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Single‐breathhold, four‐dimensional, quantitative assessment of LV and RV function using triggered, real‐time, steady‐state free precession MRI in heart failure patients
Author(s) -
Narayan Girish,
Nayak Krishna,
Pauly John,
Hu Bob
Publication year - 2005
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20358
Subject(s) - steady state free precession imaging , medicine , cardiology , heart failure , ejection fraction , cardiac function curve , cardiac imaging , nuclear medicine , gold standard (test) , magnetic resonance imaging , radiology
Purpose To validate a novel, real‐time, steady‐state free precession (SSFP), single‐breathhold technique for the assessment of left ventricular (LV) and right ventricular (RV) function in heart failure patients. Materials and Methods A total of 20 heart failure patients (mean age 59 ± 17 years) underwent scanning with our new, real‐time, spiral SSFP sequence in which each cardiac phase was acquired in 118 msec at a resolution of 1.8 × 1.8 mm. Each cardiac slice (1‐cm thick) was automatically advanced based on a cardiac trigger, allowing complete coverage of the heart in a single breathhold. The patients also underwent LV and RV assessment with the gold standard: multiple breathhold, cardiac‐gated, segmented k‐space strategy. LV and RV end‐systolic volume (ESV) and end‐diastolic volume (EDV) and LV mass were compared between the two imaging techniques. Results The new real‐time strategy was highly concordant with the gold standard technique in the assessment of LVEDV (r = 0.98), LVESV (r = 0.98), RVESV (r = 0.86), RVEDV (r = 0.91), LVMASS (r = 0.95), RVEF (r = 0.70), and LVEF (r = 0.94). The mean bias (95% confidence interval [CI]) for each parameter is LVEDV: 10.6 cc (cm 3 ) (3.8–17.4 cc), LVESV: −0.8 cc (−5.3 to 3.7 cc), RVEDV: 3.7 cc (−5.6 to 13.2 cc), RVESV: −3.1 cc (−11.1 to 4.9 cc), LVMASS: 26 g (12.4–39.8 g), RVEF: −2.9% (1.3 to −7.2 %), LVEF: 1.9% (5 to −1.1%). In addition, data acquisition was only nine ± two seconds with the real‐time strategy vs. 312 ± 41 seconds for the standard technique. Conclusion In patients with heart failure, real‐time, spiral SSFP allows rapid and accurate assessment of RV and LV function in a single‐breath hold. Using the same strategy, increased temporal resolution will allow real‐time assessment of cardiac wall motion during stress studies. J. Magn. Reson. Imaging 2005;22:59–66. © 2005 Wiley‐Liss, Inc.