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Background Cardiac diffusion MRI (CDMRI) has the potential to identify acute myocardial ischemia and assess the chronic change of myofiber orientation after a myocardial infarction [1,2]. Cardiac motion and SNR limitations have been the primary challenges for the application of the technique in vivo. A few previous in vivo studies have demonstrated the feasibility of CDMRI in humans using diffusion-weighted (DW) EPI. However, these approaches suffer from inherently poor SNR efficiency in the case of STEAM DW encoding [3] or require the use of a reduced field-of-view (FOV) [4]. In addition, they employ a first order motion compensation (MOCO) to account for cardiac motion, while limiting diffusion encoding duration to less than 30 ms to avoid non-constant velocity motion. This severely hinders the ability to achieve an acceptable b-value for CDMRI with clinical hardware limitations. We propose a novel application of diffusion-prepared balanced steady-state free precession (Diff Prep bSSFP) [5] to include second order MOCO (SOMOCO). This not only allows for sufficiently high b-values, but also takes advantage of the higher SNR efficiency and image quality of bSSFP while ensuring a large FOV.

In vivo cardiac diffusion MRI: second order motion compensated diffusion-prepared balanced steady state free precession (SOMOCO Diff Prep bSSFP)