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Collins JD. Global and regional functional assessment of ischemic heart disease with cardiac MR imaging. Radiol Clin North Am 2015; 53:369-95. [PMID: 25727001 DOI: 10.1016/j.rcl.2014.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiac MR imaging (CMR) combines assessment of myocardial function and tissue characterization, and is therefore ideally suited to evaluating patients with ischemic heart disease (IHD). This article discusses evaluation of left ventricular global function at CMR, reviewing the literature supporting global parameters in risk stratification and assessment of treatment response in IHD. Techniques for assessment of regional myocardial function are reviewed, and normal myocardial motion and fiber arrangement discussed. Despite barriers to clinical adoption, integration of this assessment into clinical routine should improve the ability to detect functional consequences of early myocardial structural alterations in patients with IHD.
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Affiliation(s)
- Jeremy D Collins
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 North Michigan Avenue, Suite 1600, Chicago, IL 60611, USA.
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Gao H, Allan A, McComb C, Luo X, Berry C. Left ventricular strain and its pattern estimated from cine CMR and validation with DENSE. Phys Med Biol 2014; 59:3637-56. [PMID: 24922458 DOI: 10.1088/0031-9155/59/13/3637] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Measurement of local strain provides insight into the biomechanical significance of viable myocardium. We attempted to estimate myocardial strain from cine cardiovascular magnetic resonance (CMR) images by using a b-spline deformable image registration method. Three healthy volunteers and 41 patients with either recent or chronic myocardial infarction (MI) were studied at 1.5 Tesla with both cine and DENSE CMR. Regional circumferential and radial left ventricular strains were estimated from cine and DENSE acquisitions. In all healthy volunteers, there was no difference for peak circumferential strain (- 0.18 ± 0.04 versus - 0.18 ± 0.03, p = 0.76) between cine and DENSE CMR, however peak radial strain was overestimated from cine (0.84 ± 0.37 versus 0.49 ± 0.2, p < 0.01). In the patient study, the peak strain patterns predicted by cine were similar to the patterns from DENSE, including the strain evolution related to recovery time and strain patterns related to MI scar extent. Furthermore, cine-derived strain disclosed different strain patterns in MI and non-MI regions, and regions with transmural and non-transmural MI as DENSE. Although there were large variations with radial strain measurements from cine CMR images, useful circumferential strain information can be obtained from routine clinical CMR imaging. Cine strain analysis has potential to improve the diagnostic yield from routine CMR imaging in clinical practice.
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Affiliation(s)
- Hao Gao
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QW, UK
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Ernande L, Thibault H, Bergerot C, Moulin P, Wen H, Derumeaux G, Croisille P. Systolic myocardial dysfunction in patients with type 2 diabetes mellitus: identification at MR imaging with cine displacement encoding with stimulated echoes. Radiology 2012; 265:402-9. [PMID: 22929334 DOI: 10.1148/radiol.12112571] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE To determine if cine displacement encoding with stimulated echoes (DENSE) can help to identify and determine the patterns of subclinical myocardial systolic dysfunction in patients with type 2 diabetes mellitus (DM) when compared with cine DENSE in control patients. MATERIALS AND METHODS After obtaining approval from the institutional ethics committee and written informed consent from the patients, 37 patients with type 2 DM without overt heart disease and 23 age-matched control patients were prospectively included in the study. The patients underwent standard cine magnetic resonance (MR) imaging with two-dimensional cine DENSE acquisitions. Circumferential (Ecc) and radial (Err) systolic strains were measured on short-axis views at basal, mid, and apical left ventricular levels. Longitudinal strain (Ell) was measured on four- and two-chamber views. Statistical testing included the intraclass correlation coefficient and multiple linear regression analysis. RESULTS The intraobserver intraclass correlation coefficient values were 0.85, 0.95, and 0.90, and the interobserver intraclass correlation coefficient values were 0.79, 0.91 and 0.80 for Ecc, Err, and Ell, respectively. The left ventricular ejection fraction was in the reference range and similar between the groups, and the patients with DM showed a decrease in Ecc (-14.4%±1.6 vs -17.0%±1.6, P<.001), Err (36.2%±10.9 vs 44.4%±9.9, P=.006) and Ell (-12.9%±2.1 vs -15.5%±1.6, P<.001) compared with the control patients. Finally, DM was independently associated with Ecc (P<.001), Err (P=.05) and Ell (P=.01) after adjustment for age, sex, hypertension, body mass index, and left ventricular mass. CONCLUSION Cine DENSE, a motion-encoding MR imaging technique for myocardial strain assessment with high spatial resolution, appears to be useful in the identification of subclinical myocardial dysfunction in patients with DM.
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Affiliation(s)
- Laura Ernande
- Service des Explorations Fonctionnelles Cardiovasculaires, Department of Endocrinology, Louis Pradel Hospital, CarMeN INSERM Unit 1060, Université de Lyon, Lyon, France
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Simpson RM, Keegan J, Firmin DN. MR assessment of regional myocardial mechanics. J Magn Reson Imaging 2012; 37:576-99. [PMID: 22826177 DOI: 10.1002/jmri.23756] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 06/15/2012] [Indexed: 12/30/2022] Open
Abstract
Regional myocardial function can be measured by several MR techniques including tissue tagging, phase velocity mapping, and more recently, displacement encoding with stimulated echoes (DENSE) and strain encoding (SENC). Each of these techniques was developed separately and has undergone significant change since its original implementation. As a result, in the current literature, the common features and the differences between the techniques and what they measure are often unclear and confusing. This review article delivers an extensively referenced introductory text which clarifies the current methodology from the starting point of the Bloch equations. By doing this in a consistent way for each method, the similarities and differences between them are highlighted. In addition, their capabilities and limitations are discussed, together with their relative advantages and disadvantages. While the focus is on sequence design and development, the principal parameters measured by each technique are also summarized, together with brief results, with the reader being directed to the extensive literature on data processing and clinical applications for more detail.
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Affiliation(s)
- Robin M Simpson
- Cardiovascular Magnetic Resonance Unit, Royal Brompton and Harefield NHS Hospital Trust, London, United Kingdom.
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Wang H, Amini AA. Cardiac motion and deformation recovery from MRI: a review. IEEE TRANSACTIONS ON MEDICAL IMAGING 2012; 31:487-503. [PMID: 21997253 DOI: 10.1109/tmi.2011.2171706] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Magnetic resonance imaging (MRI) is a highly advanced and sophisticated imaging modality for cardiac motion tracking and analysis, capable of providing 3D analysis of global and regional cardiac function with great accuracy and reproducibility. In the past few years, numerous efforts have been devoted to cardiac motion recovery and deformation analysis from MR image sequences. Many approaches have been proposed for tracking cardiac motion and for computing deformation parameters and mechanical properties of the heart from a variety of cardiac MR imaging techniques. In this paper, an updated and critical review of cardiac motion tracking methods including major references and those proposed in the past ten years is provided. The MR imaging and analysis techniques surveyed are based on cine MRI, tagged MRI, phase contrast MRI, DENSE, and SENC. This paper can serve as a tutorial for new researchers entering the field.
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Affiliation(s)
- Hui Wang
- Department of Electrical and Computer Engineering,University of Louisville, Louisville, KY 40292 USA.
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Auger DA, Zhong X, Epstein FH, Spottiswoode BS. Mapping right ventricular myocardial mechanics using 3D cine DENSE cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:4. [PMID: 22236389 PMCID: PMC3311142 DOI: 10.1186/1532-429x-14-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/11/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The mechanics of the right ventricle (RV) are not well understood as studies of the RV have been limited. This is, in part, due to the RV's thin wall, asymmetric geometry and irregular motion. However, the RV plays an important role in cardiovascular function. This study aims to describe the complex mechanics of the healthy RV using three dimensional (3D) cine displacement encoding with stimulated echoes (DENSE) cardiovascular magnetic resonance (CMR). METHODS Whole heart 3D cine DENSE data were acquired from five healthy volunteers. Tailored post-processing algorithms for RV mid-wall tissue tracking and strain estimation are presented. A method for sub-dividing the RV into four regions according to anatomical land marks is proposed, and the temporal evolution of strain was assessed in these regions. RESULTS The 3D cine DENSE tissue tracking methods successfully capture the motion and deformation of the RV at a high spatial resolution in all volunteers. The regional Lagrangian peak surface strain and time to peak values correspond with previous studies using myocardial tagging, DENSE and strain encoded CMR. The inflow region consistently displays lower peak strains than the apical and outflow regions, and the time to peak strains suggest RV mechanical activation in the following order: inflow, outflow, mid, then apex. CONCLUSIONS Model-free techniques have been developed to study the myocardial mechanics of the RV at a high spatial resolution using 3D cine DENSE CMR. The consistency of the regional RV strain patterns across healthy subjects is encouraging and the techniques may have clinical utility in assessing disrupted RV mechanics in the diseased heart.
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Affiliation(s)
- Daniel A Auger
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, USA
| | - Frederick H Epstein
- Departments of Radiology and Biomedical Engineering, University of Virginia, Charlottesville VA, USA
| | - Bruce S Spottiswoode
- MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Division of Radiology, University of Stellenbosch, Cape Town, South Africa
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Auger DA, Zhong X, Meintjes EM, Epstein FH, Spottiswoode BS. Quantifying right ventricular motion and strain using 3D cine DENSE MRI. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106615 DOI: 10.1186/1532-429x-13-s1-m3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Cardiac resynchronization therapy (CRT) is believed to benefit patients by primarily correcting heterogeneity in regional ventricular mechanical contraction, known as dyssynchrony. Although many symptomatic heart failure patients with depressed left ventricular ejection fraction and widened electrocardiographic QRS complexes have clinical improvement from CRT, a significant subset of approximately one-third do not seem to respond. Because the degree of mechanical dyssynchrony may be widely variable, interest has remained high to attempt to improve patient selection for CRT using cardiac imaging as a means to quantify dyssynchrony. This article will review the principal echocardiographic methods of dyssynchrony analysis by tissue Doppler imaging, (opposing wall delay, 12-site standard deviation or Yu index, and longitudinal strain), routine pulsed-Doppler (interventricular mechanical delay, pre-ejection delay and filling time ratio), and speckle tracking (including radial, circumferential, and longitudinal strain). In addition, dyssynchrony analysis by cardiac magnetic resonance imaging is introduced as a potential alternative technique. The technical features, strengths and limitations, and clinical evidence for these methods are discussed, including a practical clinical approach.
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Young AA, Li B, Kirton RS, Cowan BR. Generalized spatiotemporal myocardial strain analysis for DENSE and SPAMM imaging. Magn Reson Med 2011; 67:1590-9. [PMID: 22135133 DOI: 10.1002/mrm.23142] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 06/01/2011] [Accepted: 07/18/2011] [Indexed: 11/08/2022]
Affiliation(s)
- Alistair A Young
- Auckland MRI Research Group, University of Auckland, Auckland, New Zealand.
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Abstract
This work investigates and compares two different phase-correction algorithms for Dixon fat-water separation and two different quality maps (QM) for region-growing: the original QM, based on phase gradients, and a QM based on phase uncertainty, proposed in this article. A spoiled dual-gradient-echo sequence was employed at 1.5 T to acquire in-phase and out-of-phase images of joints, parotid glands, abdomen and test objects. All 97 datasets were processed eight times each: with two different phase correction algorithms (original and hierarchical phase correction), with two different QM, and with/without removing linear component of the phase drifts associated with dual-echo acquisitions and bipolar readout gradient waveforms. The linear component of the phase drift along the readout direction was found to reach 4.1° pixel(-1), depending on the geometric parameters. Pre-processing to remove linear phase shifts has little impact on outcome. The hierarchic phase-correction algorithm outperformed the original phase-correction algorithm in all applications. The proposed phase-uncertainty QM provides a small performance improvement in clinical images, but can be vulnerable to flow-related phase shifts in bright vessels. Overall the most successful phase-correction technique employed phase-uncertainty QMs and hierarchic algorithms, with pre-processing to correct the linear phase drift associated with dual-echo acquisitions and bipolar readout gradient waveform.
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Affiliation(s)
- Maria A Schmidt
- Cancer Research UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton SM2 5PT, UK.
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AlJaroudi W, Chen J, Jaber WA, Lloyd SG, Cerqueira MD, Marwick T. Nonechocardiographic imaging in evaluation for cardiac resynchronization therapy. Circ Cardiovasc Imaging 2011; 4:334-43. [PMID: 21586744 DOI: 10.1161/circimaging.111.963504] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Wael AlJaroudi
- Department of Cardiovascular Medicine, Section of Imaging, Cleveland Clinic, Cleveland, OH, USA.
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Shah SJ, Fonarow GC, Gheorghiade M, Lang RM. Phase II trials in heart failure: the role of cardiovascular imaging. Am Heart J 2011; 162:3-15.e3. [PMID: 21742085 DOI: 10.1016/j.ahj.2011.03.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 03/21/2011] [Indexed: 02/04/2023]
Abstract
The development of new therapies for heart failure (HF), especially acute HF, has proven to be quite challenging; and therapies evaluated in HF have greatly outnumbered treatments that are eventually successful in obtaining regulatory approval. Thus, the development of therapies for HF remains a vexing problem for pharmaceutical and device companies, clinical trialists, and health care professionals. Nowhere is this more apparent than in the phase II HF clinical trial, in which the goal is to determine whether an investigational agent should move forward to a phase III trial. Recent advancements in noninvasive cardiovascular imaging have allowed a new era of comprehensive phenotyping of cardiac structure and function in phase II HF trials. Besides using imaging parameters to predict success of subsequent phase III outcome studies, it is essential to also use imaging in phase II HF trials in a way that increases understanding of drug or device mechanism. Determination of the patients who would benefit most from a particular drug or device could decrease heterogeneity of phase III trial participants and lead to more successful HF clinical trials. In this review, we outline advantages and disadvantages of imaging various aspects of cardiac structure and function that are potential targets for therapy in HF, compare and contrast imaging modalities, provide practical advice for the use of cardiovascular imaging in drug development, and conclude with some novel uses of cardiac imaging in phase II HF trials.
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Affiliation(s)
- Sanjiv J Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Montet-Abou K, Viallon M, Hyacinthe JN, Delattre B, Vallee JP, Didier D, Croisille P, Montet X. The role of imaging and molecular imaging in the early detection of metabolic and cardiovascular dysfunctions. Int J Obes (Lond) 2011; 34 Suppl 2:S67-81. [PMID: 21151150 DOI: 10.1038/ijo.2010.242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Despite intense effort, obesity is still rising throughout the world. Links between obesity and cardiovascular diseases are now well established. Most of the cardiovascular changes related to obesity can be followed by magnetic resonance imaging (MRI) or by magnetic resonance spectroscopy (MRS). In particular, we will see in this review that MRI/MRS is extremely well suited to depict (1) changes in cardiac mass and function, (2) changes in stroke volume, (3) accumulation of fat inside the mediastinum or even inside the cardiomyocytes, (4) cell viability and (5) molecular changes during early cardiovascular diseases.
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Affiliation(s)
- K Montet-Abou
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
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Venkatesh BA, Gupta H, Lloyd SG, Dell 'Italia L, Denney TS. 3D left ventricular strain from unwrapped harmonic phase measurements. J Magn Reson Imaging 2010; 31:854-62. [PMID: 20373429 DOI: 10.1002/jmri.22099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To validate a method for measuring 3D left ventricular (LV) strain from phase-unwrapped harmonic phase (HARP) images derived from tagged cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS A set of 40 human subjects were imaged with tagged MRI. In each study the HARP phase was computed and unwrapped in each short-axis and long-axis image. Inconsistencies in unwrapped phase were resolved using branch cuts manually placed with a graphical user interface. 3D strain maps were computed for all imaged timeframes in each study. The strain from unwrapped phase (SUP) and displacements were compared to those estimated by a feature-based (FB) technique and a HARP technique. RESULTS 3D strain was computed in each timeframe through systole and mid-diastole in approximately 30 minutes per study. The standard deviation of the difference between strains measured by the FB and the SUP methods was less than 5% of the average of the strains from the two methods. The correlation between peak circumferential strain measured using the SUP and HARP techniques was over 83%. CONCLUSION The SUP technique can reconstruct full 3D strain maps from tagged MR images through the cardiac cycle in a reasonable amount of time and user interaction compared to other 3D analysis methods.
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Affiliation(s)
- Bharath Ambale Venkatesh
- Electrical and Computer Engineering Department, Auburn University, Auburn, Alabama 36849-5201, USA
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Le Y, Stein A, Berry C, Kellman P, Bennett EE, Taylor J, Lucas K, Kopace R, Chefd’Hotel C, Lorenz CH, Croisille P, Wen H. Simultaneous myocardial strain and dark-blood perfusion imaging using a displacement-encoded MRI pulse sequence. Magn Reson Med 2010; 64:787-98. [PMID: 20544714 PMCID: PMC2932773 DOI: 10.1002/mrm.22461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 03/01/2010] [Indexed: 11/06/2022]
Abstract
The purpose of this study is to develop and evaluate a displacement-encoded pulse sequence for simultaneous perfusion and strain imaging. Displacement-encoded images in two to three myocardial slices were repeatedly acquired using a single-shot pulse sequence for 3 to 4 min, which covers a bolus infusion of Gadolinium contrast. The magnitudes of the images were T(1) weighted and provided quantitative measures of perfusion, while the phase maps yielded strain measurements. In an acute coronary occlusion swine protocol (n = 9), segmental perfusion measurements were validated against microsphere reference standard with a linear regression (slope 0.986, R(2) = 0.765, Bland-Altman standard deviation = 0.15 mL/min/g). In a group of ST-elevation myocardial infarction patients (n = 11), the scan success rate was 76%. Short-term contrast washout rate and perfusion are highly correlated (R(2) = 0.72), and the pixelwise relationship between circumferential strain and perfusion was better described with a sigmoidal Hill curve than linear functions. This study demonstrates the feasibility of measuring strain and perfusion from a single set of images.
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Affiliation(s)
- Yuan Le
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ashley Stein
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Colin Berry
- Western Infirmary & Associated Hospital, Dept. Cardiology, Glasgow, Scotland
| | - Peter Kellman
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eric E. Bennett
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joni Taylor
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Katherine Lucas
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rael Kopace
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Pierre Croisille
- Departement de Radiologie, Hôpital Cardiologique et Pneumologique, L. Pradel, Lyon, France
| | - Han Wen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Vandsburger MH, Janiczek RL, Xu Y, French BA, Meyer CH, Kramer CM, Epstein FH. Improved arterial spin labeling after myocardial infarction in mice using cardiac and respiratory gated look-locker imaging with fuzzy C-means clustering. Magn Reson Med 2010; 63:648-57. [PMID: 20187175 DOI: 10.1002/mrm.22280] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Experimental myocardial infarction (MI) in mice is an important disease model, in part due to the ability to study genetic manipulations. MRI has been used to assess cardiac structural and functional changes after MI in mice, but changes in myocardial perfusion after acute MI have not previously been examined. Arterial spin labeling noninvasively measures perfusion but is sensitive to respiratory motion and heart rate variability and is difficult to apply after acute MI in mice. To account for these factors, a cardiorespiratory-gated arterial spin labeling sequence using a fuzzy C-means algorithm to retrospectively reconstruct images was developed. Using this method, myocardial perfusion was measured in remote and infarcted regions at 1, 7, 14, and 28 days post-MI. Baseline perfusion was 4.9 +/- 0.5 mL/g min and 1 day post-MI decreased to 0.9 +/- 0.8 mL/g min in infarcted myocardium (P < 0.05 versus baseline) while remaining at 5.2 +/- 0.8 mL/g min in remote myocardium. During the subsequent 28 days, perfusion in the remote zone remained unchanged, while a partial recovery of perfusion in the infarct zone was seen. This technique, when applied to genetically engineered mice, will allow for the investigation of the roles of specific genes in myocardial perfusion during infarct healing.
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Affiliation(s)
- Moriel H Vandsburger
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA
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Nasiraei Moghaddam A, Saber NR, Wen H, Finn JP, Ennis DB, Gharib M. Analytical method to measure three-dimensional strain patterns in the left ventricle from single slice displacement data. J Cardiovasc Magn Reson 2010; 12:33. [PMID: 20515489 PMCID: PMC2903580 DOI: 10.1186/1532-429x-12-33] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 06/01/2010] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Displacement encoded Cardiovascular MR (CMR) can provide high spatial resolution measurements of three-dimensional (3D) Lagrangian displacement. Spatial gradients of the Lagrangian displacement field are used to measure regional myocardial strain. In general, adjacent parallel slices are needed in order to calculate the spatial gradient in the through-slice direction. This necessitates the acquisition of additional data and prolongs the scan time. The goal of this study is to define an analytic solution that supports the reconstruction of the out-of-plane components of the Lagrangian strain tensor in addition to the in-plane components from a single-slice displacement CMR dataset with high spatio-temporal resolution. The technique assumes incompressibility of the myocardium as a physical constraint. RESULTS The feasibility of the method is demonstrated in a healthy human subject and the results are compared to those of other studies. The proposed method was validated with simulated data and strain estimates from experimentally measured DENSE data, which were compared to the strain calculation from a conventional two-slice acquisition. CONCLUSION This analytical method reduces the need to acquire data from adjacent slices when calculating regional Lagrangian strains and can effectively reduce the long scan time by a factor of two.
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Affiliation(s)
- Abbas Nasiraei Moghaddam
- Department of Radiological Sciences, Diagnostic Cardiovascular Imaging Section, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Bioengineering Option, California Institute of Technology, Pasadena, CA, USA
| | - Nikoo R Saber
- Bioengineering Option, California Institute of Technology, Pasadena, CA, USA
| | - Han Wen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Paul Finn
- Department of Radiological Sciences, Diagnostic Cardiovascular Imaging Section, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel B Ennis
- Department of Radiological Sciences, Diagnostic Cardiovascular Imaging Section, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Morteza Gharib
- Bioengineering Option, California Institute of Technology, Pasadena, CA, USA
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Feng L, Donnino R, Babb J, Axel L, Kim D. Numerical and in vivo validation of fast cine displacement-encoded with stimulated echoes (DENSE) MRI for quantification of regional cardiac function. Magn Reson Med 2009; 62:682-90. [PMID: 19585609 DOI: 10.1002/mrm.22045] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Quantitative assessment of regional cardiac function can improve the accuracy of detecting wall motion abnormalities due to heart disease. While recently developed fast cine displacement-encoded with stimulated echoes (DENSE) MRI is a promising modality for the quantification of regional myocardial function, it has not been validated for clinical applications. The purpose of this study, therefore, was to validate the accuracy of fast cine DENSE MRI with numerical simulation and in vivo experiments. A numerical phantom was generated to model physiologically relevant deformation of the heart, and the accuracy of fast cine DENSE was evaluated against the numerical reference. For in vivo validation, 12 controls and 13 heart-disease patients were imaged using both fast cine DENSE and myocardial tagged MRI. Numerical simulation demonstrated that the echo-combination DENSE reconstruction method is relatively insensitive to clinically relevant resonance frequency offsets. The strain measurements by fast cine DENSE and the numerical reference were strongly correlated and in excellent agreement (mean difference = 0.00; 95% limits of agreement were 0.01 and -0.02). The strain measurements by fast cine DENSE and myocardial tagged MRI were strongly correlated (correlation coefficient = 0.92) and in good agreement (mean difference = 0.01; 95% limits of agreement were 0.07 and -0.04).
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Affiliation(s)
- Li Feng
- Department of Biomedical Engineering, Polytechnic Institute of New York University, Brooklyn, New York 10016, USA
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Abstract
Cardiac resynchronization has emerged as a highly effective therapy for heart failure. However, up to 40% of patients do not benefit from this treatment. In this Review, we discuss the potential role of MRI and nuclear molecular imaging in providing additional insights into the response to cardiac resynchronization therapy. Variables with potential prognostic and therapeutic values include the evaluation of cardiac dyssynchrony, scar, cardiac sympathetic function, myocardial blood flow, myocardial glucose and oxidative metabolism. Other molecular targets to characterize apoptosis, fatty acid metabolism, angiogenesis and angiotensin-converting enzyme activity will also be described. The potential use of these techniques in identifying and measuring responses to cardiac resynchronization therapy and future areas of research will be explored.
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Liu Y, Wen H, Gorman RC, Pilla JJ, Gorman JH, Buckberg G, Teague SD, Kassab GS. Reconstruction of myocardial tissue motion and strain fields from displacement-encoded MR imaging. Am J Physiol Heart Circ Physiol 2009; 297:H1151-62. [PMID: 19561315 DOI: 10.1152/ajpheart.00074.2009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A quantitative analysis of myocardial mechanics is fundamental to understanding cardiac function, diagnosis of heart disease, and assessment of therapeutic intervention. Displacement encoding with stimulated-echo (DENSE) magnetic resonance imaging (MRI) technique was developed to track the three-dimensional (3D) displacement vector of discrete material grid points in the myocardial tissue. Despite the wealth of information gained from DENSE images, the current software only provides two-dimensional in-plane deformation. The objective of this study is to introduce a postprocessing method to reconstruct and visualize continuous dynamic 3D displacement and strain fields in the ventricular wall from DENSE data. An anatomically accurate hexagonal finite-element model of the left ventricle (LV) is reconstructed by fitting a prolate spheroidal primitive to contour points of the epi- and endocardial surfaces. The continuous displacement field in the model is described mathematically based on the discrete DENSE vectors using a minimization method with smoothness regularization. Based on the displacement, heart motion and myocardial stretch (or strain) are analyzed. Illustratory computations were conducted with DENSE data of three infarcted and one normal sheep ventricles. The full 3D results show stronger overall axial shortening, wall thickening, and twisting of the normal LV compared with the infarcted hearts. Local myocardial stretches show a dyskinetic LV in the apical region, dilation of apex in systole, and a compensatory increase in strain in the healthy basal region as a compensatory mechanism. We conclude that the proposed postprocessing method significantly extends the utility of DENSE MRI, which may provide a patient-specific 3D model of cardiac mechanics.
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Affiliation(s)
- Yi Liu
- Department of Biomedical Engineering, Indiana University-Purdue University, Indianapolis, Indiana 46202, USA
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22
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Zhong X, Helm PA, Epstein FH. Balanced multipoint displacement encoding for DENSE MRI. Magn Reson Med 2009; 61:981-8. [PMID: 19189288 DOI: 10.1002/mrm.21851] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Displacement encoding with stimulated echoes (DENSE) is a quantitative imaging technique that encodes tissue displacement in the phase of the acquired signal. Various DENSE sequences have encoded displacement using methods analogous to the simple multipoint methods of phase contrast (PC) MRI. We developed general n-dimension balanced multipoint encoding for DENSE. Using these methods, phase noise variance decreased experimentally by 73.7%, 65.6%, and 61.9% compared with simple methods, which closely matched the theoretical decreases of 75%, 66.7%, and 62.5% for one-dimensional (1D), 2D, and 3D encoding, respectively. Phase noise covariances decreased by 99.2% and 99.3% for balanced 2D and 3D encoding, consistent with the zero-covariance prediction. The direction bias inherent to the simple methods was decreased to almost zero using balanced methods. Reduced phase noise and improved displacement and strain maps using balanced methods were visually observed in phantom and volunteer images. Balanced multipoint encoding can also be applied to PC MRI.
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Affiliation(s)
- Xiaodong Zhong
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA
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23
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Delfino JG, Fornwalt BK, Oshinski JN, Lerakis S. Role of MRI in patient selection for CRT. Echocardiography 2009; 25:1176-85. [PMID: 18986405 DOI: 10.1111/j.1540-8175.2008.00783.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Magnetic resonance imaging has great potential for aiding in the selection of patients who will respond to CRT. MRI is the only imaging tool that can simultaneously assess mechanical dyssynchrony, determine the amount and location of myocardial scar tissue, and map the location of cardiac venous anatomy-three important factors in predicting a patient's response to CRT. The goal of this manuscript is to review the MRI methods that can be used in the selection of patients for CRT.
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Affiliation(s)
- Jana G Delfino
- Department of Radiology, Emory University, Atlanta, Georgia 30322, USA
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24
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Bibliography. Current world literature. Imaging and echocardiography. Curr Opin Cardiol 2008; 23:512-5. [PMID: 18670264 DOI: 10.1097/hco.0b013e32830d843f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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