Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Simultaneous non-contrast assessment of cardiac microstructure and perfusion in vivo in the human heart.","authors":"Camila Munoz, Eunji Lim, Pedro F Ferreira, Dudley J Pennell, Sonia Nielles-Vallespin, Andrew D Scott","doi":"10.1016/j.jocmr.2024.101129","DOIUrl":"10.1016/j.jocmr.2024.101129","url":null,"abstract":"<p><strong>Background: </strong>Intravoxel incoherent motion (IVIM) imaging can provide information on cardiac microstructure and microvascular perfusion from a single examination. However, the spin echo-based approaches typically used for cardiac IVIM suffer from low sensitivity to changes in perfusion. The aim of this work was to develop a stimulated-echo (STEAM)-based method for IVIM and diffusion tensor cardiovascular magnetic resonance to simultaneously provide biomarkers of microstructure and perfusion in vivo in the human heart.</p><p><strong>Methods: </strong>Here we introduce a novel STEAM-IVIM sequence incorporating phase cycling to obtain true non-diffusion weighted images (b = 0 s/mm²). STEAM-IVIM imaging was performed at 20 b-values (0 to 1000 s/mm²) to enable accurate estimation of the IVIM parameters, and with six diffusion encoding directions to enable reconstruction of the diffusion tensor. 20 healthy subjects (8 female, median age 31 years) were imaged on a clinical 3T system with STEAM-IVIM. A simulation study was performed to investigate the optimal fitting algorithms for the IVIM parameters, which was subsequently used to create pixel-wise IVIM parameter maps for the in vivo acquisitions.</p><p><strong>Results: </strong>Good image quality across the myocardium was obtained for all b-values. Mean(±SD) IVIM parameter estimates were: diffusivity D = 0.83 ± 0.07 × 10-3 mm²/s, perfusion coefficient D* = 19.08 ± 6.48 × 10-3 mm²/s, perfusion fraction f = 19.72 ± 4.11%, and mean diffusion tensor parameters were: mean diffusivity = 0.88 ± 0.06 × 10-3 mm²/s, fractional anisotropy = 0.45 ± 0.04, absolute E2 angle = 55.29 ± 6.38º, helix angle gradient = -0.68 ± 0.18º/%.</p><p><strong>Conclusion: </strong>Phase-cycled STEAM-IVIM enables fitting of cardiac diffusion tensor and perfusion parameters in healthy subjects and shows promise for the simultaneous detection of microstructural aberration and perfusion abnormalities in the presence of cardiac disease without the need for exogenous contrast agents.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101129"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic vessel segmentation and reformation of non-contrast coronary magnetic resonance angiography using transfer learning-based three-dimensional U-net with attention mechanism.","authors":"Lu Lin, Yijia Zheng, Yanyu Li, Difei Jiang, Jian Cao, Jian Wang, Yueting Xiao, Xinsheng Mao, Chao Zheng, Yining Wang","doi":"10.1016/j.jocmr.2024.101126","DOIUrl":"10.1016/j.jocmr.2024.101126","url":null,"abstract":"<p><strong>Background: </strong>Coronary magnetic resonance angiography (CMRA) presents distinct advantages, but its reliance on manual image post-processing is labor-intensive and requires specialized knowledge. This study aims to design and test an efficient artificial intelligence (AI) model capable of automating coronary artery segmentation and reformation from CMRA images for coronary artery disease (CAD) diagnosis.</p><p><strong>Methods: </strong>By leveraging transfer learning from a pre-existing coronary computed tomography angiography model, a three-dimensional attention-aware U-Net was established, trained, and validated on a dataset of 104 subjects' CMRA. Furthermore, an independent clinical evaluation was conducted on an additional cohort of 70 patients. The AI model's performance in segmenting coronary arteries was assessed using the Dice similarity coefficient (DSC) and recall. The comparison between the AI model and manual processing by experienced radiologists on vessel reformation was based on reformatted image quality (rIQ) scoring, post-processing time, and the number of necessary user interactions. The diagnostic performance of AI-segmented CMRA for significant stenosis (≥50% diameter reduction) was evaluated using conventional coronary angiography (CAG) as a reference in sub-set data.</p><p><strong>Results: </strong>The DSC of the AI model achieved on the training and validation sets were 0.952 and 0.944, with recalls of 0.936 and 0.923, respectively. In the clinical evaluation, the model outperformed manual processes by reducing vessel post-processing time, from 632.6±17.0 s to 77.4±8.9 s, and the number of user interactions from 221±59 to 8±2. The AI post-processed images maintained high rIQ scores comparable to those processed manually (2.7±0.8 vs 2.7±0.6; P = 0.4806). In subjects with CAG, the prevalence of CAD was 71%. The sensitivity, specificity, and accuracy at patient-based analysis were 94%, 71%, and 88%, respectively, by AI post-processed whole-heart CMRA.</p><p><strong>Conclusion: </strong>The AI auto-segmentation system can effectively facilitate CMRA vessel reformation and reduce the time consumption for radiologists. It has the potential to become a standard component of daily workflows, optimizing the clinical application of CMRA in the future.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101126"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cine cardiac magnetic resonance segmentation using temporal-spatial adaptation of prompt-enabled segment-anything-model: a feasibility study.","authors":"Zhennong Chen, Sekeun Kim, Hui Ren, Sunghwan Kim, Siyeop Yoon, Quanzheng Li, Xiang Li","doi":"10.1016/j.jocmr.2025.101909","DOIUrl":"10.1016/j.jocmr.2025.101909","url":null,"abstract":"<p><strong>Background: </strong>We propose an approach to adapt a segmentation foundation model, segment-anything-model (SAM), for cine cardiovascular magnetic resonance (CMR) segmentation and evaluate its generalization performance on unseen datasets.</p><p><strong>Methods: </strong>We present our model, cineCMR-SAM, which introduces a temporal-spatial attention mechanism to produce segmentation across one cardiac cycle. We freeze the pre-trained SAM's weights to leverage SAM's generalizability while fine-tuning the rest of the model on two public cine CMR datasets. Our model also enables text prompts to specify the view type (short-axis or long-axis) of the input slices and box prompts to guide the segmentation region. We evaluated our model's generalization performance on three external testing datasets including a public multi-center, multi-vendor testing dataset of 136 cases and 2 retrospectively collected in-house datasets from 2 different centers with specific pathologies: aortic stenosis (40 cases) and heart failure with preserved ejection fraction (HFpEF) (53 cases).</p><p><strong>Results: </strong>Our approach achieved superior generalization in both the public testing dataset (Dice for LV=0.94 and for myocardium=0.86) and two in-house datasets (Dice ≥0.90 for LV and ≥0.82 for myocardium) compared to existing CMR deep learning segmentation methods. Clinical parameters derived from automatic and manual segmentations showed a strong correlation (r ≥0.90). The use of both text prompts and box prompts enhanced the segmentation accuracy.</p><p><strong>Conclusion: </strong>cineCMR-SAM effectively adapts SAM for cine CMR segmentation, achieving high generalizability and superior accuracy on unseen datasets.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101909"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the limits of scan time reduction for ferumoxytol-enhanced whole-heart angiography in congenital heart disease patients.","authors":"Ludovica Romanin, Milan Prsa, Christopher W Roy, Xavier Sieber, Jérôme Yerly, Bastien Milani, Tobias Rutz, Salim Si-Mohamed, Estelle Tenisch, Davide Piccini, Matthias Stuber","doi":"10.1016/j.jocmr.2025.101854","DOIUrl":"10.1016/j.jocmr.2025.101854","url":null,"abstract":"<p><strong>Background: </strong>One major challenge in cardiovascular magnetic resonance is reducing scan times to be more compatible with clinical workflows. In 3D magnetic resonance imaging (MRI), strategies to shorten scan times mostly rely on ECG-triggering or self-navigation for motion management, but are affected by heart rate variabilities or respiratory drifts. A similarity-driven multi-dimensional binning algorithm (SIMBA) was introduced for 3D whole-heart angiography from ferumoxytol-enhanced free-running MRI. This study explores acceleration limits using SIMBA, and its compressed-sensing extension extra-dimensional motion-compensation (XD-MC)-SIMBA, while preserving image quality.</p><p><strong>Methods: </strong>Data from 6-min free-running acquisitions of 30 congenital heart disease (CHD) patients were retrospectively undersampled to simulate 5-, 4-, 3-, 2-, and 1-min datasets. SIMBA and XD-MC-SIMBA reconstructions were applied. and the consistency of the data selection together with sharpness metrics were computed as a function of undersampling. Image quality was rated on a 5-point Likert scale. Shorter 3-minute acquisitions were prospectively acquired in nine CHD patients.</p><p><strong>Results: </strong>SIMBA's motion state selection was consistent across undersampling levels, with only 2 of 30 cases showing completely different selections. Image quality metrics decreased with increased undersampling, with SIMBA scoring lower compared to XD-MC-SIMBA. The diagnostic quality was good, with lower scores for 2- and 1-min datasets. Using XD-MC-SIMBA, 43% (31/72) of cases showed improved scores compared to SIMBA and 58% (7/12) of 1-min datasets improved to good or excellent quality.</p><p><strong>Conclusions: </strong>This study demonstrates that ferumoxytol-enhanced free-running MRI can be highly accelerated for 3D angiography in CHD.With the aid of compressed sensing, XD-MC-SIMBA supports the acceleration down to 3 minutes or less.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101854"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of cardiovascular magnetic resonance in clinical application and scientific research: a national survey in China.","authors":"Huaying Zhang, Mengdi Jiang, Wenjing Yang, Di Zhou, Yining Wang, Leyi Zhu, Qiang Zhang, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao, Xiaohu Li, Xinxiang Zhao, Hui Liu, Hongjie Hu, Min Liu, Yi He, Qi Yang, Yining Wang, Yingkun Guo, Minwen Zheng, Fuhua Yan, Minjie Lu","doi":"10.1016/j.jocmr.2025.101877","DOIUrl":"10.1016/j.jocmr.2025.101877","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is rapidly expanding in China, yet comprehensive national data on its clinical application and research status are limited. This study aims to evaluate the current landscape of CMR across the country.</p><p><strong>Methods: </strong>An electronic survey was conducted targeting the following two groups: physicians trained at the Fuwai Fellowship Program and members of the Chinese Society of Radiology. The survey encompassed details on CMR equipment, clinical practices, and research activities.</p><p><strong>Results: </strong>Of 248 hospitals responded to the survey, 98.0% (243/248) were tertiary centers. The number of scanners distributed unevenly across geographic regions, with Central South China leading with 5.9/center. Siemens, Philips and GE were top three scanner vendors. Most centers initiated CMR program post-2015. Coronary artery disease was the primary indication for CMR. The median annual volume was 120/center. High-volume centers unevenly concentrated most CMR cases. The weighted average waiting period was 14.2 days, while scan durations ranged from 40 to 60 min. Two thirds of hospitals used post-processing software to analyze imaging. Half of responding centers included T1 and T2 mapping in clinical routine, but stress perfusion was underutilized in both clinic and research. Approximately one-third of centers had published CMR-related research. The majority of physicians were confident about the development of CMR. Major barriers to CMR development included long scan times, high costs, insufficient equipment, and limited training.</p><p><strong>Conclusion: </strong>CMR is experiencing rapid growth in China but faces significant regional disparities in access to technology and expertise. Efforts to reduce costs, improve training, and expand access to advanced techniques are crucial for balanced development.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101877"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How low can we go? The effect of acquisition duration on cardiac volume and function measurements in free-running cardiac and respiratory motion-resolved five-dimensional whole-heart cine magnetic resonance imaging at 1.5T.","authors":"Robert J Holtackers, Augustin C Ogier, Ludovica Romanin, Estelle Tenisch, Isabel Montón Quesada, Ruud B van Heeswijk, Christopher W Roy, Jérôme Yerly, Milan Prsa, Matthias Stuber","doi":"10.1016/j.jocmr.2025.101863","DOIUrl":"10.1016/j.jocmr.2025.101863","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is the gold standard for assessing cardiac volumes and function using two-dimensional (2D) breath-held cine imaging. This technique, however, requires a reliable electrocardiogram (ECG) signal, repetitive breath-holds, and the time-consuming and proficiency-demanding planning of cardiac views. Recently, a free-running framework has been developed for cardiac and respiratory motion-resolved five-dimensional (5D) whole-heart imaging without the need for an ECG signal, repetitive breath-holds, and meticulous plan scanning. In this study, we investigate the impact of acquisition time on cardiac volumetric and functional measurements, when using free-running imaging, compared to reference standard 2D cine imaging.</p><p><strong>Methods: </strong>Sixteen healthy adult volunteers underwent CMR at 1.5T, including standard 2D breath-held cine imaging and free-running imaging using acquisition durations ranging from 1 to 6 min in randomized order. All datasets were anonymized and analyzed for left-ventricular end-systolic volume (ESV) and end-diastolic volume (EDV), as well as ejection fraction (EF). In a subset of data, intra- and inter-observer agreement was assessed. In addition, image quality and observer confidence were scored using a 4-point Likert scale. Finally, acquisition efficiency was reported for both imaging techniques, which was defined as the time required for data sampling divided by the total scan time.</p><p><strong>Results: </strong>No significant differences in left-ventricular EDV and ESV were found between free-running imaging for 1, 2, 3, 5, and 6 min and standard 2D breath-held cine imaging. Biases in EDV ranged from -2.4 to -7.4 mL, while biases in ESV ranged from -3.8 to 2.1 mL. No significant differences in EF were found between free-running imaging of any acquisition duration and standard 2D breath-held cine imaging. Biases in EF ranged from -2.8% to 0.94%. Both image quality and observer confidence in free-running imaging improved when the acquisition duration increased. However, they were always lower than standard 2D breath-held cine imaging. Acquisition efficiency improved from 13% for standard 2D cine imaging to 50% or higher for free-running imaging.</p><p><strong>Conclusion: </strong>Free-running CMR with an acquisition duration as short as 1min can provide left-ventricular cardiac volumes and EF comparable to standard 2D breath-held cine imaging, albeit at the expense of both image quality and observer confidence.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101863"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic extracellular volume fraction as an imaging biomarker of the myocardial interstitium without blood sampling: a systematic review and meta-analysis.","authors":"Naofumi Yasuda, Shingo Kato, Nobuyuki Horita, Ryusuke Sekii, Shungo Sawamura, Hiroaki Nagase, Daisuke Utsunomiya","doi":"10.1016/j.jocmr.2025.101889","DOIUrl":"10.1016/j.jocmr.2025.101889","url":null,"abstract":"<p><strong>Background: </strong>The calculation of conventional extracellular volume fraction (ECV) requires blood hematocrit (Hct) measurement. Based on the relationship between Hct and blood T1 relaxivity for cardiac magnetic resonance (CMR), a synthetic ECV could be estimated without a blood sampling. The aim of this study was to evaluate the correlation and agreement in the quantification of synthetic ECV and laboratory ECV from conventional Hct measurements.</p><p><strong>Methods: </strong>Electronic database searches of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE were performed. The authors employed a meta-analysis using the generic inverse variance method with a random-effects model to estimate the summary correlation coefficient and mean absolute difference between synthetic and laboratory ECV.</p><p><strong>Results: </strong>Of 38 papers, 10 studies comprising 4492 patients were identified. Overall, there was an excellent correlation between synthetic ECV and laboratory ECV (0.95 [95% confidence interval (CI): 0.92 to 0.97]) at 1.5T CMR and (0.91 [95% CI: 0.86 to 0.94]) at 3.0T CMR. The pooled mean difference between synthetic ECV and laboratory ECV was 0.61% (95% CI: 0.23 to 0.98%, I² = 0%, p for heterogeneity = 0.67) at 1.5T CMR and 0.24% (95% CI: -0.13 to 0.61%, I² = 19%, p for heterogeneity = 0.25) at 3.0T CMR.</p><p><strong>Conclusion: </strong>This study is the first comprehensive systematic review and meta-analysis of synthetic ECV evaluation at CMR. Synthetic ECV demonstrated an excellent correlation with laboratory ECV, with a mean difference of less than 1%, and offers noninvasive and instantaneous quantification of the myocardial extracellular space without the need for blood sampling.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101889"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic failure mode evaluation using non-linear phase contrast correction to improve flow measurement accuracy in cardiovascular magnetic resonance phase contrast imaging.","authors":"Ana Beatriz Solana, Savine C S Minderhoud, Piotr A Wielopolski, Juan Antonio Hernandez-Tamames, Ricardo P J Budde, Willem A Helbing, Martin A Janich, Alexander Hirsch","doi":"10.1016/j.jocmr.2025.101895","DOIUrl":"10.1016/j.jocmr.2025.101895","url":null,"abstract":"<p><strong>Background: </strong>Phase contrast (PC) cardiovascular magnetic resonance (CMR) is clinically used to quantify flow. The quantification accuracy is diminished by background phase errors. Image-based background phase correction algorithms are commercially available, but their accuracy is still under evaluation. Here, we validate a recently developed non-linear phase contrast correction (nPCcor) algorithm that includes automatic failure mode classification in a large single-vendor multi-scanner retrospective study.</p><p><strong>Methods: </strong>Three hundred forty-six through-plane PC images at the aortic valve (AAo) and pulmonary artery (PA) were acquired on three different GE HealthCare 1.5T clinical MRI scanners. Each PC scan was repeated on a static phantom, and the static phantom-corrected PC series was considered as the reference standard. Two image-based static tissue background phase corrections were applied on each PC series: a linear and the nPCcor. Accuracy of nPCcor was studied by comparing the net flow in the vessel of interest for the uncorrected, linear-corrected, and nPCcor images with respect to the static phantom-corrected series. Accuracy was defined as a difference in net flow ≤10% with respect to the static phantom corrected net flow.</p><p><strong>Results: </strong>Flow measurements using the nPCcor images after nPCcor automatic classification were found to be accurate for 87% (281/323) of PC datasets, 6% and 17% better than using uncorrected and linear-corrected (p<0.05), respectively. Most importantly, nPCcor was able to correctly identify 70% (16/23) PC cases likely to provide inaccurate flow measurements. Flow measurements after nPCcor in the scanner with the largest phase offsets were found to be accurate for 74% (62/84) of PC datasets, 22% better than using the uncorrected images (p<0.05). nPCcor correction was statistically significant more accurate than linear correction for all scanners (p<0.05). The percentage of regurgitation reclassification of ≥1 category decreased to 8% (8/323) after nPCcor correction, 3% better than for uncorrected images.</p><p><strong>Conclusion: </strong>nPCcor with automatic failure mode evaluation improved accuracy with respect to no correction and linear correction and successfully identified PC scans that are likely to result in unreliable flow measurements. nPCcor performance and phase offset errors varied greatly among scanners using the same CMR protocol. nPCcor has higher impact in scanners exhibiting the largest background phase offsets.</p><p><strong>Trial registration: </strong>observational study.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":"27 1","pages":"101895"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of regadenoson stress perfusion protocol in pediatric transplant patients under general anesthesia.","authors":"Nikkan Das, Eric L Vu, Andrada Popescu, Defne Magnetta, Cynthia K Rigsby, Joshua D Robinson, Simon Lee, Nazia Husain","doi":"10.1016/j.jocmr.2025.101880","DOIUrl":"10.1016/j.jocmr.2025.101880","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance with myocardial stress perfusion (stress CMR) is a non-invasive technique that offers an assessment of myocardial function, perfusion, and viability. Regadenoson is a selective cardiac adenosine A2 receptor agonist with fewer side effects than adenosine and a favorable safety profile in older pediatric heart transplant recipients (PHTR). There are limited studies evaluating the hemodynamic response of regadenoson in pediatric patients under general anesthesia (GA).</p><p><strong>Methods: </strong>We reviewed our experience with regadenoson stress CMR in PHTR under GA from 2020-2024 and compared to a non-GA group of PHTR who underwent regadenoson stress CMR from 2015-2022. Demographic and clinical data were recorded. Hemodynamic response and adverse events were reviewed. CMRs were reviewed for perfusion abnormalities and semi-quantitative analysis was performed using myocardial perfusion reserve index (MPRI).</p><p><strong>Results: </strong>Forty-six PHTR underwent 53 stress CMRs under GA over the study period (mean age 7.8 years; range 3-19 years). All patients received endotracheal intubation and sevoflurane and were monitored during and after regadenoson administration per institutional protocol. Heart rate (HR) prior to regadenoson administration was 84±12 beats/min with a peak of 109±14 beats/min and average mean blood pressure (BP) was 63±12 mmHg with a nadir of 45±8 mmHg. Transient hypotension was observed in 33 (77%) scans, which resolved with phenylephrine. There were no other adverse events. Phenylephrine was used in 48 CMRs (91%) for BP support at the discretion of anesthesia. Thirty-eight PHTR underwent 48 stress CMRs without sedation. CMRs were matched by time since transplant. The non-GA group was significantly older (mean age 15.8 years; p<0.001). GA patients had a larger percent decrease in mean BP compared to non-GA patients (27±17% vs 15±17%; p<0.001) with no difference in HR change. There were no significant differences in rates of qualitative perfusion defects, (11% vs 4%, p=0.18), late gadolinium enhancement or MPRI values between the two groups.</p><p><strong>Conclusion: </strong>Regadenoson stress CMR is safe and feasible in PHTR under GA. While hypotension was frequently seen, it improved in all cases with phenylephrine. Semi-quantitative myocardial perfusion analysis by MPRI is feasible in these young patients, however further studies are needed to assess its clinical utility in this population.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101880"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doppler ultrasound gating for adult cardiovascular magnetic resonance: Initial experience.","authors":"Lucia D Beissel, Fabian Kording, Christian Ruprecht, Alexander Isaak, Thomas M Vollbrecht, Claus C Pieper, Daniel Kuetting, Abdulamir Ali, Pia Wölfl, Christopher Hart, Julian A Luetkens","doi":"10.1016/j.jocmr.2025.101862","DOIUrl":"10.1016/j.jocmr.2025.101862","url":null,"abstract":"<p><strong>Background: </strong>Despite being a common gating method for cardiovascular magnetic resonance (CMR), electrocardiogram (ECG) gating has its disadvantages, and new gating strategies are desirable. An alternative CMR gating method is Doppler ultrasound (DUS) gating, which detects blood flow and ventricular movement. The aim of this study was to prove the feasibility of DUS gating as a novel CMR gating method in a clinical patient population.</p><p><strong>Methods: </strong>In this prospective study, patients underwent clinically indicated CMR. Balanced steady-state free precession two-dimensional cine sequences in short-axis and 4-chamber views were acquired using ECG and DUS gating. DUS and ECG signal were recorded simultaneously. Time difference between R-wave and DUS systolic trigger detection was defined as trigger delay, the standard deviation of trigger delays as trigger jitter. Left and right ventricular parameters were assessed: left and right ventricular ejection fraction (LVEF, RVEF) and left and right ventricular end-diastolic volume index (LVEDVI, RVEDVI). Overall image quality was assessed using a 5-point Likert scale (5 = excellent to 1 = non-diagnostic). For statistical analysis, paired t-test, Wilcoxon test, Pearson correlation, and intraclass correlation coefficient (ICC) were employed.</p><p><strong>Results: </strong>Twenty-one patients (7 female) were included (age: 45.4 ± 19.7 years; body mass index: 27.6 ± 5.5 kg/m²). DUS mean trigger delay was 128 ± 28 ms. DUS mean trigger jitter was 23 ± 13 ms. Overall image quality showed no difference between ECG and DUS gating (e.g., short axis: 5 [interquartile range (IQR) 3-5] vs 4 [IQR 3.5-5]; P = 0.21). Quantitative analysis revealed no differences between ECG and DUS gating: LVEF (53.2 ± 9.2% vs 52.3 ± 9.1%; P = 0.18; ICC 0.97 [95% confidence interval [CI] 0.93-0.99]), LVEDVI (84.5 ± 15.8 mL/m² vs 83.3 ± 15.8 mL/m²; P = 0.06; ICC 0.99 [95% CI 0.98-1.00]), RVEF (52.8 ± 8.0% vs 51.6 ± 7.2%; P = 0.06; ICC 0.96 [95% CI 0.89-0.99]), and RVEDVI (80.8 ± 17.6 mL/m² vs 80.9 ± 16.5 mL/m²; P = 0.91; ICC 0.98 [95% CI 0.96-0.99]). In one patient with a prominent lingula of the lung image quality was non-diagnostic with DUS gating.</p><p><strong>Conclusion: </strong>CMR gating with DUS is feasible and can offer an equivalent performance to ECG regarding image quality and quantitative parameter assessment.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101862"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}