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Demirel OB, Yaman B, Shenoy C, Moeller S, Weingärtner S, Akçakaya M. Signal intensity informed multi-coil encoding operator for physics-guided deep learning reconstruction of highly accelerated myocardial perfusion CMR. Magn Reson Med 2023; 89:308-321. [PMID: 36128896 PMCID: PMC9617789 DOI: 10.1002/mrm.29453] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/21/2022] [Accepted: 08/21/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To develop a physics-guided deep learning (PG-DL) reconstruction strategy based on a signal intensity informed multi-coil (SIIM) encoding operator for highly-accelerated simultaneous multislice (SMS) myocardial perfusion cardiac MRI (CMR). METHODS First-pass perfusion CMR acquires highly-accelerated images with dynamically varying signal intensity/SNR following the administration of a gadolinium-based contrast agent. Thus, using PG-DL reconstruction with a conventional multi-coil encoding operator leads to analogous signal intensity variations across different time-frames at the network output, creating difficulties in generalization for varying SNR levels. We propose to use a SIIM encoding operator to capture the signal intensity/SNR variations across time-frames in a reformulated encoding operator. This leads to a more uniform/flat contrast at the output of the PG-DL network, facilitating generalizability across time-frames. PG-DL reconstruction with the proposed SIIM encoding operator is compared to PG-DL with conventional encoding operator, split slice-GRAPPA, locally low-rank (LLR) regularized reconstruction, low-rank plus sparse (L + S) reconstruction, and regularized ROCK-SPIRiT. RESULTS Results on highly accelerated free-breathing first pass myocardial perfusion CMR at three-fold SMS and four-fold in-plane acceleration show that the proposed method improves upon the reconstruction methods use for comparison. Substantial noise reduction is achieved compared to split slice-GRAPPA, and aliasing artifacts reduction compared to LLR regularized reconstruction, L + S reconstruction and PG-DL with conventional encoding. Furthermore, a qualitative reader study indicated that proposed method outperformed all methods. CONCLUSION PG-DL reconstruction with the proposed SIIM encoding operator improves generalization across different time-frames /SNRs in highly accelerated perfusion CMR.
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Affiliation(s)
- Omer Burak Demirel
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Burhaneddin Yaman
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Chetan Shenoy
- Department of Medicine (Cardiology)University of MinnesotaMinneapolisMinnesotaUSA
| | - Steen Moeller
- Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Mehmet Akçakaya
- Department of Electrical and Computer EngineeringUniversity of MinnesotaMinneapolisMinnesotaUSA,Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
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Guo L, Herzka DA. Sorted Golden-step phase encoding: an improved Golden-step imaging technique for cardiac and respiratory self-gated cine cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2019; 21:23. [PMID: 30999911 PMCID: PMC6472023 DOI: 10.1186/s12968-019-0533-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 03/19/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Numerous self-gated cardiac imaging techniques have been reported in the literature. Most can track either cardiac or respiratory motion, and many incur some overhead to imaging data acquisition. We previously described a Cartesian cine imaging technique, pseudo-projection motion tracking with golden-step phase encoding, capable of tracking both cardiac and respiratory motion at no cost to imaging data acquisition. In this work, we describe improvements to the technique by dramatically reducing its vulnerability to eddy current and flow artifacts and demonstrating its effectiveness in expanded cardiovascular applications. METHODS As with our previous golden-step technique, the Cartesian phase encodes over time were arranged based on the integer golden step, and readouts near ky = 0 (pseudo-projections) were used to derive motion. In this work, however, the readouts were divided into equal and consecutive temporal segments, within which the readouts were sorted according to ky. The sorting reduces the phase encode jump between consecutive readouts while maintaining the pseudo-randomness of ky to sample both cardiac and respiratory motion without comprising the ability to retrospectively set the temporal resolution of the original technique. On human volunteers, free-breathing, electrocardiographic (ECG)-free cine scans were acquired for all slices of the short axis stack and the 4-chamber view of the long axis. Retrospectively, cardiac motion and respiratory motion were automatically extracted from the pseudo-projections to guide cine reconstruction. The resultant image quality in terms of sharpness and cardiac functional metrics was compared against breath-hold ECG-gated reference cines. RESULTS With sorting, motion tracking of both cardiac and respiratory motion was effective for all slices orientations imaged, and artifact occurrence due to eddy current and flow was efficiently eliminated. The image sharpness derived from the self-gated cines was found to be comparable to the reference cines (mean difference less than 0.05 mm- 1 for short-axis images and 0.075 mm- 1 for long-axis images), and the functional metrics (mean difference < 4 ml) were found not to be statistically different from those from the reference. CONCLUSIONS This technique dramatically reduced the eddy current and flow artifacts while preserving the ability of cost-free motion tracking and the flexibility of choosing arbitrary navigator zone width, number of cardiac phases, and duration of scanning. With the restriction of the artifacts removed, the Cartesian golden-step cine imaging can now be applied to cardiac imaging slices of more diverse orientation and anatomy at greater reliability.
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Affiliation(s)
- Liheng Guo
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 720 Rutland Ave, Suite 726 Ross Building, Baltimore, MD 21205 USA
| | - Daniel A. Herzka
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 720 Rutland Ave, Suite 726 Ross Building, Baltimore, MD 21205 USA
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Whole Left Ventricular Coverage Versus Conventional 3-Slice Myocardial Perfusion Magnetic Resonance Imaging for the Detection of Suspected Coronary Artery Disease. Acad Radiol 2019; 26:519-525. [PMID: 29887399 DOI: 10.1016/j.acra.2018.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022]
Abstract
RATIONALE AND OBJECTIVES Sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution, and signal-to-noise ratio compared to the conventional 3-slice saturation recovery turbo-fast low-angle shot (SR-Turbo-FLASH) sequence. We prospectively compared the diagnostic value of whole leftventricular coverage myocardial perfusion magnetic resonance imaging (MRI) and conventional 3-slice technique in patients with suspected coronary artery disease (CAD). MATERIALS AND METHODS Thirty consecutive patients with suspected CAD who were scheduled for coronary angiography underwent myocardial perfusion MRI with both SW-CG-HYPR and SR-Turbo-FLASH in random order at 3.0 T. Perfusion defects were interpreted visually by two blinded observers and were correlated to x-ray angiographic stenoses ≥50%. Receiver-operating characteristic curve analysis was used to compare the diagnostic performance of the two imaging techniques. RESULTS The image quality score of SW-CG-HYPR was significantly higher than that of SR-Turbo-FLASH (3.4 ± 0.6 vs 3.0 ± 0.7, respectively; p < 0.05). In the per-patient analysis, SW-CG-HYPR provided a higher sensitivity (94% vs 89%), specificity (83% vs 75%), and diagnostic accuracy (90% vs 83%) for the detection of CAD than SR-Turbo-FLASH. In the per-vessel analysis, the diagnostic performance of SW-CG-HYPR was significantly greater than that of SR-Turbo-FLASH for the overall detection of CAD (area under receiver-operating characteristic curve: 0.96 ± 0.02 vs 0.90 ± 0.03, respectively; p < 0.05). CONCLUSION Whole left ventricular coverage myocardial perfusion MRI has higher diagnostic accuracy compared to conventional 3-slice technique for the detection of suspected CAD.
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Lamacie MM, Thavendiranathan P, Hanneman K, Greiser A, Jolly MP, Ward R, Wintersperger BJ. Quantification of global myocardial function by cine MRI deformable registration-based analysis: Comparison with MR feature tracking and speckle-tracking echocardiography. Eur Radiol 2016; 27:1404-1415. [DOI: 10.1007/s00330-016-4514-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 07/12/2016] [Accepted: 07/19/2016] [Indexed: 12/01/2022]
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5
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Fair MJ, Gatehouse PD, DiBella EVR, Firmin DN. A review of 3D first-pass, whole-heart, myocardial perfusion cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2015; 17:68. [PMID: 26231784 PMCID: PMC4522116 DOI: 10.1186/s12968-015-0162-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 06/23/2015] [Indexed: 01/19/2023] Open
Abstract
A comprehensive review is undertaken of the methods available for 3D whole-heart first-pass perfusion (FPP) and their application to date, with particular focus on possible acceleration techniques. Following a summary of the parameters typically desired of 3D FPP methods, the review explains the mechanisms of key acceleration techniques and their potential use in FPP for attaining 3D acquisitions. The mechanisms include rapid sequences, non-Cartesian k-space trajectories, reduced k-space acquisitions, parallel imaging reconstructions and compressed sensing. An attempt is made to explain, rather than simply state, the varying methods with the hope that it will give an appreciation of the different components making up a 3D FPP protocol. Basic estimates demonstrating the required total acceleration factors in typical 3D FPP cases are included, providing context for the extent that each acceleration method can contribute to the required imaging speed, as well as potential limitations in present 3D FPP literature. Although many 3D FPP methods are too early in development for the type of clinical trials required to show any clear benefit over current 2D FPP methods, the review includes the small but growing quantity of clinical research work already using 3D FPP, alongside the more technical work. Broader challenges concerning FPP such as quantitative analysis are not covered, but challenges with particular impact on 3D FPP methods, particularly with regards to motion effects, are discussed along with anticipated future work in the field.
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Affiliation(s)
- Merlin J Fair
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Peter D Gatehouse
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Edward V R DiBella
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, USA.
| | - David N Firmin
- National Heart & Lung Institute, Imperial College London, London, UK.
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
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Chen D, Sharif B, Bi X, Wei J, Thomson LEJ, Bairey Merz CN, Berman DS, Li D. Quantification of myocardial blood flow using non-electrocardiogram-triggered MRI with three-slice coverage. Magn Reson Med 2015; 75:2112-20. [PMID: 26059326 DOI: 10.1002/mrm.25787] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 11/11/2022]
Abstract
PURPOSE Accurate quantification of myocardial perfusion is dependent on reliable electrocardiogram (ECG) triggering. Measuring myocardial blood flow (MBF) in patients with arrhythmias or poor ECGs is currently infeasible with MR. The purpose of this study was to demonstrate the feasibility of a non-ECG-triggered method with clinically useful three-slice ventricular coverage for measurement of MBF in healthy volunteers. METHODS A saturation recovery magnetization-prepared gradient recalled echo acquisition was continuously repeated during first-pass imaging. A slice-interleaved radial trajectory was employed to enable image-based retrospective triggering. The arterial input function was generated using a beat-by-beat T1 estimation method. The proposed technique was validated against a conventional ECG-triggered dual-bolus technique in 10 healthy volunteers. The technique was further demonstrated under adenosine stress in 12 healthy volunteers. RESULTS The proposed method produced MBF with no significant difference compared with the ECG-triggered technique. The proposed method yielded mean myocardial perfusion reserve comparable to published literature. CONCLUSION We have developed a non-ECG-triggered quantitative perfusion imaging method. In this preliminary study, our results demonstrate that our method yields comparable MBF compared with the conventional ECG-triggered method and that it is feasible for stress imaging.
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Affiliation(s)
- David Chen
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA.,Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Behzad Sharif
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Xiaoming Bi
- MR R&D, Siemens Healthcare, Los Angeles, California, USA
| | - Janet Wei
- S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Louise E J Thomson
- S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Barbara Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California, USA
| | - C Noel Bairey Merz
- Barbara Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California, USA
| | - Daniel S Berman
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Abstract
Coronary artery disease is the most common cause of mortality and morbidity around the globe. Assessment of myocardial perfusion to diagnose ischemia is commonly performed in symptomatic patients prior to referral for cardiac catheterization. Among other noninvasive imaging modalities, cardiac MRI (CMR) is emerging as a highly sensitive and specific test for myocardial ischemia and infarction. Resting perfusion on CMR is used to evaluate for microvascular obstruction, which is shown to predict adverse left ventricular remodeling and cardiac events after acute myocardial infarction. This article summarizes the current understanding of CMR perfusion.
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Affiliation(s)
- Yasmin S Hamirani
- Division of Cardiology, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
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Pflugi S, Roujol S, Akçakaya M, Kawaji K, Foppa M, Heydari B, Goddu B, Kissinger K, Berg S, Manning WJ, Kozerke S, Nezafat R. Accelerated cardiac MR stress perfusion with radial sampling after physical exercise with an MR-compatible supine bicycle ergometer. Magn Reson Med 2014; 74:384-95. [PMID: 25105469 DOI: 10.1002/mrm.25405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 06/30/2014] [Accepted: 07/22/2014] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the feasibility of accelerated cardiac MR (CMR) perfusion with radial sampling using nonlinear image reconstruction after exercise on an MR-compatible supine bike ergometer. METHODS Eight healthy subjects were scanned on two separate days using radial and Cartesian CMR perfusion sequences in rest and exercise stress perfusion. Four different methods (standard gridding, conjugate gradient SENSE [CG-SENSE], nonlinear inversion with joint estimation of coil-sensitivity profiles [NLINV] and compressed sensing with a total variation constraint [TV]) were compared for the reconstruction of radial data. Cartesian data were reconstructed using SENSE. All images were assessed by two blinded readers in terms of image quality and diagnostic value. RESULTS CG-SENSE and NLINV were scored more favorably than TV (in both rest and stress perfusion cases, P < 0.05) and gridding (for rest perfusion cases, P < 0.05). TV images showed patchy artifacts, which negatively influenced image quality especially in the stress perfusion images acquired with a low number of radial spokes. Although CG-SENSE and NLINV received better scores than Cartesian sampling in both rest and exercise stress perfusion cases, these differences were not statistically significant (P > 0.05). CONCLUSION We have demonstrated the feasibility of accelerated CMR perfusion using radial sampling after physical exercise using a supine bicycle ergometer in healthy subjects. For reconstruction of undersampled radial perfusion, CG-SENSE and NLINV resulted in better image quality than standard gridding or TV reconstruction. Further technical improvements and clinical assessment are needed before using this approach in patients with suspected coronary artery disease.
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Affiliation(s)
- Silvio Pflugi
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sébastien Roujol
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Mehmet Akçakaya
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Keigo Kawaji
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Murilo Foppa
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Bobby Heydari
- Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Beth Goddu
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Kraig Kissinger
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Sophie Berg
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Warren J Manning
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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Ma H, Wang Y, Wen Z, Liu Y, Liu J, Yang J, Wang B. Letter regarding Bettencourt et al. “Cardiac magnetic resonance myocardial perfusion imaging for detection of functionally significant obstructive coronary artery disease: A prospective study”. Int J Cardiol 2013; 168:553. [DOI: 10.1016/j.ijcard.2013.01.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 01/13/2013] [Indexed: 10/27/2022]
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10
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Chen L, Adluru G, Schabel MC, McGann CJ, Dibella EVR. Myocardial perfusion MRI with an undersampled 3D stack-of-stars sequence. Med Phys 2012; 39:5204-11. [PMID: 22894445 DOI: 10.1118/1.4738965] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine the feasibility of three-dimensional (3D) hybrid radial (stack-of-stars) MRI with spatiotemporal total variation (TV) constrained reconstruction for dynamic contrast enhanced myocardial perfusion imaging. METHODS An ECG-triggered saturation recovery turboFLASH sequence with undersampled stack-of-stars sampling with spatiotemporal TV constrained reconstruction was developed for dynamic contrast enhanced myocardial perfusion imaging. Simulations were performed to study the dependence of the approach to steady state on flip angle and saturation recovery time for this stack-of-stars acquisition. Phantom studies were used to show the effect of the flip angle selection and imperfect spoiling on image qualities. Studies were done in three humans to test the feasibility of the approach for myocardial perfusion imaging. RESULTS The simulation and phantom studies showed that imperfect spoiling and magnetization changes during the readout were a function of flip angle and nonoptimized selection of flip angle could degrade the images. Low flip angle acquisitions in the human subjects result in images with good quality similar to multislice radial 2D images. CONCLUSIONS 3D stack-of-stars sampling with spatiotemporal TV constrained reconstruction provides a promising alternative for myocardial perfusion imaging.
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Affiliation(s)
- Liyong Chen
- Department of Bioengineering, University of Utah, Salt Lake City, Utah 84108, USA
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Ma H, Yang J, Liu J, Ge L, An J, Tang Q, Li H, Zhang Y, Chen D, Wang Y, Liu J, Liang Z, Lin K, Jin L, Bi X, Li K, Li D. Myocardial perfusion magnetic resonance imaging using sliding-window conjugate-gradient highly constrained back-projection reconstruction for detection of coronary artery disease. Am J Cardiol 2012; 109:1137-41. [PMID: 22264595 DOI: 10.1016/j.amjcard.2011.11.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 11/30/2011] [Accepted: 11/30/2011] [Indexed: 11/17/2022]
Abstract
Myocardial perfusion magnetic resonance imaging (MRI) with sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution and signal/noise ratio, and reduced cardiac motion-related image artifacts. The accuracy of this technique for detecting coronary artery disease (CAD) has not been determined in a large number of patients. We prospectively evaluated the diagnostic performance of myocardial perfusion MRI with SW-CG-HYPR in patients with suspected CAD. A total of 50 consecutive patients who were scheduled for coronary angiography with suspected CAD underwent myocardial perfusion MRI with SW-CG-HYPR at 3.0 T. The perfusion defects were interpreted qualitatively by 2 blinded observers and were correlated with x-ray angiographic stenoses ≥50%. The prevalence of CAD was 56%. In the per-patient analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SW-CG-HYPR was 96% (95% confidence interval 82% to 100%), 82% (95% confidence interval 60% to 95%), 87% (95% confidence interval 70% to 96%), 95% (95% confidence interval 74% to100%), and 90% (95% confidence interval 82% to 98%), respectively. In the per-vessel analysis, the corresponding values were 98% (95% confidence interval 91% to 100%), 89% (95% confidence interval 80% to 94%), 86% (95% confidence interval 76% to 93%), 99% (95% confidence interval 93% to 100%), and 93% (95% confidence interval 89% to 97%), respectively. In conclusion, myocardial perfusion MRI using SW-CG-HYPR allows whole left ventricular coverage and high resolution and has high diagnostic accuracy in patients with suspected CAD.
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Affiliation(s)
- Heng Ma
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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