Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Impaired myocardial oxygen metabolism and energy efficiency in patients with dilated cardiomyopathy.","authors":"Liya Dai, Jinhan Qiao, Keyan Wang, Ran Li, Yang Yang, Caleb Berberet, Qi Huang, Chenying Lu, Jiansong Ji, Scott M Bugenhagen, Thomas H Schindler, Linda R Peterson, Pamela K Woodard, Yong Zhang, Jie Zheng","doi":"10.1016/j.jocmr.2026.102800","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102800","url":null,"abstract":"<p><strong>Background: </strong>Myocardial oxygen metabolism and mechano-energetic efficiency are key determinants of cardiac function and clinical outcomes, but their status in dilated cardiomyopathy (DCM) remains incompletely understood. This study applied a non-contrast cardiovascular magnetic resonance (CMR) technique to assess myocardial oxygenation, cardiac work, and energy efficiency in DCM.</p><p><strong>Methods: </strong>We enrolled 49 DCM patients and 23 age- and sex- matched controls. All subjects underwent cine CMR imaging for left ventricular ejection fraction (LVEF) and global longitudinal strain (LVGLS), pre- and post-contrast T1 mapping for extracellular volume (ECV), and first-pass perfusion imaging for semi-quantification of myocardial blood flow (MBF). A non-contrast CMR technique was applied to quantify myocardial oxygen extraction fraction (mOEF). Semi-quantitative myocardial oxygen consumption (MVO₂), external work (EW), and myocardial external efficiency (MEE) were derived for analysis.</p><p><strong>Results: </strong>Compared with controls, DCM patients exhibited significantly lower mOEF (50.3 [47.9, 53.9] % vs. 57.6 [56.2, 60.4] %, p < 0.001), MVO₂ per gram tissue (0.07 ± 0.01 vs. 0.08 ± 0.01, p = 0.027), EW (248.38 ± 97.87 vs. 341.88 ± 86.98mmHg×mL/min×10³, p < 0.001), and MEE (22.88 ± 10.62% vs. 45.95 ± 10.53%, p < 0.001), but higher total MVO₂ (7.99 ± 2.58 vs. 5.30 ± 1.48, p < 0.001). Resting mOEF showed no significant association with LVEF and LVGLS, whereas total MVO₂ and MEE correlated significantly with both LVEF and LVGLS. Female DCM patients exhibited higher LVEF (31.30 ± 10.18% vs. 22.47 ± 9.74%, p = 0.006), absolute LVGLS (9.81 ± 3.55% vs. 7.24 ± 2.86%, p = 0.011) and MEE (27.29 ± 11.87% vs. 20.74 ± 9.43%, p = 0.049) compared with males.</p><p><strong>Conclusion: </strong>This feasibility study demonstrates the potential of this non-contrast CMR technique for noninvasive assessment of myocardial oxygen metabolism and mechano-energetic coupling in DCM. Patients with DCM showed impaired resting myocardial oxygen metabolism and reduced energy efficiency.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102800"},"PeriodicalIF":5.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061267","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":"Growth of Cardiac Fibromas During Infancy.","authors":"Kelsey Jurow, Francesca Sperotto, Tal Geva, Lynn A Sleeper, Rebecca S Beroukhim","doi":"10.1016/j.jocmr.2026.102799","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102799","url":null,"abstract":"<p><strong>Background: </strong>Cardiac fibromas commonly present in childhood as large intramyocardial tumors that are frequently associated with arrhythmias, hemodynamic compromise, sudden cardiac death, and/or associated cardiac or lung compression. Although unoperated cardiac fibromas were historically thought to remain stable in size throughout life, their natural history has not been studied.</p><p><strong>Methods: </strong>In this retrospective single-center study, we identified all patients with cardiac fibromas and serial cardiovascular magnetic resonance (CMR) and/or cardiac computed tomography (CT) before or after surgical intervention to characterize fibroma growth.</p><p><strong>Results: </strong>A total of 36 infants and children with at least 2 serial imaging studies were identified. Younger age at first imaging study was associated with faster cardiac fibroma growth, with infants (<12 months) demonstrating a body surface area (BSA)-indexed growth rate of 11 ± 2mL/m²/month; whereas children older than 2.5 years demonstrated no growth (p=0.005). In one child, the tumor's unadjusted volume increased by 933% and the BSA-adjusted volume increased by 334% between CMR examinations obtained in the first week of life and at age 1.5 years. A higher T2 tumor:myocardium intensity ratio was associated with both younger age at initial examination and faster growth rate (p=0.001). A higher tumor growth rate was associated with the development of hemodynamic impact of the tumor, in particular pulmonary vein compression and/or lung compression. No significant tumor growth was observed after tumor resection.</p><p><strong>Conclusions: </strong>Cardiac fibromas may exhibit rapid growth in infancy, and tumor growth is associated with the development of hemodynamic compromise. Based on this observation, consideration should be given to frequent monitoring of tumor size and clinical status during the first years of life.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102799"},"PeriodicalIF":5.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038913","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":"Left Atrium Myocardial Remodeling and Prognostic Marker Derived from CMR Feature Tracking in Pediatric Hypertrophic Cardiomyopathy.","authors":"Xingrui Chen, Yun Tang, Xuan Ma, Shujuan Yang, Kai Yang, Jiaxin Wang, Zhixiang Dong, Kankan Zhao, Zhuxin Wei, Xi Jia, Pengyu Zhou, Yujie Liu, Wenqing Xu, Bo Li, Fen Sa, Kaisaierjiang Aisikaier, Xiuyu Chen, Shihua Zhao","doi":"10.1016/j.jocmr.2026.102798","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102798","url":null,"abstract":"<p><strong>Background: </strong>The left atrium is an early sensor of left ventricular (LV) dysfunction. The prognostic value of left atrial (LA) strain derived from CMR Feature-Tracking has been demonstrated in adult patients with hypertrophic cardiomyopathy (HCM); however, its significance in pediatric patients with HCM remains unknown. Our study aims to assess LA myocardial function using multi-parametric CMR and to explore the relationship between LA strains with adverse outcomes in pediatric patients with HCM.</p><p><strong>Methods: </strong>This retrospective study included pediatric patients with HCM who underwent CMR from January 2011 to December 2020. Strain parameters were assessed using CMR -FT analysis. Cox regression analysis was performed to assess the associations between variables and clinical outcomes which included sudden cardiac death (SCD) or equivalent events and heart failure-related events.</p><p><strong>Results: </strong>The cohort comprised 284 patients (median age, 15.0 years [interquartile range (IQR) 13.0-18.0]; 184 men) and 42 age- and sex-matched normal controls. Compare with normal controls, pediatric patients with HCM had impaired LA reservoir and conduit strains (all P<0.001), with no evidence of a difference in LA booster strain. After a median follow-up period of 62.8 months, a total of 41 (14.4%) patients reached composite outcomes. After adjusting clinical and imaging parameters in multivariable cox analysis, LA reservoir strain (HR: 0.95, 95% CI: 0.91-0.98, P = 0.007), and conduit strain (HR: 0.92, 95% CI: 0.87-0.97, P = 0.002) remained significantly independent predictors of composite outcomes, but not showed in booster strain. Adding LA reservoir strain or conduit strain in turn to the clinical and imaging model resulted in significant improvements in model performance for both composite outcomes and SCD events, respectively (all p < 0.001).</p><p><strong>Conclusion: </strong>LA reservoir and conduit strains derived from CMR -FT were impaired in pediatric patients with HCM and showed important prognostic value for adverse clinical outcomes, providing incremental prognostic value when combined in a model with clinical and conventional risk factors.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102798"},"PeriodicalIF":5.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945023","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":"Noninvasive Estimation of Post-TIPS Portosystemic Pressure Gradient Using 4D Flow MRI Relative Pressure Mapping and CT-Based CFD Driven by MRI-Derived Inflow: A Retrospective Validation Study.","authors":"Xiaorong Chen, Xiaoxian Yang, Linhao Hu, Jianji Dai, Jiangfeng Pan, Qing Liu, Suping Wang, Meiling Hu, Dingjun Wang, Tianqi Wang, Haojia Qu, Xinyang Ge, Xiaogang Hu","doi":"10.1016/j.jocmr.2026.102797","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102797","url":null,"abstract":"<p><strong>Background: </strong>Post-transjugular intrahepatic portosystemic shunt (TIPS) portosystemic pressure gradient (PPG) is invasive and a key hemodynamic marker for post-TIPS management. Longitudinal monitoring motivates development of reliable noninvasive alternatives.</p><p><strong>Objective: </strong>To validate the performance of non-invasively assessing post-TIPS PPG using four-dimensional flow MRI (MRI_PPG), CT (CT_PPG) (driven by MRI-derived inflow), and concordance with invasively measured PPG.</p><p><strong>Materials and methods: </strong>This retrospective study included 31 post-TIPS patients who underwent PPG measurement and 4D flow MRI within 7 days of the invasive measurement, a subset (n=18) underwent abdominal CT. MRI_PPG was computed from 4D flow MRI velocity fields using relative pressure mapping. For CT-Based CFD Driven by MRI-Derived Inflow, portal venous phase CT was segmented to create patient-specific geometry, and 4D flow MRI-derived inflow at the main portal vein was used to define three inlet protocols: (i) time-averaged peak velocity (CT_PPG1), (ii) time-resolved flow waveform (CT_PPG2), and (iii) time-averaged mean velocity (CT_PPG3). Correlation and agreement with PPG were assessed, and classification performance for clinically relevant PPG ranges was evaluated.</p><p><strong>Results: </strong>In the full cohort (n=31), MRI_PPG (11.23±4.74mmHg) correlated strongly with PPG (11.84±4.72mmHg) (r=0.94, P<0.01) and showed excellent agreement (ICC=0.94), with Bland-Altman bias of 0.61mmHg and limits of agreement (LoA) from -2.70 to 3.92mmHg. In the CT subset (n=18), MRI_PPG remained highly correlated (r=0.91, P<0.01) and showed good agreement (ICC=0.90; bias 0.80mmHg; LoA -3.04 to 4.63mmHg). Among CT‑based estimates, CT_PPG1 demonstrated the best performance (12.47±5.31mmHg; r=0.79, P<0.01; ICC=0.77; bias -0.42mmHg; LoA -6.84 to 6.00mmHg). Three‑range classification accuracy in the CT subset was 77.78% for MRI_PPG, compared with 66.67% for CT_PPG1, 50% for CT_PPG2, and 61.11% for CT_PPG3.</p><p><strong>Conclusion: </strong>Both MRI_PPG and CT-PPG CFD estimates are feasible noninvasive approaches for post-TIPS hemodynamic assessment. 4D flow MRI-derived relative pressure mapping demonstrated superior performance, supporting its potential value for post-TIPS follow-up.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102797"},"PeriodicalIF":5.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945012","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":"CPU-based fast cardiac cine MRI segmentation using lightweight CNNs and knowledge distillation.","authors":"Xue Feng, Cristiane C Singulane, Amit R Patel, Craig H Meyer","doi":"10.1016/j.jocmr.2026.102795","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102795","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiac cine MRI segmentation is essential for quantifying ventricular function, but current deep learning methods typically require GPU hardware for inference, limiting deployment in clinical settings with constrained computational resources. This study develops and evaluates lightweight CNN architectures trained via knowledge distillation for fast and accurate cardiac cine segmentation on CPU devices, including deployment in web browsers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A residual-encoder U-Net teacher (9.22M parameters) was distilled into three lightweight student networks - MobileUNetV2 (2.09M), MobileUNetV3 (4.52M, with squeeze-and-excitation attention), and EfficientLiteUNet (5.08M, fused mobile convolutions) - trained with deep supervision at four output scales. Distillation matched softened teacher and student probabilities via Kullback-Leibler divergence, with a grid search over temperature T ∈ {1.0, 3.0, 5.0} and KD loss weight W ∈ {0.5, 0.99}, giving 6 KD configurations per architecture. Models were trained on 560 image series from the combined ACDC and M&Ms datasets, evaluated on 280 held-out series, and on a 29-patient external cohort (UVA). Paired t-tests on per-case mean Dice with Holm-Bonferroni correction (m = 6) compared each KD configuration with its baseline. Inference was benchmarked on CPU using PyTorch, native ONNX Runtime (C++), and ONNX Runtime Web - the latter running entirely inside the user's web browser with no images sent to any server.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The teacher reached a mean Dice of 0.894 across the three structures (LV cavity, LV myocardium, RV cavity). The best KD students reached 0.883 (MobileUNetV2), 0.883 (MobileUNetV3), and 0.888 (EfficientLiteUNet) at T=3.0, W=0.99, versus baselines of 0.871, 0.871, and 0.876. KD improved every architecture (Holm-adjusted p ≤ 5 × 10⁻⁷ at the best configuration), the top configurations forming a plateau rather than a unique optimum. Students tracked the teacher on the external cohort (0.903 versus 0.891 - 0.895) and on segmentation-derived ejection fraction in both cohorts, where no student's error differed from the teacher's (internal LV_EF bias -0.2 to +0.8%). On CPU, EfficientLiteUNet ran at 11 ms per frame natively (ONNX Runtime, 4 threads) while MobileUNetV2 was smallest (8.3 MB) and second-fastest in the browser (183 ms per frame), behind MobileUNetV3 (159 ms).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Lightweight CNNs trained with knowledge distillation come within 0.006 - 0.011 Dice of the teacher and match its downstream clinical measurements, while running on CPUs and inside ordinary web browsers. The browser deployment performs every step locally on the user's device, so no patient images leave the local environment - a practical path to clinical use without GPU infrastructure or outbound transfer of imaging data. A reference instance is at https://cmrsegmentation.org and the code is at https://github.com/xf4j/cmrsegmenta","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102795"},"PeriodicalIF":5.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905997","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":"Vasodilator stress perfusion CMR for outcome prediction in patients under 45 years with suspected CAD.","authors":"Elsa Richard de Vesvrotte, Jérôme Garot, Suzanne Duhamel, Mariama Akodad, Thomas Hovasse, Francesca Sanguineti, Stéphane Champagne, Thierry Unterseeh, Antoinette Neylon, Riccardo Mager, Neyla Sayah, Alexandre Unger, Trecy Gonçalves, Aicha Kante, Emmanuel Gall, Alexandre Pfeffer, Raphael Mirailles, Julien Hudelo, Valérie Bousson, Jean Guillaume Dillinger, Solenn Toupin, Philippe Garot, Théo Pezel","doi":"10.1016/j.jocmr.2026.102794","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102794","url":null,"abstract":"<p><strong>Background: </strong>Although the prognostic value of vasodilator stress cardiovascular magnetic resonance (CMR) is established, it has never been assessed in patients <45 years with suspected coronary artery disease. The aim was to assess the long-term prognostic value of stress CMR to predict mortality in a multicenter cohort of patients <45 years-old.</p><p><strong>Methods: </strong>Between December 2008 and December 2024, a prospective multicenter registry enrolled all consecutive patients undergoing vasodilator stress CMR at three French centers. For the present retrospective analysis, all patients aged <45 years were included. The primary endpoint was all-cause mortality, assessed through the French National Death Registry. Cox regression analyses were performed to determine the prognostic value of inducible ischemia and late gadolinium enhancement (LGE).</p><p><strong>Results: </strong>Of the 3,671 patients (mean age 38±6 years, 65% males), 102 (2.8%) died after a median follow-up of 6.8 years (interquartile range: 3-11 years). Annualized mortality rates increased gradually with the number of segments of ischemia and LGE (both p-trend<0.001). The extent of ischemia (hazard ratio [HR]: 1.45; 95% confidence interval [CI]: 1.24-1.70) and LGE (HR: 1.56; 95% CI: 1.39-1.75) were both associated with mortality (both p<0.001). After adjustment for traditional prognostic factors, both the extent of ischemia (adjusted HR: 1.26, per 1-segment increase; 95% CI: 1.06-1.51, p=0.011) and LGE (adjusted HR: 1.50, per 1-segment increase; 95% CI: 1.25-1.80, p<0.001) remained independent predictors of mortality.</p><p><strong>Conclusions: </strong>In patients <45 years undergoing stress CMR, the extent of both inducible ischemia and LGE provide strong and independent prognostic value for predicting all-cause mortality.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102794"},"PeriodicalIF":5.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887667","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":"Accelerated Cardiac MRI Using Deep Learning Cine Imaging: Validation in Pediatric Patients both with and without Congenital Heart Disease.","authors":"Jonathan Kochav, Junjie Ma, Sachin Jambawalikar, Maggie Fung, Patrick Quarterman, Amee Shah, Kanwal Farooqi, Amara Majeed, Simone Jhaveri, Alexandra Channing, Sophia Hsien, Martin Janich, Michael P DiLorenzo","doi":"10.1016/j.jocmr.2026.102793","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102793","url":null,"abstract":"<p><strong>Background: </strong>Conventional breath-held 2D bSSFP cine CMR requires multiple breath holds and prolonged acquisition time, posing challenges for children and patients with congenital heart disease (CHD). Deep-learning (DL)-based reconstruction enables undersampled data acquisition with rapid image completion, offering the potential for substantial time savings while preserving diagnostic accuracy.</p><p><strong>Methods: </strong>Fifty pediatric patients (median age 16.1 years [14.7, 17.5], 56% CHD) with two-ventricle physiology were prospectively recruited, and underwent conventional breath-held bSSFP cine imaging and DL-accelerated cine imaging at three acceleration levels: with breath-held acquisitions over 3-RR intervals, 1-RR interval, and 1-RR interval with free-breathing. Acquisition time, image quality, and quantitative ventricular measurements were compared across sequences.</p><p><strong>Results: </strong>Median short-axis cine stack acquisition time was reduced by 66%, 83%, and 89% for the 3-RR, 1-RR, and 1-RR free-breathing sequences, respectively, compared with conventional cine (all p<0.001). Image quality remained diagnostic in 96%, 88%, and 88% of cases, respectively with no statistical difference in image quality score between conventional cine and 3-RR acquisition. Quantitative assessment of myocardial thickening via radial strain demonstrated excellent agreement (ICC = 0.92, 95% CI 0.82-0.96, p < 0.001) between conventional cine and 3-RR acquisition, with only slightly higher measurements. on 3-RR sequences (29.7 ± 6.5% vs. 28.5 ± 6.1%, p<0.001). LV and RV volumes differed by <5 and <10mL/m² across all acceleration levels, LV mass by <3g/m², and LVEF/RVEF by ≤2%. Among CHD patients, a 2% overestimation of RVEF was observed.</p><p><strong>Conclusions: </strong>DL Cine enables rapid and diagnostically robust quantification of biventricular size and function in pediatric patients, including those with CHD. Image acceleration with 3-RR acquisitions optimally balances efficiency and image quality, supporting integration of DL cine imaging into routine pediatric and congenital CMR workflows.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102793"},"PeriodicalIF":5.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865213","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":"Volumetric real-time MRI for the guidance of cardiac catheterization at 0.55T.","authors":"Prakash Kumar, Rajiv Ramasawmy, Ahsan Javed, Duc Le, Pierre Daudé, Kendall J O'Brien, Andrea E Jaimes, Dominique Franson, Kelvin Chow, Fang Dong, Florian Maier, Robert J Lederman, Krishna S Nayak, Adrienne E Campbell-Washburn","doi":"10.1016/j.jocmr.2026.102792","DOIUrl":"10.1016/j.jocmr.2026.102792","url":null,"abstract":"<p><strong>Background: </strong>Interventional cardiovascular MRI (iCMR) uses rapid high-contrast images to guide invasive procedures, such as right-heart catheterization (RHC), an important diagnostic tool for characterizing pulmonary hypertension and heart failure. Current iCMR uses interleaved multi-planar 2D acquisitions (1-3 planes) with balanced steady-state free precession (bSSFP) contrast. A common challenge is tracking devices as they move out of plane and the operational burden of updating views in real-time. We propose a volumetric method that images the heart and great vessels in their entirety, and offers flexible real-time re-slicing, volumetric 3D visualization, and the potential for improved device monitoring.</p><p><strong>Methods: </strong>Volumetric real-time MRI (3DRT) was implemented at 0.55T using a stack-of-spirals bSSFP acquisition paired with a low-latency online spatiotemporally constrained image reconstruction, to achieve 3.5 mm³ isotropic spatial resolution and ~500 ms/volume temporal resolution. Numerical simulations were performed to evaluate tracking capability of gadolinium balloons as a function of device speed, and to verify image quality. Six healthy volunteers were imaged without catheterization to test performance on human subjects. Six naïve pigs were imaged during RHC, with gadolinium-filled polymer balloon wedge end-hole catheters.</p><p><strong>Results: </strong>Simulation experiments demonstrated that 3DRT imaging with low-latency spatiotemporally constrained reconstruction can resolve moving catheters at ~2.0cm/s. 3DRT with bSSFP contrast was successfully demonstrated for right-heart catheterization procedures in porcine models, providing adequate blood-myocardium contrast, and balloon-blood contrast to track the catheter tip. 3DRT images provided adequate image quality and resolved respiratory motion in healthy volunteers. Volumes were re-sliced live and re-sliced planes could be flexibly manipulated during the scan in real-time before the next volume was acquired.</p><p><strong>Conclusion: </strong>Volumetric real-time MRI is feasible for the guidance of invasive procedures such as right-heart catheterization at 0.55T. 3DRT imaging has been demonstrated in model pig experiments with ~500 ms temporal resolution and 3.5 mm³ isotropic spatial resolution, providing improved balloon tracking.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102792"},"PeriodicalIF":5.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813018","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":"4D flow cardiac magnetic resonance postprocessing in congenital heart disease: SCMR FLIICR workgroup recommendations.","authors":"Julio Garcia, Julia Geiger, Adam Christopher, Christian Meierhofer, Shiraz Maskatia, Francesca Raimondi, Lynette Teo, Sergio Uribe, Julio Sotelo, Kwannapas Saengsin, Kenichiro Suwa, Liang Zhong, Animesh Tandon, Tobias Rutz","doi":"10.1016/j.jocmr.2026.102789","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102789","url":null,"abstract":"<p><p>The large majority of patients with congenital heart disease (CHD) survive into adulthood in the modern era of surgical advancements. However, patients require life-long follow-up and non-invasive imaging is crucial for diagnostic and therapeutic purposes. Cardiovascular magnetic resonance (CMR) plays a major role in patients with CHD as it is a non-invasive and ionizing radiation free imaging tool which overcomes the technical limitations of echocardiography. 4D flow is an evolving technique for flow quantification allowing improved CMR exam quality and reduced scan time. However, comprehensive postprocessing of hemodynamics in CHD may be demanding. This document addresses the needs for an \"ideal\" post-processing software for 4D flow in patients with CHD. It provides information on general requirements, velocity encoding, offset and aliasing correction, visualization, segmentation and reconstruction as well as output data. This document aims to support stakeholders in the field to develop solutions for improved 4D flow post-processing and visualization in CHD patients and thus improve the accuracy and efficiency of patient care.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102789"},"PeriodicalIF":5.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793577","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":"Assessment of Coronary Plaque Burden using Non-Contrast T1-weighted Cardiovascular MR: Comparison with Coronary CT Angiography.","authors":"Alexandra Amalie Uglebjerg Pedersen, Gregory Wood, Andreas Kabel, Damini Dey, Erik Thorlund Parner, Jesper Møller Jensen, Martin Bødtker Mortensen, Karl P Kunze, Claudia Prieto, René M Botnar, Bjarne Linde Nørgaard, Won Yong Kim","doi":"10.1016/j.jocmr.2026.102788","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102788","url":null,"abstract":"<p><strong>Background: </strong>Non-contrast T1-weighted cardiovascular MR (CMR) enables assessment of coronary atherosclerotic plaques by exploiting elevated signal intensity within high-risk plaque components. The novel iT2prep-BOOST sequence provides co-registered coronary lumen and vessel wall whole-heart imaging, potentially facilitating plaque assessment. However, direct comparison of quantitative plaque measures between iT2prep-BOOST and coronary computed tomography angiography (CCTA), the non-invasive standard for plaque assessment, remains limited. This study aimed to compare coronary plaque burden and plaque signal intensity measured by iT2prep-BOOST with plaque burden and plaque attenuation characteristics derived from CCTA.</p><p><strong>Methods: </strong>In this prospective, observational study, patients with stable coronary artery disease confirmed by diagnostic CCTA were recruited and subsequently underwent CMR using the iT2prep-BOOST sequence. Using semi-automated software, per-lesion cross-sectional areas of total, calcified, non-calcified, and low-density non-calcified plaque (≤30 Hounsfield unit) together with measures of plaque burden (percentage vessel atheroma) were quantified on CCTA. The corresponding coronary atherosclerotic lesion was analysed on T1-weighted black-blood iT2prep-BOOST CMR to assess cross-sectional plaque area, burden, and plaque-to-myocardial signal intensity ratio (PMR).</p><p><strong>Results: </strong>A total of 188 lesions in 85 patients were analysed and compared between iT2prep-BOOST and CCTA. Plaque burden estimates derived from iT2prep-BOOST demonstrated moderate correlation with CCTA-derived total plaque burden (r = 0.58) and non-calcified plaque burden (r = 0.54). However, agreement between modalities was limited. For total plaque burden, the mean difference was -4% (95% CI: -7% to -2%) with limits of agreement ranging from -38% to 29%. For non-calcified plaque burden, the mean difference was 3% (95% CI: 0% to 5%) with limits of agreement from -34% to 39%. In univariate regression analyses, PMR was associated with increasing total, non-calcified, and low-density non-calcified plaque areas and decreasing CT attenuation values.</p><p><strong>Conclusion: </strong>Coronary plaque burden assessed by iT2prep-BOOST demonstrated modest correlation and limited agreement with CCTA-derived plaque burden, indicating that the two modalities are not directly interchangeable for plaque burden quantification. Nevertheless, the observed associations between PMR and adverse CCTA plaque characteristics support the potential role of T1-weighted CMR as a complementary, non-invasive tool for coronary plaque characterization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102788"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793547","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}