Efficient radial tagging CMR exam: A coherent k-space reading and image reconstruction approach

Real-time radial tagging for quantification of left ventricular torsion

PURPOSE

To develop a real-time radial tagging MRI for accurate measurement of rotational motion and twist of the left ventricle (LV).

METHODS

A FLASH-based radial tagging sequence with an undersampled radial reading scheme was developed for both single and double-slice imaging in real-time. The Polar Fourier Transform was used for reconstruction to push the undersampling artifacts out of a reduced FOV. The developed technique was used to image five normal subjects during rest, plus one during both exercise and rest conditions. LV rotational motions were estimated for five consecutive cardiac cycles in all cases. The process was validated using a numerical phantom. The real-time measurement of global rotational motion was compared with those measured from a non-real-time exam using linear regression analysis and the Bland-Altman plot.

RESULTS

The real-time acquisition was performed successfully with a temporal resolution of 46.2 ms. Image quality was sufficient for the reproducible calculation of rotation at rest and exercise. The feasibility of double-slice acquisition on human was further studied and a real-time twist of the left ventricle was demonstrated. The difference between LV global rotations from real-time and non-real-time approaches was 0.27 degrees. A significant reverse recoiling, induced by exercise, was reproducibly measured by the technique.

CONCLUSION

A real-time radial tagging MRI technique was developed based on the undersampled radial acquisition and Polar Fourier Transform reconstruction, for accurate measuring of the heart rotational motion and twist. The technique was able to extract a meaningful change of diastolic recoiling under stress test conditions during physical activities (cycling).

SSFP fMRI at 3 tesla: Efficiency of polar acquisition-reconstruction technique

SSFP-based fMRI techniques, known for their high specificity and low geometrical distortion, look promising for high-resolution brain mapping. Nevertheless, they suffer from lack of speed and sensitivity, leading them to be exploited mostly in high-field scanners. Radial acquisition can help with these inefficiencies through better tSNR and more effective coverage of the spatial frequencies. Here, we present a SSFP-fMRI approach and experimentally investigate it at 3 T scanners using radial readout for acquisition. In particular, the visual activity is mapped through three bSSFP techniques: 1- Cartesian, 2- Radial with re-gridding reconstruction, 3- Radial with Polar Fourier Transform (PFT) reconstruction. In the PFT technique streaking artifacts, generated at high acceleration rates by re-gridding reconstruction, are avoided and pixel size in the final framework is retrospectively selectable. General agreement, but better tSNR of Radial reading, was first confirmed for these techniques in detection of neural activities at 2 × 2 mm² in-plane resolution for all 28 subjects,. Next the outcome of the PFT algorithm with 1 × 1 mm² pixel size was compared to images reconstructed by re-gridding (from the same raw data) with the identical pixel size through interpolation. The localization of the activity showed improvement in PFT over interpolation both qualitatively (i.e., well-fitting in gray-matter) and quantitatively (i.e., higher z-scores and tSNR). The proposed technique can therefore be considered as a remedy for lack of speed and sensitivity in SSFP-based fMRI, in conventional field strengths. The proposed approach is particularly useful in task-based studies when we concentrate on a ROI considerably smaller than FOV, without sacrificing spatial resolution.

Biatrial performance in children with hypertrophic cardiomyopathy: CMR study

OBJECTIVES

To investigate biatrial mechanics and their relation with left ventricular outflow tract (LVOT) obstruction (LVOTO), the degree of hypertrophy, indices of ventricular diastolic function and fibrosis in children with hypertrophic cardiomyopathy (HCM).

METHODS

Fifty-five consecutive, prospectively recruited children with HCM (mean age 12.5 ± 4.6 years, 69.1% male), 19 (34.5%) of whom had LVOTO, underwent cardiac magnetic resonance and echocardiography with quantification of phasic components of biatrial function, biventricular diastolic function and fibrosis. Twenty healthy, sex-matched subjects served as controls.

RESULTS

We found a significant increase of left atrial (LA) and right atrial (RA) volumes and reduction in the majority of indices of contractile function, strains and strain rates (p < 0.05) in children with HCM compared with controls. Nearly all of the LA dynamics markers attained a significant association with the LVOT gradient (p < 0.05), the RA volumes and contractile functions were affected by LV fibrosis and mass (p < 0.05), and the RA mechanical components were related to the degree of LVOTO (p < 0.05). The minority of biatrial dynamics markers were associated with indices of ventricular diastolic function.

CONCLUSIONS

The majority of biatrial volumetric and functional indices were severely compromised in children with HCM compared with controls. The degree of LVOTO appears to trigger LA volumetric and LA and RA mechanical malfunction. On the other hand, the deterioration of RA volumetric components was linked to LV fibrosis and mass.

KEY POINTS

• Biatrial function was severely compromised in children with HCM. • Left atrial malfunction was associated with the degree of LVOTO. • Fibrosis and LV mass were related to RA volumetric and contractile dysfunction. • The degree of LVOTO was linked to right atrial mechanical abnormalities.