Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Artifacts in cardiac T1 and T2 mapping techniques - Influence on reliable quantification.","authors":"Maximilian Fenski, Jan Gröschel, Peter Gatehouse, Christoph Kolbitsch, Jeanette Schulz-Menger","doi":"10.1016/j.jocmr.2025.101934","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101934","url":null,"abstract":"<p><p>Cardiac T1 and T2 mapping techniques are well-established methods for obtaining quantitative pixelwise representations of myocardial tissue properties. Mapping images are commonly evaluated quantitatively, and their resulting values play a crucial role in diagnosis and therapeutic decision making in various cardiac pathologies. Despite the validated effectiveness of these techniques, both methodological and patient-specific confounders must be considered when applying them in clinical and research settings. Artifacts - erroneous features within the MR image - can be misinterpreted as true anatomical structures or pathologies, potentially confounding quantitative analyses, conducted by both human readers and AI algorithms. Artifacts can arise from sources such as patient motion, metal objects, hardware constraints, patient-specific scanner adjustments (e.g. flip-angle calibration) and processing errors, particularly within the complex environment of cardiac imaging. While artifact sources in other CMR sequences are well documented, cardiac parametric mapping presents unique challenges due to its distinct image generation and quantitative assessment. This article provides an overview of artifacts encountered in cardiac T1 and T2 mapping, along with a concise explanation of their origins, aiming to raise awareness of their potential impact on clinical decision making. Future developments, including sequences designed to mitigate mapping artifacts, are also briefly discussed. A strong interaction between scientists and clinicians is needed to overcome these challenges and maintain the reliability of quantification results.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101934"},"PeriodicalIF":6.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic Switch-Off in 3D Adenosine Stress CMR Perfusion for Differentiating False-Negative from True-Negative Studies Identified by FFR.","authors":"Mihály Károlyi, Maximilian Fuetterer, Márton Kolossváry, Verena C Wilzeck, Sven Plein, Andrea Biondo, Alexander Gotschy, Michael Frick, Rolf Gebker, Hatem Alkadhi, Ingo Paetsch, Cosima Jahnke, Sebastian Kozerke, Robert Manka","doi":"10.1016/j.jocmr.2025.101933","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101933","url":null,"abstract":"<p><strong>Background: </strong>False-negative cardiac magnetic resonance (CMR) perfusion results may arise from inadequate stress responses, even when patients exhibit an adequate clinical or heart-rate response to adenosine. This study aimed to explore the ability of qualitative and quantitative splenic switch-off markers to differentiate false-negative from true-negative adenosine stress-perfusion CMR findings, in a cohort where fractional flow reserve (FFR) was used to adjudicate lesion significance.</p><p><strong>Methods: </strong>Patients with known or suspected coronary artery disease (CAD) from five centers underwent 3D adenosine stress perfusion CMR and coronary angiography with FFR. Splenic switch-off was assessed qualitatively using both standard stress-to-rest (SSO) and a stress-only (SSO_stress) approach. In addition, quantitative signal intensity (SI) ratios were assessed, including the splenic stress-to-rest SI-ratio (SI_stress/rest) and the spleen-to-myocardium SI ratio at stress (SI_{spleen/myocarcium}). The diagnostic accuracy of these measures was evaluated using cross-validated area under the curve (cvAUC) analysis.</p><p><strong>Results: </strong>Among 179 patients (mean age 63 ± 10 years; 130 male), SSO prevalence was 73% and was significantly more frequent in true-negative than false-negative CMR cases (80.6% vs. 36.8%, p<0.001). SSO_stress showed moderate agreement (κ = 0.60) and robust diagnostic performance (AUC 0.80), as compared to SSO. Splenic SI_stress/rest and SI_{spleen/myocarcium} at stress demonstrated high predictive accuracy for visual SSO, with cvAUCs of 0.94 (95% CI: 0.90-0.96) and 0.90 (95% CI: 0.86-0.95), respectively. The positive likelihood ratio of SSO for true-negative CMR was 1.70, while the negative likelihood ratio was 0.24, indicating false-negative CMR when SSO was absent. Qualitative and quantitative splenic-switch off metrics classified 77-80% of negative CMR cases correctly as true- or false-negatives, with sensitivities ranging from 81.4% to 91.2%. Clinically applicable cut-offs for differentiating true- and false-negative studies with splenic SI_stress/rest and SI_{spleen/myocarcium} at stress were identified as ≤0.32 and ≤0.38, respectively.</p><p><strong>Conclusion: </strong>In a multicenter cohort using FFR-adjudicated reference for lesion severity, qualitative SSO and quantitative signal intensity metrics were associated with myocardial stress adequacy and these markers may improve the interpretation of negative stress-perfusion CMR studies.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101933"},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a deep learning algorithm for detecting significant coronary artery stenosis in whole-heart coronary magnetic resonance angiography.","authors":"Masafumi Takafuji, Masaki Ishida, Takuma Shiomi, Ryohei Nakayama, Miyuko Fujita, Shintaro Yamaguchi, Yuzo Washiyama, Motonori Nagata, Yasutaka Ichikawa, R T Inoue Katsuhiro, Satoshi Nakamura, Hajime Sakuma","doi":"10.1016/j.jocmr.2025.101932","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101932","url":null,"abstract":"<p><strong>Background: </strong>Whole-heart coronary magnetic resonance angiography (CMRA) enables noninvasive and accurate detection of coronary artery stenosis. Nevertheless, the visual interpretation of CMRA is constrained by the observer's experience, necessitating substantial training. The purposes of this study were to develop a deep learning (DL) algorithm using a deep convolutional neural network to accurately detect significant coronary artery stenosis in CMRA and to investigate the effectiveness of this DL algorithm as a tool for assisting in accurate detection of coronary artery stenosis.</p><p><strong>Methods: </strong>Nine hundred and fifty-one coronary segments from 75 patients who underwent both CMRA and invasive coronary angiography (ICA) were studied. Significant stenosis was defined as a reduction in luminal diameter of >50% on quantitative ICA. A DL algorithm was proposed to classify CMRA segments into those with and without significant stenosis. A 4-fold cross-validation method was used to train and test the DL algorithm. An observer study was then conducted using 40 segments with stenosis and 40 segments without stenosis. Three radiology experts and 3 radiology trainees independently rated the likelihood of the presence of stenosis in each coronary segment with a continuous scale from 0 to 1, first without the support of the DL algorithm, then using the DL algorithm.</p><p><strong>Results: </strong>Significant stenosis was observed in 84 (8.8%) of the 951 coronary segments. Using the DL algorithm trained by the 4-fold cross-validation method, the area under the receiver operating characteristic curve (AUC) for the detection of segments with significant coronary artery stenosis was 0.890, with 83.3% sensitivity, 83.6% specificity and 83.6% accuracy. In the observer study, the average AUC of trainees was significantly improved using the DL algorithm (0.898) compared to that without the algorithm (0.821, p<0.001). The average AUC of experts tended to be higher with the DL algorithm (0.897), but not significantly different from that without the algorithm (0.879, p=0.082).</p><p><strong>Conclusion: </strong>We developed a DL algorithm offering high diagnostic accuracy for detecting significant coronary artery stenosis on CMRA. Our proposed DL algorithm appears to be an effective tool for assisting inexperienced observers to accurately detect coronary artery stenosis in whole-heart CMRA.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101932"},"PeriodicalIF":4.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of Circumferential Strain on Cine DENSE MRI Before and After Contrast at 3T.","authors":"Siyue Li, Shu-Fu Shih, Arutyun Pogosyan, Zhengyang Ming, Brian M Dale, Fei Han, J Paul Finn, Kim-Lien Nguyen, Xiaodong Zhong","doi":"10.1016/j.jocmr.2025.101931","DOIUrl":"10.1016/j.jocmr.2025.101931","url":null,"abstract":"<p><strong>Background: </strong>MRI with displacement encoding with stimulated echoes (DENSE) is well recognized for accurate and precise quantification of myocardial displacement and strain, but its reproducibility before and after contrast injection has not been investigated. Gadolinium is the most widely used contrast agent. Ferumoxytol is increasingly used off-label in specific patient groups. We aim to assess the reproducibility of cine DENSE MRI to measure global and segmental circumferential myocardial strain (E_cc) before and after contrast injection for gadolinium and ferumoxytol respectively.</p><p><strong>Methods: </strong>All imaging was conducted using 3T scanners. In 11 patients with cardiac disease, breath-hold 2D cine DENSE was acquired in a mid-ventricular short-axis slice prior to and following the injection of gadolinium (0.1mmol/kg). A separate cohort of 11 subjects (5 healthy subjects and 6 patients with ischemic heart disease) received three incremental doses of ferumoxytol: 0.125, 1.875, and 2.0mg/kg (to a cumulative dose of 4mg/kg). The same DENSE acquisition was performed before and after each incremental dose. Post-processing generated left ventricular (LV) displacement and E_ccmaps, and strain-time curves. Global and segmental E_ccin 6 mid-level short-axis LV segments were compared. Signal-to-noise (SNR) was evaluated on the magnitude images throughout the cardiac cycle in the myocardium, liver, and back muscle respectively. A Bayesian analysis was performed to test results with regions of practical equivalence (ROPE) at ±5 for SNR and ±0.02 for E_cc (p<0.05 as significant).</p><p><strong>Results: </strong>Based on the percentage within the ROPE and the corresponding p-values, global E_ccexhibited excellent practical equivalence under pre- and post-contrast conditions for gadolinium (p = 0.413) and ferumoxytol (p≥0.161). Segmental E_cc reproducibility was consistently high across all comparative analyses, with at least 87.02% falling within the ROPE. Gadolinium administration significantly improved SNR in all tissues during the early systolic phases (1-5, p≤0.021). Ferumoxytol resulted in a reduction in liver SNR during diastolic phases (10-20, p ≤ 0.011) and a significant increase in myocardium SNR during systolic phases (1-5, p ≤ 0.034).</p><p><strong>Conclusions: </strong>Good reproducibility of global and segmental E_CC measurements using cine DENSE before and after contrast injection is achievable at 3T.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101931"},"PeriodicalIF":4.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Phenotype Characterization at MRI in ALPK3 Associated Hypertrophic Cardiomyopathy.","authors":"Lutong Pu, Jie Wang, Mengdi Yu, Yuanwei Xu, Ke Wan, Jiajun Guo, Yangjie Li, Yuchi Han, Yucheng Chen","doi":"10.1016/j.jocmr.2025.101930","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101930","url":null,"abstract":"<p><strong>Background: </strong>Alpha-protein kinase 3 (ALPK3) was recently identified as a candidate gene associated with hypertrophic cardiomyopathy (HCM). However, clinical data regarding carriers of ALPK3 variants are limited.</p><p><strong>Objectives: </strong>To evaluate the prevalence of heterozygous ALPK3 variants in adult patients with HCM through whole-exome sequencing, and to elucidate the phenotypes of individuals harboring these variants.</p><p><strong>Methods: </strong>Consecutive 575 patients diagnosed with HCM who underwent 3 Tesla cardiac magnetic resonance imaging (CMR) and whole exome sequencing genetic testing were recruited. Patients harboring ALPK3 rare missense variants (minor allele frequency < 0.0005) or truncating variants were considered genotype-positive.</p><p><strong>Results: </strong>Among the 575 included patients (65.0% male; median age: 50 [40-61] years), 37 (6.43%) showed heterozygous ALPK3 variants. In comparison with sarcomere variant carriers, ALPK3 heterozygotes showed a higher prevalence of apical hypertrophy (59.5% vs. 20.2%, P < 0.001) and a lower fibrosis burden, with a 2-fold reduction in the incidence of extensive fibrosis (≥15% left ventricle [LV] mass: 8.1% vs. 14.7%, P < 0.001). Patients with single ALPK3 variants were more likely to present with apical HCM (ApHCM; 80.0% vs. 35.3%, P, 0.006) and show a lower extent of late gadolinium enhancement (LGE; 1.26 [0.00-5.77] % vs. 6.00 [3.63-8.50] %, P, 0.011) than those with both ALPK3 and sarcomere variants. CMR characteristics showed no significant differences between carriers with truncating and missense ALPK3 variants. Moreover, among patients with ApHCM, those with single ALPK3 variants were more likely to present with mixed ApHCM (87.5% vs. 55.2% vs. 14.3%, P < 0.05), a lower extent of LGE (0.67 [0-5.77] % vs. 6.32 [2.39-10.90] % vs. 3.32 [0.00-4.68] %, P < 0.05), and greater free-wall and apex LGE involvement (85.7% [six/7] vs. 41.6% [ten/24] vs. 50% [two/4]) than those with MYBPC3 or MYH7 variants.</p><p><strong>Conclusion: </strong>The clinical phenotype of individuals harboring heterozygous ALPK3 variants showed distinct characteristics, characterized by apical hypertrophy, especially mixed apical hypertrophy, and a lower extent of fibrosis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101930"},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ΔR1_blood, a surrogate of blood-pool gadolinium concentration, is related to BMI, gender, LVEDVi, cardiac index and field strength at cardiac magnetic resonance late enhancement imaging.","authors":"Patrick Doeblin, Shing Ching, Wensu Chen, Natalia Solowjowa, Stefanie Maria Werhahn, Rebecca Elisabeth Beyer, Misael Estepa, Christian Stehning, Jeffrey Ji-Peng Li, Henryk Dreger, Sebastian Kelle","doi":"10.1016/j.jocmr.2025.101929","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101929","url":null,"abstract":"<p><strong>Background: </strong>Late Gadolinium Enhancement (LGE) imaging is the cornerstone of tissue characterization via cardiac magnetic resonance imaging. The contrast-enhancing effect of gadolinium is caused by a linear increase of tissue longitudinal R1 relaxation rates (R1=1/T1). The change in R1 of blood pre- and post-contrast (ΔR1_blood) is therefore a surrogate for the blood-pool gadolinium concentration, which in turn correlates linearly to the tissue gadolinium concentration. The total volume of distribution for gadolinium is the extracellular volume of the body, which differs with body composition, potentially leading to variations in blood-pool and tissue gadolinium concentrations.</p><p><strong>Methods: </strong>This study is a hypothesis-generating secondary analysis of a dataset of 1098 patients who underwent contrast CMR between August 2014 and November 2020 at a tertiary center. ΔR1_blood was calculated from T1 relaxation time maps acquired before and approx. 15minutes after application of 0.15mmol/kg gadobutrol. Explorative data analysis and multiple linear regression was performed to assess the influence of body mass index (BMI), gender, age, cardiac index (CI), Hematocrit (HCT) and left ventricular end-diastolic volume index (LVEDVi) on ΔR1_blood.</p><p><strong>Results: </strong>In bivariate analysis, ΔR1_blood showed moderate correlation to BMI and weak correlation to LVEDVi, Hct and CI. The correlation to BMI was higher in women (r=0.52 at 1.5T and r=0.47 at 3T) than in men (r=0.27 at 1.5T and r=0.37 at 3T). Multiple linear regression showed independent predictive value of BMI, BMI:gender, gender, cardiac index (CI), field strength (FS) and LVEDVi (R² =.268, P<.001), with BMI remaining the strongest individual predictor (b = 0.032 [0.025; 0.040], η² = 0.13, P<.001).</p><p><strong>Conclusion: </strong>ΔR1_blood, a measurement of gadolinium contrast enhancement in the blood-pool and a surrogate of plasma C_Gd at the time of late enhancement imaging, showed moderate association with BMI, FS and gender and weak association with LVEDVi and CI. Further research is necessary to assess the need for individualized gadolinium dosing.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101929"},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operational Costs of 4D Flow MRI: A Break-Even Analysis.","authors":"Joshua Engel, Tyler A Jacobson, Michael Markl, Bradley D Allen, Maria Ibanez","doi":"10.1016/j.jocmr.2025.101928","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101928","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic hemodynamics derived from 4D flow MRI (4DF) have shown many advantages for risk stratification and treatment planning. However, clinical adoption has been limited to academic medical centers due to high costs, long scan and post-processing times, and low reimbursement. We quantify these barriers to identify break-even points and assess methods of improving clinical adoption.</p><p><strong>Methods: </strong>We modeled the costs, resource utilization, and reimbursement under case scenarios of base scans of cardiac MRI, MR angiography, adult congenital, and 4DF add-on to the MRI protocol. Price estimates were generated from market research by the purchasing department at a large academic medical center. Time estimates were derived from workflow efficiency studies at the same center. Reimbursement rates were from CMS for 2024b. The opportunity cost of 4DF was calculated as the margin from utilizing incremental scanner time for a mixture of alternate studies. Break-even points were modeled as the number of scans needed for the yearly margin of performing 4DF to exceed performing the base scans alone. Sensitivity analyses were performed for ranges of CPT 75565 reimbursement, 4DF exam time, and 4DF annual software cost.</p><p><strong>Results: </strong>The incremental variable cost per 4DF scan was $101.40 at a 4DF scan time of 15minutes, after accounting for the opportunity cost of scanner utilization. Break-even points were calculated across reimbursement ranging from $40-65/unit of CPT 75565, annual software costs of $10,000-70,000, and 4DF scan times of 5-20minutes. At a scan time of 15minutes and reimbursement of $47.87/unit of CPT 75565, break-even points ranged from 112 to 778 scans as software cost increased from $10,000 to $70,000. Highly accelerated 4DF with a 5-minute scan time instead of standard 15-minute techniques would break even with about half of the scans, with break-even points ranging from 64 to 444 as software costs increased from $10,000 to $70,000.</p><p><strong>Discussion: </strong>Long scan times and high resource utilization limit the financial viability of 4DF outside of high-volume academic medical centers. Further development of accelerated 4D flow imaging techniques and expanded reimbursement criteria are needed to enable wider clinical adoption.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101928"},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of pilot tone-triggered and electrocardiogram-triggered cardiac magnetic resonance imaging: a prospective clinical feasibility study.","authors":"Xianling Qian, Yali Wu, Peter Speier, Caixia Fu, Yunzhu Wu, Lude Cheng, Yinyin Chen, Shiyu Wang, Caizhong Chen, Kai Liu, Ling Chen, Hang Jin, Mengsu Zeng","doi":"10.1016/j.jocmr.2025.101925","DOIUrl":"10.1016/j.jocmr.2025.101925","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiogram (ECG)-triggered cardiovascular magnetic resonance (CMR) can be challenging in patients with ECG unreliability. Pilot tone (PT)-triggered CMR may offer a reliable alternative.</p><p><strong>Purpose: </strong>To evaluate the feasibility of PT-triggered CMR and compare its performance with ECG-triggered imaging across various sequences in patients with common cardiovascular diseases.</p><p><strong>Methods: </strong>This prospective study included 50 participants (26 males, 24 females; mean age 46.0±19.0y), including 15 with normal CMR findings and 35 with various cardiovascular diseases. All participants underwent both PT-triggered and ECG-triggered CMR on a 3T MRI system. Imaging included T2-weighted imaging (T2WI), T1-mapping, T2-mapping, cine, late gadolinium enhancement (LGE), and post-contrast T1-mapping sequences. Image quality and quantitative measurements were evaluated, including T2WI signal intensity, native T1-mapping, T2-mapping, and extracellular volume fraction (ECV) values, and comparative signal-to-noise ratio (compSNR) and comparative contrast-to-noise ratio (compCNR) of cine and LGE images, left/right ventricular function. Inter-reader agreement was evaluated using the intraclass correlation coefficient (ICC). Comparisons between the two methods were performed using paired t-test or the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>No significant differences were observed in scanning times (p=.253-.864) or image quality (ICC: .589-1.000, p=.057-1.000) between PT- and ECG-triggered scans and images. Quantitative assessments showed good to excellent consistency (ICC=.843-.987). While PT-triggered LGE images showed higher compCNR (14.14±7.68 vs. 13.24±7.52, p=.016), other quantitative parameters showed no significant differences between PT- and ECG-triggered images. Six participants with hypertrophic cardiomyopathy or heart valve disease experienced false R-wave triggering during ECG gating, leading to motion artifacts, which were not visible in PT-triggered images.</p><p><strong>Conclusion: </strong>PT-triggered cardiac MRI provides comparable image quality and quantitative assessments to ECG-triggered sequences and may offer advantages in minimizing motion artifacts, particularly in patients with conditions affecting ECG reliability, making it a promising alternative for cardiac MRI synchronization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101925"},"PeriodicalIF":4.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal values of high-resolution transmural perfusion distribution metrics for automated quantitative pixel-wise myocardial perfusion cardiovascular magnetic resonance.","authors":"Christel H Kamani, Louise Brown, Thomas Anderton, Raluca Tomoaia, Chin Soo, Gaurav S Gulsin, David A Broadbent, Jian L Yeo, Alice L Wood, Christopher E D Saunderson, Ioannis Botis, Arka Das, Nicholas Jex, Amrit Chowdhary, Sharmaine Thirunavukarasu, Noor Sharrack, Peter P Swoboda, Hui Xue, John P Greenwood, David Adlam, Eylem Levelt, Gerry P McCann, Peter Kellman, Sven Plein","doi":"10.1016/j.jocmr.2025.101927","DOIUrl":"10.1016/j.jocmr.2025.101927","url":null,"abstract":"<p><strong>Background: </strong>The myocardial blood flow (MBF) transmural distribution between the subendocardial (ENDO) and subepicardial (EPI) layers under resting and hyperemic conditions can aid in the diagnosis of several forms of heart disease. Recently proposed automated in-line myocardial perfusion cardiovascular magnetic resonance (CMR) allows pixel-wise quantification of ENDO- and EPI-MBF, but normal values for these parameters are lacking. We therefore aimed to establish normal values for transmural distribution of MBF in a healthy population.</p><p><strong>Methods: </strong>138 healthy participants from two centers underwent adenosine stress and rest myocardial perfusion CMR. Global and myocardial slice-specific stress/rest ENDO- and EPI-MBF values were derived using pixel-wise in-line automatic post-processing, and transmural perfusion metrics (ENDO and EPI myocardial perfusion reserve [MPR_ENDO, MPR_EPI]; stress and rest ENDO-to-EPI gradient [sGRAD and rGRAD]) were computed using the Gadgetron software.</p><p><strong>Results: </strong>The study cohort comprised 84 males and 54 females (mean age: 50±36) with no cardiovascular disease or risk factors. In the entire cohort, MPR_ENDO (3.3±1.2) was significantly lower (p<0.001) than MPR_EPI (3.9±1.2). sGRAD (0.98±0.09) was significantly lower (p<0.001) than rGRAD (1.11±0.07). \"While there were no sex-specific differences in the majority of these metrics, all correlated inversely with increasing age. We propose specific values for each slice. These are conditional to the pulse sequence, acquisition timing and analysis method used in this work, as mean ± SD values at the basal, mid and apical level for MPR_ENDO (3.7±1.1, 3.3±0.9, 3.6±1.0), MPR_EPI (4.0±1.1, 3.9±1.1, 4.0±1.1), sGRAD (1.00±0.13, 0.92±0.09, 1.06±0.18) and rGRAD (1.10±0.09, 1.09±0.07, 1.18±0.11).</p><p><strong>Conclusion: </strong>Normal global and myocardial slice-specific values of MPR_ENDO, MPR_EPI, sGRAD and rGRAD using in-line automated MBF quantification from first pass myocardial perfusion CMR are presented. While there were no sex-specific differences in any of these metrics, all correlated inversely with increasing age. Understanding the MBF dynamics of the myocardial layers in healthy subjects will help to characterize MBF alterations in patients with coronary artery disease or microvascular dysfunction.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101927"},"PeriodicalIF":4.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-efficient simultaneous fat and water cardiac cine imaging using spiral MRI.","authors":"Tzu Cheng Chao, Dinghui Wang, James G Pipe, Tim Leiner","doi":"10.1016/j.jocmr.2025.101926","DOIUrl":"10.1016/j.jocmr.2025.101926","url":null,"abstract":"<p><strong>Background: </strong>Cardiac cine imaging is routinely used in patient with suspected or known cardiac dysfunction. Water and fat (W/F) separated cardiovascular magnetic resonance (CMR) will be helpful to distinguish adipose tissue, blood and myocardium. Inclusion of a multi-echo acquisition in the conventional balanced steady-state free precession (bSSFP) cine sequence can introduce artifacts and reduce temporal resolution. Spiral MRI is known for its signal-to-noise ratio (SNR) efficiency and has the potential to improve temporal efficiency for W/F separated cine imaging. The present work implements a spoiled gradient echo sequence (SPGR) with spiral trajectory to obtain W/F separated cine images simultaneously.</p><p><strong>Methods: </strong>Three different sequences were performed for comparison, a Cartesian 2-TE bSSFP sequence, a Cartesian 3-TE bSSFP sequence, and the proposed spiral SPGR sequence. Five volunteers were recruited for the scans on a 1.5T scanner with spatial resolution 1.7×1.7×8.0mm³ over a 400×400mm² FOV. In addition to qualitative comparisons, a quantitative measurement is performed in terms of the contrast to noise ratio (CNR).</p><p><strong>Results: </strong>The proposed method to obtain W/F separated cine images provides better temporal efficiency and fewer artifacts compared to conventional Cartesian bSSFP sequences. The 2-TE bSSFP features the highest artifact level including susceptibility artifacts and fat/water swaps. The proposed method reduces scan time by approximately 50% with similar spatial and temporal resolution with lower specific absorption rate (SAR). The contrast between the blood pool and myocardium is higher when using the spiral readout (p≤0.05). The results suggest that the presented sequence has potential to facilitate simultaneous imaging for water and fat components in a cine scan while shortening exam time and lowering SAR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101926"},"PeriodicalIF":4.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}