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WE‐FG‐206‐04: Comprehensive Evaluation of Left Ventricular (LV) Filling and Ejection Using High Frame Rate Cine MR Imaging: Key Technical and Methodological Requirements
Author(s) -
Zhang J,
Cheong B,
Pednekar A,
Arena C,
Dees D,
Muthupillai R
Publication year - 2016
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.4957934
Subject(s) - steady state free precession imaging , temporal resolution , nuclear medicine , medicine , diastole , cardiac imaging , flip angle , ejection fraction , magnetic resonance imaging , cardiology , physics , radiology , heart failure , blood pressure , quantum mechanics
Purpose: Unlike echocardiography which can quantify both LV filling and ejection, cine steady state free precession sequence (SSFP)‐despite its high intrinsic signal and contrast to noise ratio, accuracy and precision of volume measurements‐, is mostly relegated to quantifying LV ejection. The steady‐state requirement typically constrains SSFP sequence to a breathhold (and limited temporal resolution). We describe: (a) free breathing cine SSFP approach that meets the SS requirement allowing high frame rate acquisition, (b) two MRI indices based on time‐LV volume (TV) change during filling and compare against echocardiagraphic diastolic index (E/A ratio), and (c) evaluate the effect of temporal resolution on: LV volumes; ejection and filling rates; and normalized indices of systolic and diastolic function. Methods: A stack of contiguous LV short axis slices at high temporal resolution (τ=15 ms) was acquired using an in‐house respiratory‐triggered (RT), SS prepared, cardiac gated, free‐breathing cine SSFP sequence (TR/TE/flip: 3.2 ms/1.5 ms/55°). All 24 study subjects provided written informed consent per IRB requirements. Subjects underwent both echo and MRI in one imaging session. From the expert‐drawn contours, TV curve, and its derivative (dV/dt) were generated and these curves were downsampled to rates at 2τ,3τ,and 4τ. From TV and dV/dt curves during the early filling period (EFP) and late filling periods (LFP), volume based (V EFP /V LFP ) and rate based (R EFP /R LFP ) diastolic indices were respectively defined, and calculated for each temporal resolution. Results: V EFP /V LFP and R EFP /R LFP correlated well with E/A echo . As temporal resolution declined from τ to 3τ, absolute percentage errors were: LV chamber volumes < 5%, V EFP /V LFP < 10%, and R EFP /R LFP > 20%.. Conclusion: By incorporating SS prep, RT can be used to obtain high frame rate cine SSFP sequence that can evaluate both LV systolic and diastolic function. Temporal resolution of cine SSFP is a key determinant of error in rate based diastolic indices. Research was partly supported by funding from Philips Healthcare.