Feasibility of single breath-hold left ventricular function with 3 Tesla TSENSE acquisition and 3D modeling analysis

<p>Abstract</p> <p>Background</p> <p>A single breath-hold evaluation of ventricular function would allow assessment in cases where scan time or patient tolerance is limited. Spatiotemporal acceleration techniques such as TSENSE decrease cardiovascular MR acquisition time, but standard slice summation analysis requires enough short axis slices to cover the left ventricle (LV). By reducing the number of short axis slices, incorporating long axis slices, and applying a 3D model based analysis, it may be possible to obtain accurate LV mass and volumes. We evaluated LV volume, mass and ejection fraction at 3.0T using a 3D modeling analysis in 9 patients with a history of myocardial infarction and one healthy volunteer. Acquisition consisted of a standard short axis SSFP stack and a 15 heart-beat single breath-hold six slice multi-planar (4 short and 2 long axis) TSENSE SSFP protocol with an acceleration factor of <it>R </it>= 4.</p> <p>Results</p> <p>Differences (standard minus accelerated protocol mean ± s.d.) and coefficients of variation (s.d. of differences as a percentage of the average estimate) were 7.5 ± 9.6 mL and 6% for end-diastolic volume (p = 0.035), 0.4 ± 5.1 mL and 7% for end-systolic volume (p = NS), 7.1 ± 8.1 mL and 9% for stroke volume (p = 0.022), 2.2 ± 2.8% and 5% for ejection fraction (p = 0.035), and -7.1 ± 6.2 g and 4% for LV mass (p = 0.005), respectively. Intra- and inter-observer errors were similar for both protocols (p = NS for all measures).</p> <p>Conclusion</p> <p>These results suggest that clinically useful estimates of LV function can be obtained in a TSENSE accelerated single breath-hold reduced slice acquisition at 3T using 3D modeling analysis techniques.</p

Dynamic and Static Magnetic Resonance Angiography of the Supra-aortic Vessels at 3.0 T Intraindividual Comparison of Gadobutrol, Gadobenate Dimeglumine, and Gadoterate Meglumine at Equimolar Dose

Purpose: The purpose of this study was the intraindividual comparison of a 1.0 M and two 0.5 M gadolinium-based contrast agents (GBCA) using equimolar dosing in dynamic and static magnetic resonance angiography (MRA) of the supra-aortic vessels. Materials and Methods: In this institutional review board-approved study, a total of 20 healthy volunteers (mean +/- SD age, 29 +/- 6 years) underwent 3 consecutive supra-aortic MRA examinations on a 3.0 T magnetic resonance system. The order of GBCA (Gadobutrol, Gadobenate dimeglumine, and Gadoterate meglumine) was randomized with a minimum interval of 48 hours between the examinations. Before each examination and 45 minutes after each examination, circulatory parameters were recorded. Total GBCA dose per MRA examination was 0.1 mmol/kg with a 0.03 mmol/kg and 0.07 mmol/kg split for dynamic and static MRA, respectively, injected at a rate of 2 mL/s. Two blinded readers qualitatively assessed static MRA data sets independently using pairwise rankings (superior, inferior, and equal). In addition, quantitative analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) evaluation as well as vessel sharpness analysis of static MRA using an in-house-developed semiautomated tool. Dynamic MRA was evaluated for maximal SNR. Statistical analysis was performed using the Cohen kappa, the Wilcoxon rank sum tests, and mixed effects models. Results: No significant differences of hemodynamic parameters were observed. In static MRA, Gadobutrol was rated superior to Gadoterate meglumine (P 0.05). Maximal SNR in dynamic MRA using Gadobutrol was significantly higher than both comparators at the level of the proximal and distal internal carotid artery (P < 0.05 and P < 0.05; P < 0.05 and P < 0.05). Conclusions: At equimolar doses, 1.0 M Gadobutrol demonstrates higher SNR/CNR than do Gadobenate dimeglumine and Gadoterate meglumine, with superior image quality as compared with Gadoterate meglumine for dynamic and static carotid MRA. Despite the shortened bolus with Gadobutrol, no blurring of vessel edges was observed

Multimodality Imaging in the Evaluation of Cardiovascular Manifestations of Malignancy

Up to one third of the population will die as a direct result of cancer. Accurate and timely diagnosis of disease often requires multiple different approaches including the use of modern imaging techniques. Prompt recognition of adverse consequences of some anti-cancer therapies also requires a knowledge of the optimum imaging strategy for the problem at hand. The purpose of this article is to review not only some of the commoner cardiovascular manifestations of malignancy but also to discuss the strengths, weaknesses and appropriate use of cardiovascular imaging modalities

Free Breathing Real-Time Cardiac Cine Imaging With Improved Spatial Resolution at 3 T

Objectives: The aim of this study was to evaluate free-breathing single-shot real-time cine imaging for functional cardiac imaging at 3 +/- with increased spatial resolution. Special emphasis of this study was placed on the influence of parallel imaging techniques. Materials and Methods: Gradient echo phantom images were acquired with GRAPPA and modified SENSE reconstruction using both integrated and separate reference scans as well as TGRAPPA and TSENSE. In vivo measurements were performed for GRAPPA reconstruction with an integrated and a separate reference scan, as well as TGRAPPA using balanced steady-state free precession protocols. Three clinical protocols, rtLRInt (T-res = 51.3 milliseconds; voxel, 2.5 x 5.0 x 10 mm(3)), rtMRSep (T-res = 48.8 milliseconds; voxel, 1.9 x 3.1 x 10 mm(3)), and rtHRSep ((Tres) = 48.3 milliseconds; voxel, 1.6 x 2.6 x 10 mm(3)), were investigated on 20 volunteers using GRAPPA reconstruction with internal as well as separate reference scans. End-diastolic volume, end-systolic volume, ejection fraction, peak ejection rate, peak filling rate, and myocardial mass were evaluated for the left ventricle and compared with an electrocardiogram-triggered segmented readout cine protocol used as standard of reference. All studies were performed at 3 T. Results: Phantom and in vivo data demonstrate that the combination of GRAPPA reconstruction with a separate reference scan provides an optimal compromise of image quality as well as spatial and temporal resolution. Functional values (P values) for the standard of reference, rtLRInt, rtMRSep, and rtHRSep end-diastolic volume were 141 +/- 24 mL, 138 +/- 21 mL, 138 +/- 19 mL, and 128 +/- 33 mL, respectively (P = 0.7, 0.7, 0.4); end-systolic volume, 55 +/- 15 mL, 61 +/- 14 mL, 58 +/- 12 mL, and 55 +/- 20 mL, respectively (P = 0.23, 0.43, 0.62); ejection fraction, 61% +/- 5%, 57% +/- 5%, 58% +/- 4%, and 56% +/- 8%, respectively (P = 0.01, 0.11, 0.06); peak ejection rate, 481 +/- 73 mL/s, 425 +/- 62 mL/s, 434 +/- 67 mL/s, and 381 +/- 86 mL/s, respectively (P = 0.03, 0.04, 0.01); peak filling rate, 555 +/- 80 mL/s, 480 +/- 70 mL/s, 500 +/- 70 mL/s, and 438 +/- 108 mL/s, respectively (P = 0.007, 0.05, 0.004); and myocardial mass, 137 +/- 26 g, 141 T 25 g, 141 +/- 23 g, and 130 +/- 31 g, respectively (P = 0.62, 0.54, 0.99). Conclusions: Using a separate reference scan and high acceleration factors up to R = 6, single-shot real-time cardiac imaging offers adequate temporal and spatial resolution for accurate assessment of global left ventricular function in free breathing with short examination times

Free Breathing Real-Time Cardiac Cine Imaging With Improved Spatial Resolution at 3 T

Objectives: The aim of this study was to evaluate free-breathing single-shot real-time cine imaging for functional cardiac imaging at 3 +/- with increased spatial resolution. Special emphasis of this study was placed on the influence of parallel imaging techniques. Materials and Methods: Gradient echo phantom images were acquired with GRAPPA and modified SENSE reconstruction using both integrated and separate reference scans as well as TGRAPPA and TSENSE. In vivo measurements were performed for GRAPPA reconstruction with an integrated and a separate reference scan, as well as TGRAPPA using balanced steady-state free precession protocols. Three clinical protocols, rtLRInt (T-res = 51.3 milliseconds; voxel, 2.5 x 5.0 x 10 mm(3)), rtMRSep (T-res = 48.8 milliseconds; voxel, 1.9 x 3.1 x 10 mm(3)), and rtHRSep ((Tres) = 48.3 milliseconds; voxel, 1.6 x 2.6 x 10 mm(3)), were investigated on 20 volunteers using GRAPPA reconstruction with internal as well as separate reference scans. End-diastolic volume, end-systolic volume, ejection fraction, peak ejection rate, peak filling rate, and myocardial mass were evaluated for the left ventricle and compared with an electrocardiogram-triggered segmented readout cine protocol used as standard of reference. All studies were performed at 3 T. Results: Phantom and in vivo data demonstrate that the combination of GRAPPA reconstruction with a separate reference scan provides an optimal compromise of image quality as well as spatial and temporal resolution. Functional values (P values) for the standard of reference, rtLRInt, rtMRSep, and rtHRSep end-diastolic volume were 141 +/- 24 mL, 138 +/- 21 mL, 138 +/- 19 mL, and 128 +/- 33 mL, respectively (P = 0.7, 0.7, 0.4); end-systolic volume, 55 +/- 15 mL, 61 +/- 14 mL, 58 +/- 12 mL, and 55 +/- 20 mL, respectively (P = 0.23, 0.43, 0.62); ejection fraction, 61% +/- 5%, 57% +/- 5%, 58% +/- 4%, and 56% +/- 8%, respectively (P = 0.01, 0.11, 0.06); peak ejection rate, 481 +/- 73 mL/s, 425 +/- 62 mL/s, 434 +/- 67 mL/s, and 381 +/- 86 mL/s, respectively (P = 0.03, 0.04, 0.01); peak filling rate, 555 +/- 80 mL/s, 480 +/- 70 mL/s, 500 +/- 70 mL/s, and 438 +/- 108 mL/s, respectively (P = 0.007, 0.05, 0.004); and myocardial mass, 137 +/- 26 g, 141 T 25 g, 141 +/- 23 g, and 130 +/- 31 g, respectively (P = 0.62, 0.54, 0.99). Conclusions: Using a separate reference scan and high acceleration factors up to R = 6, single-shot real-time cardiac imaging offers adequate temporal and spatial resolution for accurate assessment of global left ventricular function in free breathing with short examination times

Dynamic and Static Magnetic Resonance Angiography of the Supra-aortic Vessels at 3.0 T Intraindividual Comparison of Gadobutrol, Gadobenate Dimeglumine, and Gadoterate Meglumine at Equimolar Dose

Purpose: The purpose of this study was the intraindividual comparison of a 1.0 M and two 0.5 M gadolinium-based contrast agents (GBCA) using equimolar dosing in dynamic and static magnetic resonance angiography (MRA) of the supra-aortic vessels. Materials and Methods: In this institutional review board-approved study, a total of 20 healthy volunteers (mean +/- SD age, 29 +/- 6 years) underwent 3 consecutive supra-aortic MRA examinations on a 3.0 T magnetic resonance system. The order of GBCA (Gadobutrol, Gadobenate dimeglumine, and Gadoterate meglumine) was randomized with a minimum interval of 48 hours between the examinations. Before each examination and 45 minutes after each examination, circulatory parameters were recorded. Total GBCA dose per MRA examination was 0.1 mmol/kg with a 0.03 mmol/kg and 0.07 mmol/kg split for dynamic and static MRA, respectively, injected at a rate of 2 mL/s. Two blinded readers qualitatively assessed static MRA data sets independently using pairwise rankings (superior, inferior, and equal). In addition, quantitative analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) evaluation as well as vessel sharpness analysis of static MRA using an in-house-developed semiautomated tool. Dynamic MRA was evaluated for maximal SNR. Statistical analysis was performed using the Cohen kappa, the Wilcoxon rank sum tests, and mixed effects models. Results: No significant differences of hemodynamic parameters were observed. In static MRA, Gadobutrol was rated superior to Gadoterate meglumine (P 0.05). Maximal SNR in dynamic MRA using Gadobutrol was significantly higher than both comparators at the level of the proximal and distal internal carotid artery (P < 0.05 and P < 0.05; P < 0.05 and P < 0.05). Conclusions: At equimolar doses, 1.0 M Gadobutrol demonstrates higher SNR/CNR than do Gadobenate dimeglumine and Gadoterate meglumine, with superior image quality as compared with Gadoterate meglumine for dynamic and static carotid MRA. Despite the shortened bolus with Gadobutrol, no blurring of vessel edges was observed