Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Randomized controlled trial of vericiguat in patients with coronary microvascular dysfunction causing stable chest pain (V-COM): study protocol for a randomized control trial.","authors":"Cho-Kiu Lo, Niki Hiu-Yee Ip, Tsun-Hei Sin, Shui-Yan Ho, Chun-Ka Wong, Frankie Chor-Cheung Tam, Simon Cheung-Chi Lam, Kai Hang Yiu, Michael Shu-Yue Sze, Thomas Tsun-Ho Lam, Alston Conrad Ho-On Chiu, Karen Ka-Ying Li, Ka Chun Un, Esther Yee-Tak Yu, Eric Kwong-Yu Chan, Kevin Ka-Chun Lee, Shing Ching, Derek Pok-Him Lee, Chi-Yuen Wong, Hiu-Lam Chan, Ngai-Yin Chan, Chun-Yu Leung, Ming-Yen Ng","doi":"10.1016/j.jocmr.2026.102744","DOIUrl":"10.1016/j.jocmr.2026.102744","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that ∼50% of patients with stable chest pain have no obstructive coronary artery disease (CAD), yet remain at higher risk of major adverse cardiovascular events (MACE) compared to patients without chest pain. Coronary microvascular dysfunction (CMD) is a major cause of ischemia with no obstructive coronary arteries (INOCA). While therapies for CMD are lacking, Vericiguat, a soluble guanylate cyclase stimulator, has shown improvement in coronary microvascular circulation in animal studies. Quantitative stress cardiovascular magnetic resonance (CMR) allows the quantification of stress myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). This study aims to conduct a randomized controlled trial to determine if Vericiguat improves MBF and MPR in patients with stable chest pain and INOCA caused by CMD.</p><p><strong>Methods/design: </strong>V-COM is a single-blind, randomized controlled trial. Ninety-four patients aged 40-80 years with recurrent stable chest pain, nonobstructive coronary arteries on recent coronary computed tomography (CT) or invasive angiography, and CMD defined by stress CMR (MPR <2.19 or stress MBF <2.19 mL/g/min) will be recruited across six centers in Hong Kong. Participants will be randomized 1:1 to vericiguat plus optimal medical therapy (intervention) or optimal medical therapy alone (control). Vericiguat will be prescribed once daily for 6 months, starting at 2.5 mg and titrated up to a target dose of 10 mg based on systolic blood pressure and tolerability. CMR (including quantitative stress perfusion) will be performed at baseline and 6 months. The primary outcome is the between-group difference in change in stress MBF and MPR from baseline to 6 months. Secondary outcomes include change in six-minute walk distance and Seattle Angina Questionnaire-7 (SAQ-7) scores.</p><p><strong>Discussion: </strong>This study will provide evidence on whether Vericiguat can improve myocardial perfusion in patients with CMD and offer insights into its potential as a novel therapy for CMD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102744"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929937","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":"Society for Cardiovascular Magnetic Resonance 2024 Cases of SCMR case series.","authors":"Rebecca Kozor, Christopher Schmitt, Shyam Sathanandam, Anthony Merlocco, Shirjeel Murtaza, Samra Haque, Alexander L Bowers, Michael Jay Campbell, Ritu Agarwal, Milind Srivastava, Borche Pavlov, Harald Lapp, Mekkaoui Abderrahmane, Chergui Abdellah, Grigorios Melas, Isabelle Cardoso, Lousie McGrath, Izgi Cemil, Tosha Desai, Ganesh Barhate, Om Tavri, Kristin N Andres, Frandics Chan, Daniel E Clark, Licheng Lee, Pelbreton Balfour, Brittany Scothorn, Chung Nguyen, Priya Chudgar, Nitin Burkule, Srinivas Lakshmivenkateshiah, Olivia A Crapanzano, Angela J Weingarten, Jonathan H Soslow, Seth Klusewitz, Marcus Chen, Peter Kellman, Edward Hulten, Othman Y Bricha, Vincent Sachs, Dany Sayad, Mohammed Faluk, David Parra, Gaurav Surana, Arjun Susar, Nikhil Borikar, Erin K Romberg, Lester C Permut, Randolph K Otto, Priyamvada Pillai, Katherine Harrington, Amro Alsaid, Avanti Gulhane, Eric Krieger, Karen Ordovas, Anna Baritussio, Pranav Bhagirath, Sylvia S M Chen, Jeffrey M Dendy, Madhusudan Ganigara, Robert D Tunks, Jason N Johnson","doi":"10.1016/j.jocmr.2026.102695","DOIUrl":"10.1016/j.jocmr.2026.102695","url":null,"abstract":"<p><p>\"Cases of SCMR\" is a case series on the Society for Cardiovascular Magnetic Resonance (SCMR) website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance in the diagnosis and management of cardiovascular disease. The 2024 digital collection of cases are presented in this article.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102695"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018697","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":"Spatiotemporal deep learning for scar screening in cardiovascular magnetic resonance: Toward selective use of gadolinium.","authors":"Amine Amyar, Shiro Nakamori, Jiwon Kim, Martin S Maron, Ethan J Rowin, Karishma Pareek, Alexander Schulz, Robert M Judd, Warren J Manning, Raymond Y Kwong, Frederick L Ruberg, Jonathan W Weinsaft, Reza Nezafat","doi":"10.1016/j.jocmr.2026.102730","DOIUrl":"10.1016/j.jocmr.2026.102730","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the gold standard for assessing myocardial scar. However, a substantial proportion of patients referred for CMR scar assessment are ultimately found to have no evidence of myocardial scarring.</p><p><strong>Purpose: </strong>To develop and evaluate a deep learning (DL) model capable of identifying patients without myocardial scar using cine imaging alone, thereby obviating the need for contrast administration and LGE imaging in these individuals.</p><p><strong>Materials and methods: </strong>We developed a novel spatiotemporal DL architecture to identify patients unlikely to have myocardial scar using contrast-free cine images. The model was trained on short-axis cine images from a consecutive cohort of 3000 patients (1753 males; mean age 54 ± 18 years) undergoing CMR for evaluation of known or suspected cardiovascular disease, using 1.5 and 3T scanners from Siemens and GE. External validation was performed in an independent multicenter cohort of 1792 patients where images were acquired on 1.5T and 3T scanners from Siemens and Philips. The architecture utilizes factorized convolutions to extract spatial and temporal features and incorporates residual attention mechanisms to emphasize features most predictive of scar presence on LGE imaging. To evaluate the incremental value of incorporating temporal information, a second model was developed that excluded the temporal kernel from the DL architecture. Both models were trained and optimized using the same training dataset and were evaluated based on similar internal and external testing cohorts. Model performance in identifying patients without myocardial scar was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>The spatiotemporal model had a higher AUC compared to the spatial model in the internal (0.79 ± 0.02 vs. 0.70 ± 0.05, p<0.05, n = 500) and external cohort (0.78 vs. 0.64, p<0.001, n = 1792). The spatiotemporal model correctly identified 64% (176/274) and 52% (410/789) of patients without scar in the internal and external test sets, while maintaining a high sensitivity (86% and 82%).</p><p><strong>Conclusions: </strong>Incorporating temporal information from cine images using an end-to-end spatiotemporal DL architecture enables non-contrast screening for myocardial scar.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102730"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716843","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":"Prognostic value of end-to-end deep learning assessment of myocardial scar and microvascular obstruction on late gadolinium enhancement cardiovascular magnetic resonance.","authors":"Pei Yang, Shuang Leng, Dexiang Zong, Mengyao Hu, Ru-San Tan, Xuan Xiao, Ching Hui Sia, Lynette Teo, Tim Leiner, Ching Ching Ong, Angela S Koh, Swee Yaw Tan, Lianggeng Gong, Derek J Hausenloy, Mark Y Chan, Liang Zhong","doi":"10.1016/j.jocmr.2026.102712","DOIUrl":"10.1016/j.jocmr.2026.102712","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the reference standard for assessing myocardial scar and microvascular obstruction (MVO), and is a strong predictor of post-acute myocardial infarction (AMI) outcomes. However, manual segmentation is time-consuming and subject to inter-observer variability, limiting clinical scalability. This study develops and validates LGE-CMRnet, an end-to-end deep learning pipeline for automated scar and MVO segmentation on LGE CMR, and evaluates its prognostic value in AMI patients.</p><p><strong>Methods: </strong>A total of 3874 LGE images from 567 AMI patients (409 for training/internal stress-test cohort; 158 for external testing) were analyzed. LGE-CMRnet integrates YOLOv8 for heart localization and nnU-Net for simultaneous segmentation of myocardium, scar, and MVO. Performance was evaluated using Dice similarity coefficient (DSC), correlation, and Bland-Altman analysis against expert annotations. Prognostic value was assessed using Cox regression for major adverse cardiac events (MACE) over a median follow-up of 24.4 months.</p><p><strong>Results: </strong>LGE-CMRnet achieved rapid processing (0.05 s per image) and high segmentation accuracy. In the external validation cohort, the model achieved mean DSC of 0.83 ± 0.11 for scar and 0.88 ± 0.11 for MVO at the patient level, with strong volumetric correlations to expert reference segmentations (scar: r = 0.90; MVO: r = 0.98, both P<0.0001). Bland-Altman analysis showed minimal bias in volumetric measurements (scar: 2.5 ± 8.9 cm³; MVO: -0.20 ± 0.89 cm³). Among the 158 patients in the external validation cohort (age 57 ± 10 years, 127 male), 35 (22.2%) experienced MACE. LGE-CMRnet-derived %MVO (hazard ratio [HR], 1.06; 95% confidence interval [CI]: 1.02 to 1.09; P = 0.003) and %Scar (HR, 1.05; 95% CI: 1.02 to 1.08; P = 0.001) were independent predictors of MACE after adjustment for established risk factors. Furthermore, LGE-CMRnet-derived metrics demonstrated non-inferior discrimination for MACE prediction compared with expert analysis. The differences in C-index were 0.02 for %MVO and 0.01 for %Scar, with the lower bounds of the 95% CIs remaining above the pre-specified non-inferiority margin.</p><p><strong>Conclusion: </strong>LGE-CMRnet enables fast and accurate scar and MVO quantification, with prognostic performance comparable to expert analysis, supporting its potential for automated clinical risk stratification after AMI.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102712"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147457314","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":"Quantitative assessment of cardiac phosphocreatine metabolism under physiological and pharmacological stress using chemical exchange saturation transfer magnetic resonance imaging.","authors":"Qi Huang, Caleb Berberet, Ryan Wahidi, Todd Pavek, Cihat Eldeniz, Liya Dai, Rong Guo, Yang Yang, Scott Bugenhagen, Linda R Peterson, Thomas H Schindler, Pamela K Woodard, Jie Zheng","doi":"10.1016/j.jocmr.2026.102739","DOIUrl":"10.1016/j.jocmr.2026.102739","url":null,"abstract":"<p><strong>Background: </strong>Phosphocreatine (PCr) exhibits a distinct chemical exchange saturation transfer (CEST) resonance at ∼2.5 ppm with slower exchange kinetics and lower pH sensitivity than creatine. This pilot study evaluated the feasibility of quantifying myocardial PCr-dominated concentration ([PCr]_d) using CEST cardiac MRI (CEST-CMR) and validated the measurements with phosphorus magnetic resonance spectroscopy (³¹P-MRS).</p><p><strong>Methods: </strong>Phantoms with varied concentrations of PCr and Cr were scanned to characterize PCr CEST signals under physiological conditions. Experiments were conducted at both room temperature and 37 °C with full Z-spectra acquisition. For the study in vivo, CEST imaging was performed in normal canines (n = 13), at rest and after regadenoson vasodilation, and during dobutamine stress (n = 5). In addition, healthy volunteers (n = 9) underwent rest-exercise-recovery studies with in-magnet plantar-flexion exercise. Both CEST images and ³¹P-MRS were acquired in separate exercise sessions. WASSR-derived corrected The Z-spectra corrected by derived B₀ maps were fitted with a three-pool Bloch-McConnell model (water, PCr, magnetization transfer) to estimate [PCr]_d. For ³¹P-MRS, PCr/γATP ratios were converted to PCr concentrations using γATP as a reference. Rate-pressure product (RPP) was used as an indicator of myocardial oxygen consumption.</p><p><strong>Results: </strong>In phantoms, PCr-dominated CEST contrast increased monotonically with PCr concentration across pure and mixed PCr/Cr solutions, while Cr-only phantoms did not produce artifactual PCr estimates. In canines, myocardial [PCr]_d was 12.0 ± 1.8 mM at rest and decreased to 7.1 ± 1.6 mM during dobutamine stress (p<0.001), while remaining unchanged with regadenoson vasodilation (11.8 ± 0.3 vs 11.8 ± 0.6 mM). Changes in [PCr]_d correlate_d negatively with RPP (r = -0.75). In human subjects, CEST-derived [PCr]_d was 13.2 ± 1.4 mM at rest, 7.1 ± 1.0 mM during exercise (p<0.001), and 12.9 ± 1.5 mM during hyperemia. Corresponding ³¹P-MRS estimates were 12.9 ± 1.4 mM, 7.7 ± 2.3 mM, and 12.2 ± 1.6 mM, respectively. CEST-derived [PCr]_d showed a moderate negative correlation with RPP (r = -0.52).</p><p><strong>Conclusion: </strong>CEST-CMR enables noninvasive estimation of myocardial [PCr]_d in vivo and detects physiologic energetic changes during stress, with measurements consistent with ³¹P-MRS.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102739"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772575","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":"Epicardial adipose tissue: When good fat goes bad.","authors":"Jamey Cutts, Connie W Tsao, Amit R Patel","doi":"10.1016/j.jocmr.2025.101973","DOIUrl":"10.1016/j.jocmr.2025.101973","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101973"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318360","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":"Confounders, diagnostic accuracy, and reproducibility in cardiovascular magnetic resonance-feature tracking-derived left atrial strain: A Berlin Research Network for cardiovascular magnetic resonance multi-software, multi-site comparison.","authors":"Leo Dyke Krüger, Leonhard Grassow, Jan Gröschel, Johanna Kuhnt, Edyta Blaszczyk, Maximilian Müller, Ralf Felix Trauzeddel, Teodora Chitiboi, Jeanette Schulz-Menger, Maximilian Fenski","doi":"10.1016/j.jocmr.2026.102692","DOIUrl":"10.1016/j.jocmr.2026.102692","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance-feature tracking (CMR-FT) derived left atrial global longitudinal strain (LA-GLS) has prognostic relevance, even in the early stages of cardiovascular diseases. Identifying technical and subject-related confounders is essential for ensuring comparability across sites and for reliably distinguishing healthy from pathological conditions. This study aimed to evaluate the influence of post-processing software and subject-related factors on CMR-FT-derived LA-GLS, diagnostic accuracy, and to evaluate inter-site reproducibility.</p><p><strong>Methods: </strong>This study included 149 healthy individuals and 40 patients with atrial fibrillation (AF; 19 persistent, 21 paroxysmal) from a single site. A subgroup of 18 traveling volunteers underwent CMR at four different sites. All participants underwent CMR in sinus rhythm. LA-GLS was assessed using three post-processing software packages (CVI42, TrufiStrain Research Prototype, Medis). Mixed models with repeated measures were applied to evaluate the effect of software, site, and subject-related factors on LA-GLS components. ROC curve analysis was used to assess diagnostic accuracy across software in distinguishing healthy controls from AF patients.</p><p><strong>Results: </strong>All GLS components differed across post-processing software (p<.001). Reservoir and contractile GLS were lowest in CVI42 (23.9% ± 3.3%, 9.9% ± 2.2%), followed by TrufiStrain (27.4% ± 6.3%, 15.0% ± 4.8%) and Medis (45.4% ± 9.7%, 20.3% ± 5.7%). Conduit GLS was lowest in TrufiStrain (12.4% ± 4.8%), followed by CVI42 (16.3% ± 4.5%) and Medis (25.1% ± 8.2%). Among traveling volunteers, LA-GLS values were consistent across sites when the same software was used. Across all software, reservoir GLS negatively correlated with age. Diagnostic accuracy was comparable across software packages (AUC for reservoir strain: CVI: 0.81 [0.69-0.90], TrufiStrain 0.76 [0.64-0.88], Medis: 0.84 [0.72-0.94]).</p><p><strong>Conclusion: </strong>Post-processing software is a significant confounder in CMR-FT-based LA-GLS analysis and age substantially influences LA-GLS. LA-GLS demonstrates excellent inter-site reproducibility when analyzed with the same software and offers comparable diagnostic accuracy across platforms.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102692"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994524","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":"The severity of post-infarction edema suggests a bimodal pattern, whereas the extent does not.","authors":"Robert Jablonowski, David Nordlund, Christos Xanthis, Sebastian Bidhult, Sascha Kopic, Jonathan Berg, Henrik Engblom, Anthony H Aletras, Håkan Arheden","doi":"10.1016/j.jocmr.2026.102741","DOIUrl":"10.1016/j.jocmr.2026.102741","url":null,"abstract":"<p><strong>Background: </strong>Preclinical and clinical data following acute myocardial infarction (MI) have shown conflicting results whether a bimodal pattern of edematous myocardium at risk (MaR) on cardiovascular magnetic resonance (CMR) imaging during the first week exists or not. The objective was to assess the dynamics of MaR following acute experimental MI using a comprehensive CMR protocol.</p><p><strong>Methods: </strong>Acute MI was induced in seven pigs with reperfusion after 40 min. CMR was performed at baseline, 120 min, 24 h and 7 days post reperfusion. The CMR protocol comprised two T2-mapping sequences, a T2-SSFP sequence (T2-mapping_SSFP) and a T2-TSE sequence (T2-mapping_TSE), as well as a T2w short-tau inversion recovery (T2-STIR) sequence. After contrast administration, CE-SSFP and LGE images were acquired. The severity of MaR was defined as the T2 relaxation on T2 maps and the extent of MaR as percentage of edematous myocardium on CE-SSFP and T2-STIR images.</p><p><strong>Results: </strong>The severity of edema within the MaR was significantly lower at 24 h compared to 120 min (T2 mapping_SSFP:69±9 vs 80±8 ms; T2 mapping_TSE:57±7 vs 69±9 ms), followed by a recovery at 7 days (T2 mapping_SSFP:77±10 ms; T2 mapping_TSE:67±12 ms). The extent of MaR showed a gradual decrease between 120 min and 24 h on CE-SSFP (29±10 vs 26±9%LVM) and at 7 days compared to both previous time points (CE-SSFP: 24±11%LVM).</p><p><strong>Conclusion: </strong>The severity of edema within the MaR following acute MI suggests a bimodal pattern, whereas the extent of MaR does not.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102741"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815416","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":"Clinical implications of vessel wall imaging-State-of-the-art review.","authors":"Niranjan Balu, Gador Canton, Mahmud Mossa-Basha, Luca Saba, Scott McNally, Thomas Hatsukami, Chun Yuan","doi":"10.1016/j.jocmr.2026.102733","DOIUrl":"10.1016/j.jocmr.2026.102733","url":null,"abstract":"<p><p>Diseases of the arterial wall are best diagnosed using vessel wall magnetic resonance imaging (MRI) since luminal imaging does not show the extent of wall pathology. Intracranial and extracranial carotid artery pathology such as atherosclerosis, dissections, vasculitis, and occlusions can lead to clinically significant events such as stroke. Direct visualization of the arterial wall pathology using vessel wall MRI can direct clinical diagnosis and management. This review highlights the importance of carotid and intracranial vessel wall MRI and their clinical applications in neurovascular pathologies. Recent developments such as the carotid Plaque-Reporting and Data System risk scoring and intracranial vasculopathy differentiation using vessel wall MRI are reviewed. Technical requirements of vessel wall MRI sequences for clinical diagnosis and future diagnostic approaches such as stroke etiology reclassification are also discussed.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102733"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722754","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":"Cardiac function assessment with deep-learning-based automatic segmentation of free-running four-dimensional whole-heart cardiovascular magnetic resonance.","authors":"Augustin C Ogier, Salomé Baup, Gorun Ilanjian, Aisha Touray, Angela Rocca, Jaume Banús, Isabel Montón Quesada, Martin Nicoletti, Jean-Baptiste Ledoux, Jonas Richiardi, Robert J Holtackers, Jérôme Yerly, Matthias Stuber, Roger Hullin, David Rotzinger, Ruud B van Heeswijk","doi":"10.1016/j.jocmr.2025.102677","DOIUrl":"10.1016/j.jocmr.2025.102677","url":null,"abstract":"<p><strong>Background: </strong>Free-running (FR) cardiac magnetic resonance imaging (MRI) enables free-breathing electrocardiogram (ECG)-free fully dynamic five-dimensional (5D) (three-dimensional [3D] spatial+cardiac+respiration dimensions) imaging but poses significant challenges for clinical integration due to the volume of data and complexity of image analysis. Existing segmentation methods are tailored to two-dimensional (2D) cine or static 3D acquisitions and cannot leverage the unique spatial-temporal wealth of FR data. The aim of this study was to develop and validate a deep learning (DL)-based segmentation framework for isotropic 3D+cardiac cycle FR cardiac MRI that enables accurate, fast, and clinically meaningful anatomical and functional analysis.</p><p><strong>Methods: </strong>Free-running, contrast-free balanced steady-state free precession (bSSFP) acquisitions at 1.5T and contrast-enhanced gradient-recalled echo (GRE) acquisitions at 3T were used to reconstruct motion-resolved 5D datasets. From these, the end-expiratory respiratory phase was retained to yield fully isotropic four-dimensional (4D) datasets. Automatic propagation of a limited set of manual segmentations was used to segment the left and right ventricular blood pool (LVB, RVB) and left-ventricular myocardium (LVM) on reformatted short-axis (SAX) end-systolic (ES) and end-diastolic (ED) images. These were used to train a 3D nnU-Net model. Validation was performed using geometric metrics (Dice similarity coefficient [DSC], relative volume difference [RVD]), clinical metrics (ED and ES volumes, ejection fraction [EF]), and physiological consistency metrics (systole-diastole LVM volume mismatch and LV-RV stroke volume agreement). To assess the robustness and flexibility of the approach, we evaluated multiple additional DL training configurations, such as using 4D propagation-based data augmentation to incorporate all cardiac phases into training.</p><p><strong>Results: </strong>The main proposed method achieved automatic segmentation within a minute, delivering high geometric accuracy and consistency (DSC: 0.94 ± 0.01 [LVB], 0.86 ± 0.02 [LVM], 0.92 ± 0.01 [RVB]; RVD: 2.7%, 5.8%, 4.5%). Clinical LV metrics showed excellent agreement (ICC >0.98 for EDV/ESV/EF, bias <2 mL for EDV/ESV, <1% for EF), while RV metrics remained clinically reliable (ICC >0.93 for EDV/ESV/EF, bias <1 mL for EDV/ESV, <1% for EF) but exhibited wider limits of agreement. Training on all cardiac phases improved temporal coherence, reducing LVM volume mismatch from 4.0% to 2.6%.</p><p><strong>Conclusion: </strong>This study validates a DL-based method for fast and accurate segmentation of whole-heart free-running 4D cardiac MRI. Robust performance across diverse protocols and evaluation with complementary metrics that match state-of-the-art benchmarks supports its integration into clinical and research workflows, helping to overcome a key barrier to the broader adoption of free-running imaging.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102677"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843772","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}