Reliability of respiratory-triggered two-dimensional cine k-adaptive-t-autocalibrating reconstruction for Cartesian sampling for the assessment of biventricular volume and function in patients with repaired tetralogy of Fallot

Reliability of respiratory-gated real-time two-dimensional cine incorporating deep learning reconstruction for the assessment of ventricular function in an adult population

This study aimed to assess the image quality and accuracy of respiratory-gated real-time two-dimensional (2D) cine incorporating deep learning reconstruction (DLR) for the quantification of biventricular volumes and function compared with those of the standard reference, that is, breath-hold 2D balanced steady-state free precession (bSSFP) cine, in an adult population. Twenty-four patients (15 men, mean age 50.7 ± 16.5 years) underwent cardiac magnetic resonance for clinical indications, and 2D DLR and bSSFP cine were acquired on the short-axis view. The image quality scores were based on three main criteria: blood-to-myocardial contrast, endocardial edge delineation, and presence of motion artifacts throughout the cardiac cycle. Biventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and left ventricular mass (LVM) were analyzed. The 2D DLR cine had significantly shorter scan time than bSSFP (41.0 ± 11.3 s vs. 327.6 ± 65.8 s; p < 0.0001). Despite an analysis of endocardial edge definition and motion artifacts showed significant impairment using DLR cine compared with bSSFP (p < 0.01), the two sequences demonstrated no significant difference in terms of biventricular EDV, ESV, SV, and EF (p > 0.05). Moreover, the linear regression yielded good agreement between the two techniques (r ≥ 0.76). However, the LVM was underestimated for DLR cine (109.8 ± 34.6 g) compared with that for bSSFP (116.2 ± 40.2 g; p = 0.0291). Respiratory-gated 2D DLR cine is a reliable technique that could be used in the evaluation of biventricular volumes and function in an adult population.

Differential subsampling with cartesian ordering: A high spatial-temporal resolution dixon imaging sequence for assessment of dural arteriovenous fistula

Objective

To evaluate the accuracy of differential subsampling with cartesian ordering (DISCO) in comparison to time of flight (TOF) in detecting dural arteriovenous fistulas (DAVF), cerebral venous thrombosis (CVT) and hemodynamics.

Methods

Sixty-two cases (24 female; aged 14–75; mean age, 51.3 years) were included in our study, with 42 positive and 20 negative cases via Digital Subtraction Angiography (DSA). Two neuroradiologists independently evaluated the DISCO and TOF. The sensitivity, specificity, and accuracy of the DISCO and TOF-MRA were individually calculated using DSA as the gold standard. Inter-observer reliability was assessed by using a weighted Cohen's kappa (κ) test; P < 0.05 was set as the threshold for statistical significance.

Results

Diagnostic sensitivities of DISCO and TOF for DAVF were 92.86 and 64.29%; specificities were 95.0% and 95.0%; while accuracies were 93.55 and 74.19% respectively. For detected CVT, sensitivities of DISCO and TOF were 100 and 92.31%; specificities were 96.55 and 93.10%; with accuracies 97.62 and 92.86% respectively. In hemodynamic analysis, sensitivity of DISCO for reflux was 95.45%; with a specificity of 95.0%; and accuracy 95.24%. The inter-observer kappa values were 0.857 for DISCO (P < 0.001).

Conclusion

DISCO showed a high degree of sensitivity and specificity, suggesting its effectiveness in detecting DAVF with or without CVT. Intracranial hemodynamics can be identified using DISCO in DAVF patients, providing accurate evaluation of cerebral blood flow dynamics during the pre-treatment phase.