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Background: Real-time (RT) assessment of ventricular volumes and functionenables data acquisition during free-breathing. However, in children therequirement for high spatiotemporal resolution requires accelerated imagingtechniques. In this study, we implemented a novel RT bSSFP spiral sequencereconstructed using Compressed Sensing (CS) and validated it against thebreath-hold (BH) reference standard for assessment of ventricular volumes inchildren with heart disease.  Methods: Data was acquired in 60 children. Qualitative image scoring andevaluation of ventricular volumes was performed by 3 clinical cardiac MRspecialists. 30 cases were reassessed for intra-observer variability, and theother 30 cases for inter-observer variability.  Results: Spiral RT images were of good quality, however qualitative scoresreflected more residual artefact than standard BH images and slightly loweredge definition. Quantification of Left Ventricular (LV) and Right Ventricular(RV) metrics showed excellent correlation between the techniques with narrowlimits of agreement. However, we observed small but statistically significantoverestimation of LV end-diastolic volume, underestimation of LV end-systolicvolume, as well as a small overestimation of RV stroke volume and ejectionfraction using the RT imaging technique. No difference in inter-observer orintra-observer variability were observed between the BH and RT sequences.  Conclusions: Real-time bSSFP imaging using spiral trajectories combined witha compressed sensing reconstruction is feasible. The main benefit is that itcan be acquired during free breathing. However, another important secondarybenefit is that a whole ventricular stack can be acquired in ~20 seconds, asopposed to ~6 minutes for standard BH imaging. Thus, this technique holds thepotential to significantly shorten MR scan times in children.

Real-time Assessment of Right and Left Ventricular Volumes and Function  in Children Using High Spatiotemporal Resolution Spiral bSSFP with Compressed  Sensing