavi R, Schaeffter T, Greil GF. Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique--comparison of an intravascular and extravascular contrast agent. J Cardiovasc Magn Reson 2012; 14:53. [PMID: 22849703 PMCID: PMC3438073 DOI: 10.1186/1532-429x-14-53] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 07/10/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). METHODS LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18-25 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. RESULTS All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, Bland-Altman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD. CONCLUSIONS A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function.
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Affiliation(s)
- Marcus R Makowski
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Department of Radiology, Charite, Berlin, Germany
| | - Andrea J Wiethoff
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Philips Healthcare, Guildford, UK
| | - Christian HP Jansen
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Sergio Uribe
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Radiology Department and Biomedical Imaging Center, School of Medicine, Pontifica Universidad Catolica de Chile
| | - Victoria Parish
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Andreas Schuster
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Rene M Botnar
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Aaron Bell
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Christoph Kiesewetter
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Reza Razavi
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Tobias Schaeffter
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Gerald F Greil
- King’s College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
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Serial monitoring of reverse left-atrial remodeling after pulmonary vein isolation in patients with atrial fibrillation: A magnetic resonance imaging study. Int J Cardiol 2011; 153:42-6. [DOI: 10.1016/j.ijcard.2010.08.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/18/2010] [Accepted: 08/07/2010] [Indexed: 11/20/2022]
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Rochitte CE, Azevedo CF, Rosário MA, Siqueira MHR, Monsão V, Saranathan M, Foo TK, Kalil Filho R, Cerri GG, Ramires JAF. Single-Breathhold Four-Dimensional Assessment of Left Ventricular Morphological and Functional Parameters by Magnetic Resonance Imaging Using the VAST Technique. Open Cardiovasc Med J 2011; 5:90-8. [PMID: 21673978 PMCID: PMC3111704 DOI: 10.2174/1874192401105010090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 02/10/2011] [Accepted: 02/11/2011] [Indexed: 12/18/2022] Open
Abstract
Introduction: The accurate and reproducible assessment of cardiac volumes, function, and mass is of paramount importance in cardiology. In the present study we sought to determine whether the 3D cine-magnetic resonance (MR) technique, using the variable asymmetric sampling in time (VAST) approach, provided an accurate assessment of LV functional parameters when compared with the conventional 2D cine-MR technique. Methods: A total of 43 consecutive patients referred for a CMR examination for clinical reasons and 14 healthy volunteers were included in the study. Cine images were acquired using a steady-state free precession pulse sequence. Two different multiphase acquisitions were performed: conventional 2D cine-MR and 3D cine-MR. The short-axis cine images acquired by both cine-MR techniques were used for the quantitative assessment of LV end-diastolic, end-systolic and stroke volumes, LV mass and ejection fraction. Results: All CMR examinations were completed successfully, with both cine-MR imaging techniques yielding interpretable diagnostic results in all patients. Regarding the quantitative assessment, Bland-Altman analyses demonstrated a good agreement between the measurements of both cine-MR techniques for all LV parameters. In addition, the agreement between 2D and 3D cine-MR techniques for the qualitative assessment of LV global function was perfect (kappa = 1.0, P<0.001) for the two observers in consensus. The assessment performed by the third independent observer also demonstrated very good agreement (kappa = 0.88, P<0.001). Conclusion: The single breathhold 3D cine-MR technique provides an accurate and reproducible quantitative assessment of LV volumes, mass and function when compared with the conventional 2D cine-MR method.
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Maffei E, Messalli G, Martini C, Rossi A, van Pelt N, van Geuns RJ, Weustink AC, Mollet NR, Nieman K, Aldrovandi A, Imbriaco M, Bogaert J, Cademartiri F. Magnetic resonance assessment of left ventricular volumes and mass using a single-breath-hold 3D k-t BLAST cine b-SSFP in comparison with multiple-breath-hold 2D cine b-SSFP. Insights Imaging 2011; 2:39-45. [PMID: 22865424 PMCID: PMC3288975 DOI: 10.1007/s13244-010-0056-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 10/07/2010] [Accepted: 11/25/2010] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the feasibility of single-breath-hold three-dimensional cine b-SSFP (balanced steady-state free precession gradient echo) sequence (3D-cine), accelerated with k-t BLAST (broad-use linear acquisition speed-up technique), compared with multiple-breath-hold 2D cine b-SSFP (2D-cine) sequence for assessment of left ventricular (LV) function. Methods Imaging was performed using 1.5-T MRI (Achieva, Philips, The Netherlands) in 46 patients with different cardiac diseases. Global functional parameters, LV mass, imaging time and reporting time were evaluated and compared in each patient. Results Functional parameters and mass were significantly different in the two sequences [3D end-diastolic volume (EDV) = 129 ± 44 ml vs 2D EDV = 134 ± 49 ml; 3D end-systolic volume (ESV) = 77 ± 44 ml vs 2D ESV = 73 ± 50 ml; 3D ejection fraction (EF) = 43 ± 15% vs 2D EF = 48 ± 15%; p < 0.05], although an excellent correlation was found for LV EF (r = 0.99). Bland-Altman analysis showed small confidence intervals with no interactions on volumes (EF limits of agreement = 2.7; 7.6; mean bias 5%). Imaging time was significantly lower for 3D-cine sequence (18 ± 1 s vs 95 ± 23 s; p < 0.05), although reporting time was significantly longer for the 3D-cine sequence (29 ± 7 min vs 8 ± 3 min; p < 0.05). Conclusions A 3D-cine sequence can be advocated as an alternative to 2D-cine sequence for LV EF assessment in patients for whom shorter imaging time is desirable.
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Affiliation(s)
- Erica Maffei
- Department of Radiology and Cardiology, University Hospital, Parma, Italy
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Lutz A, Bornstedt A, Manzke R, Etyngier P, Nienhaus GU, Rasche V. Acceleration of tissue phase mapping by k-t BLAST: a detailed analysis of the influence of k-t-BLAST for the quantification of myocardial motion at 3T. J Cardiovasc Magn Reson 2011; 13:5. [PMID: 21223566 PMCID: PMC3024407 DOI: 10.1186/1532-429x-13-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 01/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The assessment of myocardial motion with tissue phase mapping (TPM) provides high spatiotemporal resolution and quantitative motion information in three directions. Today, whole volume coverage of the heart by TPM encoding at high spatial and temporal resolution is limited by long data acquisition times. Therefore, a significant increase in imaging speed without deterioration of the quantitative motion information is required. For this purpose, the k-t BLAST acceleration technique was combined with TPM black-blood functional imaging of the heart. Different k-t factors were evaluated with respect to their impact on the quantitative assessment of cardiac motion. RESULTS It is demonstrated that a k-t BLAST factor of two can be used with a marginal, but statistically significant deterioration of the quantitative motion data. Further increasing the k-t acceleration causes substantial alteration of the peak velocities and the motion pattern, but the temporal behavior of the contraction is well maintained up to an acceleration factor of six. CONCLUSIONS The application of k-t BLAST for the acceleration of TPM appears feasible. A reduction of the acquisition time of almost 45% could be achieved without substantial loss of quantitative motion information.
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Affiliation(s)
- Anja Lutz
- Department of Internal Medicine II, University Hospital of Ulm, Ulm, Baden-Württemberg, Germany
| | - Axel Bornstedt
- Department of Internal Medicine II, University Hospital of Ulm, Ulm, Baden-Württemberg, Germany
| | | | | | - G Ulrich Nienhaus
- Institute of Applied Physics Karlsruhe, Institute of Technology (KIT), Karlsruhe, Germany
| | - Volker Rasche
- Department of Internal Medicine II, University Hospital of Ulm, Ulm, Baden-Württemberg, Germany
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Liu J, Wieben O, Jung Y, Samsonov AA, Reeder SB, Block WF. Single breathhold cardiac CINE imaging with multi-echo three-dimensional hybrid radial SSFP acquisition. J Magn Reson Imaging 2010; 32:434-40. [PMID: 20677274 DOI: 10.1002/jmri.22269] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To achieve single breathhold whole heart cardiac CINE imaging with improved spatial resolution and temporal resolution by using a multi-echo three-dimensional (3D) hybrid radial SSFP acquisition. MATERIALS AND METHODS Multi-echo 3D hybrid radial SSFP acquisitions were used to acquire cardiac CINE imaging within a single breathhold. An optimized interleaving scheme was developed for view ordering throughout the cardiac cycle. RESULTS Whole heart short axis views were acquired with a spatial resolution of 1.3 x 1.3 x 8.0 mm(3) and temporal resolution of 45 ms, within a single 17 s breathhold. The technique was validated on eight healthy volunteers by measuring the left ventricular volume throughout the cardiac cycle and comparing with the conventional 2D multiple breathhold technique. The left ventricle functional measurement bias of our proposed 3D technique from the conventional 2D technique: end diastolic volume -3.3 mL +/- 13.7 mL, end systolic volume 1.4 mL +/- 6.1 mL, and ejection fraction -1.7% +/- 4.3%, with high correlations 0.94, 0.97, and 0.91, accordingly. CONCLUSION A multi-echo 3D hybrid radial SSFP acquisition was developed to allow for a whole heart cardiac CINE exam in a single breathhold. Cardiac function measurements in volunteers compared favorably with the standard multiple breathhold exams.
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Affiliation(s)
- Jing Liu
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Wisconsin, USA.
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Parish V, Hussain T, Beerbaum P, Greil G, Nagel E, Razavi R, Schaeffter T, Uribe S. Single breath-hold assessment of ventricular volumes using 32-channel coil technology and an extracellular contrast agent. J Magn Reson Imaging 2010; 31:838-44. [PMID: 20373427 DOI: 10.1002/jmri.22061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate the feasibility of a single breath-hold 3D cine balanced steady-state free precession (b-SSFP) sequence after gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) injection for volumetric cardiac assessment. MATERIALS AND METHODS Fifteen adult patients routinely referred for cardiac magnetic resonance imaging (MRI) underwent quantitative ventricular volumetry on a clinical 1.5T MR-scanner using a 32-channel cardiac coil. A stack of 2D cine b-SSFP slices covering the ventricles was used as reference, followed by a single breath-hold 3D cine balanced SSFP protocol acquired before and after administration of Gd-DTPA. The acquisition was accelerated using SENSE in both phase encoding directions. Volumetric and contrast-to-noise data for each technique were assessed and compared. RESULTS The 3D cine protocol was accomplished within one breath-hold (mean acquisition time 20 sec; spatial resolution 2.1 x 2.1 x 10 mm; temporal resolution 51 msec). The contrast-to-noise ratio between blood and myocardium was 234 determined for the multiple 2D cine data, and could be increased for the 3D acquisition from 136 (3D precontrast) to 203 (3D postcontrast) after injecting Gd-DTPA. In addition the endocardial definition was significantly improved in postcontrast 3D cine b-SSFP. There was no significant difference for left and right ventricular volumes between standard 2D and 3D postcontrast cine b-SSFP. However, Bland-Altman plots showed greater bias and scatter when comparing 2D with 3D cine b-SSFP without contrast. CONCLUSION 3D cine b-SSFP imaging of the heart using 32 channel coil technology and spatial undersampling allows reliable volumetric assessment within a single breath-hold after application of Gd-DTPA.
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Affiliation(s)
- Victoria Parish
- Division of Imaging Sciences, NIHR Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust, King's College London, London, UK.
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Omoumi P, Métais J, Bertrand P, Alison D. Volumétrie et fraction d’éjection ventriculaires gauches et droites en IRM : critères de contourage et reproductibilité interobservateur. ACTA ACUST UNITED AC 2010; 91:769-78. [DOI: 10.1016/s0221-0363(10)70114-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Manka R, Buehrer M, Boesiger P, Fleck E, Kozerke S. Performance of simultaneous cardiac-respiratory self-gated three-dimensional MR imaging of the heart: initial experience. Radiology 2010; 255:909-16. [PMID: 20501728 DOI: 10.1148/radiol.10091103] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study was approved by the local institutional ethics committee, and informed consent was obtained from all volunteers and patients. The objective of the present study was to assess the performance of high-spatial-resolution three-dimensional prospective cardiac-respiratory self-gated (CRSG) magnetic resonance (MR) imaging for determining left ventricular (LV) volumes and mass, as well as right ventricular (RV) volumes, in comparison with standard electrocardiography (ECG)-triggered, two-dimensional multisection, multiple-breath-hold cine imaging. The self-gated method derives cardiac triggering and respiratory gating information prospectively on the basis of additional MR imaging signals acquired in every repetition time and, thereby, eliminates the need for ECG triggering and multiple-breath-hold procedures. Data were acquired in 15 healthy volunteers (mean age, 27.2 years +/- 7.2 [standard deviation]) and 11 patients (mean age, 60.7 years +/- 11.3). The bias between the self-gating and the reference imaging techniques was minimal for all LV and RV parameters (mean values: LV end-diastolic volume, 2.0 mL; LV end-systolic volume, 0.6 mL; RV end-diastolic volume, 2.2 mL; and RV end-systolic volume, 0.8 mL). Prospective CRSG is a valuable alternative to ECG-triggered, multisection, multiple-breath-hold cine imaging of the heart and holds considerable promise for simplifying functional imaging of the heart, particularly in patients who are unable to hold their breath for a long period and patients who show ECG signal disturbances.
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Affiliation(s)
- Robert Manka
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland.
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26
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Attili AK, Schuster A, Nagel E, Reiber JHC, van der Geest RJ. Quantification in cardiac MRI: advances in image acquisition and processing. Int J Cardiovasc Imaging 2010; 26 Suppl 1:27-40. [PMID: 20058082 PMCID: PMC2816803 DOI: 10.1007/s10554-009-9571-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Accepted: 12/18/2009] [Indexed: 12/25/2022]
Abstract
Cardiac magnetic resonance (CMR) imaging enables accurate and reproducible quantification of measurements of global and regional ventricular function, blood flow, perfusion at rest and stress as well as myocardial injury. Recent advances in MR hardware and software have resulted in significant improvements in image quality and a reduction in imaging time. Methods for automated and robust assessment of the parameters of cardiac function, blood flow and morphology are being developed. This article reviews the recent advances in image acquisition and quantitative image analysis in CMR.
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Affiliation(s)
- Anil K Attili
- Department of Radiology and Cardiology, University of Kentucky, Lexington, KY, USA
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27
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Rapid MR assessment of left ventricular systolic function after acute myocardial infarction using single breath-hold cine imaging with the temporal parallel acquisition technique (TPAT) and 4D guide-point modelling analysis of left ventricular function. Eur Radiol 2009; 20:73-80. [DOI: 10.1007/s00330-009-1522-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 06/02/2009] [Accepted: 06/22/2009] [Indexed: 11/25/2022]
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28
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Lockie T, Nagel E, Redwood S, Plein S. Use of cardiovascular magnetic resonance imaging in acute coronary syndromes. Circulation 2009; 119:1671-81. [PMID: 19332480 DOI: 10.1161/circulationaha.108.816512] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Tim Lockie
- Division of Imaging Sciences, The Rayne Institute, KCL, St. Thomas' Campus, London, UK
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29
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Hamdan A, Kelle S, Schnackenburg B, Wellnhofer E, Fleck E, Nagel E. Single-breathhold four-dimensional assessment of left ventricular volumes and function using k-t BLAST after application of extracellular contrast agent at 3 Tesla. J Magn Reson Imaging 2008; 27:1028-36. [PMID: 18425828 DOI: 10.1002/jmri.21332] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To prospectively determine the feasibility and accuracy of a four-dimensional (4D) k-space over time broad-use linear acquisition speed-up technique (k-t BLAST) for the evaluation of left ventricular (LV) volumes in comparison to standard multiple-breathhold cine imaging, using a 3.0 Tesla (3T) MR system. MATERIALS AND METHODS In 23 subjects, short-axis cine loops completely covering the LV were acquired using conventional turbo gradient echo (GRE) imaging. Immediately after administration of gadobenate dimeglumine, a rapid single-breathhold k-t BLAST 4D dataset with the same coverage was acquired and reconstructed to short-axis views. Quantitative aortic flow measurement for LV stroke volume (LVSV) was used to calibrate both techniques. For GRE and k-t BLAST cine imaging: LV volumes, ejection fraction (EF), and blood-to-myocardium-contrast (BMC) were determined. RESULTS k-t BLAST and GRE sequences showed a strong correlation for LV volumes and EF (r = 0.97-0.99; P < 0.001). Excellent agreement was also found between the LVSV determined by aortic flow measurements and LVSV assessed using GRE sequence and k-t BLAST sequence. BMC of GRE was similar to that of k-t BLAST cine imaging. CONCLUSION The use of the single-breathhold 4D k-t BLAST technique for the assessment of LV volume is feasible and accurate in 3T MRI.
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Affiliation(s)
- Ashraf Hamdan
- Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Berlin, Germany.
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Uribe S, Tangchaoren T, Parish V, Wolf I, Razavi R, Greil G, Schaeffter T. Volumetric Cardiac Quantification by Using 3D Dual-Phase Whole-Heart MR Imaging. Radiology 2008; 248:606-14. [DOI: 10.1148/radiol.2482071568] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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31
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Thunberg P, Emilsson K, Rask P, Kähäri A. Separating the left cardiac ventricle from the atrium in short axis MR images using the equation of the atrioventricular plane. Clin Physiol Funct Imaging 2008; 28:222-8. [PMID: 18325030 DOI: 10.1111/j.1475-097x.2008.00799.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Short axis (SA) images obtained from cardiac magnetic resonance imaging are used to advantage in the calculation of important clinical parameters such as the ejection fraction and stroke volume (SV). A prerequisite for these calculations is the separation of the left ventricle and the left atrium. When only using the information seen in the SA images this separation can be a source of error due to the through-plane motion of the basal part of the left ventricle. In this study a method is proposed where the separation of the left ventricle and the atrium is performed by identifying the intersections of the atrioventricular plane in the SA images. The equation of the atrioventricular plane was determined in both systole and diastole using long axis and four chamber image views. Stroke volumes were measured in 20 patients using SA images where the endocardium had been delineated. The SV obtained using the new method was compared with quantitative flow measurements and the conventional technique for calculation of SV from SA images, respectively. The agreement of SV was, according to Bland-Altman analysis, 2.0 ml (95% CI -12.0 to 15.9 ml) in comparison with the flow measurements and 2.2 ml (95% CI -9.2 to 13.6 ml) compared to the conventional method. Inter- and intra-observer variability, when using the new proposed method, was small. This study shows that the identification of the left atrioventricular plane in SA images can be used in the separation of the left atrium and ventricle.
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Affiliation(s)
- Per Thunberg
- Department of Biomedical Engineering, Orebro University Hospital, Orebro, Sweden.
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32
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Huber S, Muthupillai R, Mojibian H, Cheong B, Kouwenhoven M, Flamm SD. Rapid assessment of regional and global left ventricular function using three-dimensional k-t BLAST imaging. Magn Reson Imaging 2008; 26:727-38. [DOI: 10.1016/j.mri.2008.01.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 12/26/2007] [Accepted: 01/06/2008] [Indexed: 11/28/2022]
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Kozerke S, Plein S. Accelerated CMR using zonal, parallel and prior knowledge driven imaging methods. J Cardiovasc Magn Reson 2008; 10:29. [PMID: 18534005 PMCID: PMC2426690 DOI: 10.1186/1532-429x-10-29] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Accepted: 06/05/2008] [Indexed: 11/17/2022] Open
Abstract
Accelerated imaging is highly relevant for many CMR applications as competing constraints with respect to spatiotemporal resolution and tolerable scan times are frequently posed. Three approaches, all involving data undersampling to increase scan efficiencies, are discussed in this review. Zonal imaging can be considered a niche but nevertheless has found application in coronary imaging and CMR flow measurements. Current work on parallel-transmit systems is expected to revive the interest in zonal imaging techniques. The second and main approach to speeding up CMR sequences has been parallel imaging. A wide range of CMR applications has benefited from parallel imaging with reduction factors of two to three routinely applied for functional assessment, perfusion, viability and coronary imaging. Large coil arrays, as are becoming increasingly available, are expected to support reduction factors greater than three to four in particular in combination with 3D imaging protocols. Despite these prospects, theoretical work has indicated fundamental limits of coil encoding at clinically available magnetic field strengths. In that respect, alternative approaches exploiting prior knowledge about the object being imaged as such or jointly with parallel imaging have attracted considerable attention. Five to eight-fold scan accelerations in cine and dynamic CMR applications have been reported and image quality has been found to be favorable relative to using parallel imaging alone.With all acceleration techniques, careful consideration of the limits and the trade-off between acceleration and occurrence of artifacts that may arise if these limits are breached is required. In parallel imaging the spatially varying noise has to be considered when measuring contrast- and signal-to-noise ratios. Also, temporal fidelity in images reconstructed with prior knowledge driven methods has to be studied carefully.
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Affiliation(s)
- Sebastian Kozerke
- Institute for Biomedical Engineering, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Sven Plein
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
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Maredia N, Kozerke S, Larghat A, Abidin N, Greenwood JP, Boesiger P, Plein S. Measurement of left ventricular dimensions with contrast-enhanced three-dimensional cine imaging facilitated by k-t SENSE. J Cardiovasc Magn Reson 2008; 10:27. [PMID: 18507849 PMCID: PMC2435112 DOI: 10.1186/1532-429x-10-27] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 05/28/2008] [Indexed: 12/20/2022] Open
Abstract
AIM To compare three-dimensional (3D) k-t sensitivity encoded (k-t SENSE) cine cardiovascular magnetic resonance (CMR), before and after contrast administration, against standard 2D imaging for the assessment of left ventricular volumes and mass. METHOD Twenty-six subjects (14 volunteers, 12 patients) underwent multiple breathhold 2D balanced turbo-field echo cine CMR in addition to k-t SENSE accelerated 3D imaging (acceleration factor 5; 5x k-t SENSE), performed before and after administration of a high-relaxivity gadolinium-based contrast agent (Gadobutrolum). k-t acceleration factors of 7 and 10 were also assessed in six volunteers. Left ventricular end diastolic volume (EDV), end systolic volume (ESV), mass, and ejection fraction (EF) were calculated for each method. RESULTS There was at least moderate agreement between the EDV, ESV, mass and EF calculated by 2D and 3D 5x k-t SENSE methods before contrast (concordance coefficients 0.92, 0.95, 0.97, 0.92, respectively). Agreement improved following contrast (concordance coefficients 0.97, 0.99, 0.98, 0.93, respectively). The 3D method underestimated all parameters compared to 2D (mean bias pre-contrast 6.1 ml, 0.6 ml, 3.5 g, 2.0% respectively). 3D image quality scores were significantly poorer than 2D, showing a non-significant trend to improvement following contrast administration. Parameters derived with k-t acceleration factors of 7 and 10 showed poorer agreement with 2D values. CONCLUSION Left ventricular volumes and mass are reliably assessed using 3D 5x k-t SENSE accelerated CMR. Contrast administration further improves agreement between 5x k-t SENSE and 2D-derived measurements. k-t acceleration factors greater than 5, though feasible, produce poorer agreement with 2D values.
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Affiliation(s)
- Neil Maredia
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Abdul Larghat
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
| | - Nik Abidin
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
| | - John P Greenwood
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
| | - Peter Boesiger
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sven Plein
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Young AA, Cowan BR, Schoenberg SO, Wintersperger BJ. Feasibility of single breath-hold left ventricular function with 3 Tesla TSENSE acquisition and 3D modeling analysis. J Cardiovasc Magn Reson 2008; 10:24. [PMID: 18495040 PMCID: PMC2413233 DOI: 10.1186/1532-429x-10-24] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 05/21/2008] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A single breath-hold evaluation of ventricular function would allow assessment in cases where scan time or patient tolerance is limited. Spatiotemporal acceleration techniques such as TSENSE decrease cardiovascular MR acquisition time, but standard slice summation analysis requires enough short axis slices to cover the left ventricle (LV). By reducing the number of short axis slices, incorporating long axis slices, and applying a 3D model based analysis, it may be possible to obtain accurate LV mass and volumes. We evaluated LV volume, mass and ejection fraction at 3.0 T using a 3D modeling analysis in 9 patients with a history of myocardial infarction and one healthy volunteer. Acquisition consisted of a standard short axis SSFP stack and a 15 heart-beat single breath-hold six slice multi-planar (4 short and 2 long axis) TSENSE SSFP protocol with an acceleration factor of R = 4. RESULTS Differences (standard minus accelerated protocol mean +/- s.d.) and coefficients of variation (s.d. of differences as a percentage of the average estimate) were 7.5 +/- 9.6 mL and 6% for end-diastolic volume (p = 0.035), 0.4 +/- 5.1 mL and 7% for end-systolic volume (p = NS), 7.1 +/- 8.1 mL and 9% for stroke volume (p = 0.022), 2.2 +/- 2.8% and 5% for ejection fraction (p = 0.035), and -7.1 +/- 6.2 g and 4% for LV mass (p = 0.005), respectively. Intra- and inter-observer errors were similar for both protocols (p = NS for all measures). CONCLUSION These results suggest that clinically useful estimates of LV function can be obtained in a TSENSE accelerated single breath-hold reduced slice acquisition at 3T using 3D modeling analysis techniques.
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Affiliation(s)
- Alistair A Young
- Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
| | - Brett R Cowan
- Auckland MRI Research Group, University of Auckland, Auckland, New Zealand
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernd J Wintersperger
- Department of Clinical Radiology, University Hospitals Munich-Grosshadern Campus, University of Munich, Munich, Germany
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Affiliation(s)
- Rajesh Krishnamurthy
- EB Singleton Division of Diagnostic Imaging, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
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37
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Stellenwert der kardiovaskulären Magnetresonanztomographie in der Diagnostik der koronaren Herzerkrankung. Wien Med Wochenschr 2008; 158:140-7. [DOI: 10.1007/s10354-008-0513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2007] [Accepted: 02/09/2008] [Indexed: 10/22/2022]
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