Comparison of cardiac volumetry using real-time MRI during free-breathing with standard cine MRI during breath-hold in children

Background Cardiac real-time magnetic resonance imaging (RT-MRI) provides high-quality images even during free- breathing. Difficulties in post-processing impede its use in clinical routine. Objective To demonstrate the feasibility of quantitative analysis of cardiac free-breathing RT-MRI and to compare image quality and volumetry during free-breathing RT-MRI in pediatric patients to standard breath-hold cine MRI. Materials and methods Pediatric patients (n= 22) received cardiac RT-MRI volumetry during free breathing (1.5 T; short axis; 30 frames per s) in addition to standard breath-hold cine imaging in end-expiration. Real-time images were binned retrospec- tively based on electrocardiography and respiratory bellows. Image quality and volumetry were compared using the European Cardiovascular Magnetic Resonance registry score, structure visibility rating, linear regression and Bland–Altman analyses. Results Additional time for binning of real-time images was 2 min. For both techniques, image quality was rated good to excellent. RT-MRI was significantly more robust against artifacts (P< 0.01). Linear regression revealed good correlations for the ventricular volumes. Bland–Altman plots showed a good limit of agreement (LoA) for end-diastolic volume (left ventricle [LV]: LoA -0.1 ± 2.7 ml/m2, right ventricle [RV]: LoA -1.9 ± 3.4 ml/m2), end-systolic volume (LV: LoA 0.4 ± 1.9 ml/m2, RV: LoA 0.6 ± 2.0 ml/m2), stroke volume (LV: LoA -0.5± 2.3 ml/m2, RV: LoA -2.6± 3.3 ml/m2) and ejection fraction (LV: LoA -0.5 ± 1.6%, RV: LoA -2.1 ± 2.8%). Conclusion Compared to standard cine MRI with breath hold, RT-MRI during free breathing with retrospective respiratory binning offers good image quality, reduced image artifacts enabling fast quantitative evaluations of ventricular volumes in clinical practice under physiological conditions

What controls star formation in the central 500 pc of the Galaxy?

The star formation rate (SFR) in the Central Molecular Zone (CMZ, i.e. the central 500 pc) of the Milky Way is lower by a factor of ≥10 than expected for the substantial amount of dense gas it contains, which challenges current star formation theories. In this paper, we quantify which physical mechanisms could be responsible. On scales larger than the disc scaleheight, the low SFR is found to be consistent with episodic star formation due to secular instabilities or possibly variations of the gas inflow along the Galactic bar. The CMZ is marginally Toomre-stable when including gas and stars, but highly Toomre-stable when only accounting for the gas, indicating a low condensation rate of self-gravitating clouds. On small scales, we find that the SFR in the CMZ may be caused by an elevated critical density for star formation due to the high turbulent pressure. The existence of a universal density threshold for star formation is ruled out. The H I–H2 phase transition of hydrogen, the tidal field, a possible underproduction of massive stars due to a bottom-heavy initial mass function, magnetic fields, and cosmic ray or radiation pressure feedback also cannot individually explain the low SFR. We propose a self-consistent cycle of star formation in the CMZ, in which the effects of several different processes combine to inhibit star formation. The rate-limiting factor is the slow evolution of the gas towards collapse – once star formation is initiated it proceeds at a normal rate. The ubiquity of star formation inhibitors suggests that a lowered central SFR should be a common phenomenon in other galaxies. We discuss the implications for galactic-scale star formation and supermassive black hole growth, and relate our results to the star formation conditions in other extreme environments