Journal of Cardiovascular Magnetic Resonance最新文献

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

{"title":"Automated segmentation of thoracic aortic lumen and vessel wall on three-dimensional bright- and black-blood magnetic resonance imaging using nnU-Net.","authors":"Matteo Cesario, Simon J Littlewood, James Nadel, Thomas J Fletcher, Anastasia Fotaki, Carlos Castillo-Passi, Reza Hajhosseiny, Jim Pouliopoulos, Andrew Jabbour, Ruperto Olivero, Jose Rodríguez-Palomares, M Eline Kooi, Claudia Prieto, René M Botnar","doi":"10.1016/j.jocmr.2025.101923","DOIUrl":"10.1016/j.jocmr.2025.101923","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance angiography (MRA) is an important tool for aortic assessment in several cardiovascular diseases. Assessment of MRA images relies on manual segmentation, a time-intensive process that is subject to operator variability. We aimed to optimize and validate two deep-learning models for automatic segmentation of the aortic lumen and vessel wall in high-resolution electrocardiogram-triggered free-breathing respiratory motion-corrected three-dimensional (3D) bright- and black-blood MRA images.</p><p><strong>Methods: </strong>Manual segmentation, serving as the ground truth, was performed on 25 bright-blood and 15 black-blood 3D MRA image sets acquired with the iT2PrepIR-BOOST sequence (1.5T) in thoracic aortopathy patients. The training was performed with no new U-Net (nnUNet) for bright-blood (lumen) and black-blood image sets (lumen and vessel wall). Training consisted of a 70:20:10% (17/25:5/25:3/25 datasets) training:validation:testing split. Inference was run on datasets (single vendor) from different centers (UK, Spain, and Australia), sequences (iT2PrepIR-BOOST, T2 prepared coronary magnetic resonance angiography [CMRA], and time-resolved angiography with interleaved stochastic trajectories [TWIST] MRA), acquired resolutions (from 0.9-3 mm³), and field strengths (0.55T, 1.5T, and 3T). Predictive measurements comprised Dice similarity coefficient (DSC) and Intersection over Union (IoU). Postprocessing (3D slicer) included centreline extraction, diameter measurement, and curved planar reformatting (CPR).</p><p><strong>Results: </strong>The optimal configuration was the 3D U-Net. Bright-blood segmentation at 1.5T on iT2PrepIR-BOOST datasets (1.3 and 1.8 mm³) and 3D CMRA datasets (0.9 mm³) resulted in DSC ≥ 0.96 and IoU ≥ 0.92. For bright-blood segmentation on 3D CMRA at 0.55T, the nnUNet achieved DSC and IoU scores of 0.93 and 0.88 at 1.5 mm³, and 0.68 and 0.52 at 3.0 mm³, respectively. DSC and IoU scores of 0.89 and 0.82 were obtained for CMRA image sets (1 mm³) at 1.5T (Barcelona dataset). DSC and IoU scores of the BRnnUNet model were 0.90 and 0.82, respectively, for the contrast-enhanced dataset (TWIST MRA). Lumen segmentation on black-blood 1.5T iT2PrepIR-BOOST image sets achieved DSC ≥ 0.95 and IoU ≥ 0.90, and vessel wall segmentation resulted in DSC ≥ 0.80 and IoU ≥ 0.67. Automated centreline tracking, diameter measurement, and CPR were successfully implemented in all subjects.</p><p><strong>Conclusion: </strong>Automated aortic lumen and wall segmentation on 3D bright- and black-blood image sets demonstrated excellent agreement with ground truth. This technique demonstrates a fast and comprehensive assessment of aortic morphology with great potential for future clinical application in various cardiovascular diseases.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101923"},"PeriodicalIF":4.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293826","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":"Highly efficient, free-breathing whole-chest equilibrium phase bT1RESS MR angiography: Initial clinical experience.","authors":"Robert R Edelman, Amit Pursnani, Kevin Lee, Hang Chen, Reza Nezafat, Tess Wallace, Nondas Leloudas, Derek Clarke, Ioannis Koktzoglou","doi":"10.1016/j.jocmr.2025.101922","DOIUrl":"10.1016/j.jocmr.2025.101922","url":null,"abstract":"<p><strong>Background: </strong>A fundamental limitation of both computed tomography angiography (CTA) and contrast-enhanced MRA (CEMRA) is that angiographic image quality greatly deteriorates when scans are obtained after the first pass, so that the useful post-contrast scan window is limited to a few tens of seconds. To overcome this limitation, we recently described a breath-hold, slab-selective technique called equilibrium phase balanced T1 relaxation-enhanced steady-state (bT1RESS) that permits diagnostic CEMRA to be obtained for tens of minutes after contrast agent infusion. Further improving upon this technique, we implemented a highly efficient free-breathing version for very rapid whole-chest imaging and tested it in a series of patients.</p><p><strong>Main body: </strong>This study was IRB approved. 34 patients with cardiovascular indications were imaged using a standard CMR protocol plus a post-contrast prototype navigator-gated, whole-chest bT1RESS sequence using either 2×2 or 3×2 (slice x phase) generalized autocalibrating partially parallel acquisition (GRAPPA) acceleration.</p><p><strong>Results: </strong>Median scan time for 20 patients using 3×2 acceleration was 1.25 min vs. 2.21 min for 14 patients using 2×2 acceleration. Mean blood pool-to-muscle signal intensity ratio for bT1RESS obtained >20 min post-contrast was 88% of the value for scans obtained <5 min post-contrast. Inline reconstruction time for a complete 128-slice data set was <15 s. Good-to-excellent image quality and visualization of the aorta, pulmonary arteries and veins, coronary origins, coronary sinus, left atrial appendage, atria and ventricles were obtained in all cases with 3×2 acceleration and all but one case with 2×2 acceleration. There was also excellent correlation (0.92/0.93, p<0.001) between left/right end-diastolic ventricular volumes obtained from short axis cine stacks vs. bT1RESS, and good-to-excellent correlation (0.84/0.64), p<0.001) for left/right end-diastolic atrial volumes.</p><p><strong>Discussion and conclusion: </strong>Free-breathing, whole-chest bT1RESS shows promise as a highly efficient and useful method for cardiovascular imaging. Diagnostic quality scans can be acquired regardless of post-contrast scan delay. Given the very short scan and reconstruction times, navigator-gated bT1RESS can be easily incorporated into any CMR protocol to allow volumetric evaluation of the thoracic vasculature and heart. With further development, the technique could also prove useful for rapid 3D functional evaluation of the heart.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101922"},"PeriodicalIF":4.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293827","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":"Cost analysis of exercise cardiac magnetic resonance imaging in suspected dilated cardiomyopathy-a single-center experience.","authors":"Sameera Senanayake, Sheryl Wei Xuan Lieo, Aisyah Binte Latib, Sanjeewa Kularatna, Nicholas Graves, Michelle Swee Leng Kui, Declan P O'Regan, Mark Yan Yee Chan, Derek John Hausenloy, Calvin Woon Loong Chin, Thu-Thao Le","doi":"10.1016/j.jocmr.2025.101924","DOIUrl":"10.1016/j.jocmr.2025.101924","url":null,"abstract":"<p><strong>Background: </strong>Exercise cardiovascular magnetic resonance (ExCMR) imaging using supine in-scanner ergometer has shown promise in differentiating pathological dilated cardiomyopathy (DCM) from physiological exercise-induced cardiac remodeling. Since 2020, the National Heart Centre Singapore (NHCS) has incorporated ExCMR into its clinical workflow for patients with suspected DCM. This study aims to compare the costs associated with ExCMR versus conventional CMR in the evaluation of DCM.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients referred for conventional CMR between 2016 and 2019, and those referred for ExCMR from 2020 to 2023. Both imaging modalities followed standardized protocols, with ExCMR incorporating additional assessments during peak exercise. Costs were recorded in Singapore dollars (SGD) prior to the application of healthcare subsidies.</p><p><strong>Results: </strong>The total cost for conventional CMR was SGD 1831.36, while ExCMR was associated with a higher initial cost of SGD 2336.48. However, ExCMR resulted in significantly fewer abnormal imaging findings and a reduced need for follow-up investigations (6.5% (9/139) vs 56.8% (71/125), p<0.001). A decision tree analysis and probabilistic sensitivity analysis (PSA) revealed that diagnosing 1000 suspected DCM patients with ExCMR could result in a cost savings of approximately SGD 182,323 compared to conventional CMR, with a 64% probability of being cost-effective.</p><p><strong>Conclusion: </strong>These findings indicate that ExCMR offers a physiologically informative approach for diagnosing DCM, with the potential to reduce overdiagnosis of cardiac dilatation in active, healthy adults. Although further research is necessary to assess long-term outcomes, ExCMR appears to be a cost-effective imaging modality for DCM diagnosis, warranting reconsideration of its perceived higher cost.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101924"},"PeriodicalIF":4.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284436","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":"Temporal trends and geographic accessibility to cardiac magnetic resonance readers across the United States: an analysis of Medicare Part B data.","authors":"Ahmad El Yaman, Ahmed Sayed, Maria Alwan, Asim Shaikh, Mahmoud Al Rifai, Maan Malahfji, Dipan J Shah, Ibrahim M Saeed, Chiara Bucciarelli-Ducci, Mouaz H Al-Mallah","doi":"10.1016/j.jocmr.2025.101921","DOIUrl":"10.1016/j.jocmr.2025.101921","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) has a growing role in the diagnosis and management of cardiac disease. However, there is little recent data on the availability of CMR physicians (readers) in the United States (US).</p><p><strong>Objective: </strong>To demonstrate the geographic proximity and accessibility of patients to CMR services and CMR physicians across the US.</p><p><strong>Methods: </strong>Using Medicare Part B data in 2022, we analyzed the number and characteristics of CMR readers, their geographical location, and the volume of CMR scans between 2013 and 2022. CMR procedure types were identified using healthcare common procedure coding system (HCPCS) codes 75557, 75559, 75561, and 75563.</p><p><strong>Results: </strong>Among Medicare beneficiaries in 2022, there were 48,622 CMR scans, up from 17,944 in 2013 (170.9% increase). The lowest scans and reader density were in West Virginia (125.8 procedures and 2.2 readers per million beneficiaries, respectively) and the highest in the District of Columbia (4566.5 procedures and 52.9 readers per million beneficiaries, respectively). No CMR scans were billed in Puerto Rico. Among states and territories that billed for CMR, 50.8 million U.S. citizens were located more than 50 miles from CMR readers and 18.1 million were located more than 100 miles away. Out of 991 readers, 51.9% were radiologists and 48.1% were cardiologists. The median number of scans interpreted by cardiologists was higher than radiologists across all graduation year intervals, and male and female readers interpreted a similar median number of scans. The relative proportion of female readers increased markedly when assessing physicians who graduated after 2010.</p><p><strong>Conclusion: </strong>This study highlights significant geographic disparities and barriers to accessing CMR in the US.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101921"},"PeriodicalIF":4.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248030","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":"Measurement of myocardial blood flow in atrial fibrillation using high-resolution, free-breathing in-line quantitative cardiovascular magnetic resonance.","authors":"Richard J Crawley, Karl-Philipp Kunze, Anmol Kaushal, Xenios Milidonis, Jack Highton, Blanca Domenech-Ximenos, Irum D Kotadia, Can Karamanli, Nathan C K Wong, Robbie Murphy, Ebraham Alskaf, Radhouene Neji, Mark O'Neill, Steven E Williams, Cian M Scannell, Sven Plein, Amedeo Chiribiri","doi":"10.1016/j.jocmr.2025.101917","DOIUrl":"10.1016/j.jocmr.2025.101917","url":null,"abstract":"<p><strong>Background: </strong>Stress perfusion cardiovascular magnetic resonance (CMR) in the presence of atrial fibrillation (AF) has long been challenging due to electrocardiogram (ECG) mis-triggering. However, non-invasive ischemia imaging is important due to an increased risk of myocardial infarction in patients with AF, which has been attributed to underlying microvascular dysfunction. Myocardial blood flow (MBF) in patients with AF is poorly understood, and few studies have attempted to quantify this through non-invasive imaging.</p><p><strong>Methods: </strong>Patients were recruited for stress perfusion CMR using a research sequence at 3-Tesla. Image acquisition occurred during both vasodilator-induced hyperemia and at rest. Stress and rest MBF maps were automatically generated. Analysis of perfusion maps included assessment of myocardial perfusion reserve (MPR) and endocardial-to-epicardial MBF ratios.</p><p><strong>Results: </strong>Around 442 patients were analyzed; 63 of whom had a history of AF and were in AF during the scan. Both MBF during hyperemia (stress MBF) and MPR were reduced in patients with AF compared to those in sinus rhythm (median stress MBF 1.85 [1.52-2.24] vs. 2.35 [1.98-2.77] mL/min/g, p<0.001; median MPR 1.95 [1.62-2.19] vs. 2.37 [2.05-2.80], p<0.001). No significant difference was seen between the two groups at rest (p=0.451). When considering co-factors affecting MBF, multivariate linear regression analysis identified the presence of AF as a significant independent contributor to stress MBF and MPR values. Both endocardial and epicardial stress MBF and MPR were reduced in AF compared with sinus rhythm (both p<0.001) and endocardial/epicardial ratios were similar between the groups.</p><p><strong>Conclusion: </strong>Automated quantitative MBF assessment can be performed in patients with AF. At hyperemia, MBF is reduced in AF compared to sinus rhythm.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101917"},"PeriodicalIF":6.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248076","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":"Three-Dimensional joint bright, gray and black blood MR imaging technique for multi-parametric imaging of carotid artery: A feasibility and repeatability study.","authors":"Ning Xu, Shuo Chen, Ziming Xu, Zihan Ning, Shuwan Yu, Guimei Liu, Tao Wang, Yanbo Ma, Xiaomei Sun, Xiufeng Meng, Yazheng Chen, Jiachen Liu, Qinxin Wang, Huiyu Qiao, Xihai Zhao","doi":"10.1016/j.jocmr.2025.101918","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101918","url":null,"abstract":"<p><strong>Background: </strong>Multi-parametric imaging of the carotid artery enables quantitative characterization of vulnerable atherosclerotic plaques, which is crucial for preventing ischemic stroke. However, the existing sequential acquisition based multi-parametric imaging techniques of carotid artery lack bright blood imaging, which is essential for plaque components identification and boundary delineation. This study aims to develop a joint bright, gray and black blood imaging technique for carotid artery multi-parametric imaging and validate its accuracy and feasibility.</p><p><strong>Methods: </strong>The proposed technique incorporated variable flip angles, variable duration of improved motion-sensitized driven equilibrium prepulse and variable time of echo mapping strategies with 3D multi-shot SPGR acquisition, generating T1, T2 and T2* maps. Bright, gray and black blood images were sequentially acquired in six scans covering the entire extracranial artery with isotropic resolution (0.7mm) when natural inflow blood enhancement and imposed blood suppression module were alternatively performed. A B1 specific dictionary was simulated and matched to the measured signal for T1 and T2 estimation while least square fitting was applied for T2* estimation. The proposed technique was compared against reference sequences and validated on healthy volunteers (n=8), and patients (n=4) with carotid atherosclerotic plaques.</p><p><strong>Results: </strong>The proposed technique achieved an agreement of R² = 0.99 in T1, T2, and T2 measurements with standard sequences in phantom study. In healthy volunteer study, the proposed technique reached high intra-class correlation coefficients (ICC: 0.906-0.956) with reference sequences in measuring T1, T2 and T2* of cervical muscle, but overestimation and underestimation were observed in T1 (against MOLLI, bias = 4.8%) and T2 (against multi-echo turbo field echo sequence, bias = -3.3%), respectively. No significant difference was found in the measurement of morphology and quantitative parameters between scan and rescan, while excellent intra- (ICC: 0.804-0.999) and inter-observer (ICC: 0.816-0.982) repeatability was reached. In patient study, the proposed technique demonstrated reliable performance in analyzing vascular morphology and characterizing plaque components with distinctive signal characteristics and quantitative values.</p><p><strong>Conclusion: </strong>The proposed technique enables joint bright, gray and black blood imaging technique for carotid artery multi-parametric imaging with large coverage and isotropic resolution, indicating clinical potential for comprehensive characterization of carotid vulnerable plaque.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101918"},"PeriodicalIF":4.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234243","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":"Relationships between heart shape, function, and disease in 38,858 UK biobank participants.","authors":"Richard Burns, Laura Dal Toso, Charlène A Mauger, Alireza Sojoudi, Avan Suinesiaputra, Steffen E Petersen, Julia Ramírez, Patricia B Munroe, Alistair A Young","doi":"10.1016/j.jocmr.2025.101919","DOIUrl":"10.1016/j.jocmr.2025.101919","url":null,"abstract":"<p><strong>Background: </strong>Cardiac functional metrics such as ejection fraction, strain, and valve excursion are important diagnostic and prognostic measures of cardiac disease. However, they ignore a large amount of systolic shape change information available from modern cardiovascular magnetic resonance (CMR) examinations. We aimed to automatically quantify multidimensional shape and motion scores from CMR, investigate covariates, and test their discrimination of disease in the UK Biobank compared against standard functional metrics.</p><p><strong>Methods: </strong>An automated analysis pipeline was used to obtain quality-controlled three-dimensional left and right ventricular shape models in 38,858 UK Biobank participants, 5149 of whom had one or more diagnoses of cardiovascular or cardiometabolic disease. Principal component analysis was used to obtain a statistical shape atlas and quantify each participant's left and right ventricular shape at both end-diastole and end-systole simultaneously. Systolic strain was obtained from arc length changes computed from the shape model, and mitral/tricuspid annular plane systolic excursion (MAPSE/TAPSE) was computed from the displacement of the valves. Discrimination for prevalent disease was quantified using linear discriminant analysis area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>The first 25 principal component scores captured >90% of the total shape variance. Significantly stronger discrimination for atrial fibrillation, heart failure, diabetes, ischemic disease, and conduction disorders (p<0.001 for each) was obtained using shape scores compared with volumes, ejection fractions, strains, MAPSE, and TAPSE.</p><p><strong>Conclusion: </strong>Automatically derived shape and motion z-scores capture more discriminative information on disease effects than standard metrics, including volumes, ejection fraction, strain and valve excursions.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101919"},"PeriodicalIF":4.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225566","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":"Diagnostic utility of the revised Lake Louise criteria in myocarditis associated with active autoimmune rheumatic disease.","authors":"Alina Hua, Blanca Domenech-Ximenos, Begona Lopez, Giovanni Sanna, Amedeo Chiribiri, Ronak Rajani, Michael Marber, David D'Cruz, Michelle Fernando, Tevfik F Ismail","doi":"10.1016/j.jocmr.2025.101916","DOIUrl":"10.1016/j.jocmr.2025.101916","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is the principal non-invasive imaging modality used to diagnose idiopathic/viral myocarditis. The revised Lake Louise criteria (LLC) stipulate that a diagnosis can be made in the presence of one T1-based and one T2-based criterion. While the LLC have been extensively validated in viral myocarditis, their utility for the diagnosis of myocarditis due to an active autoimmune rheumatic disease is unknown. This study sought to assess the performance of the revised LLC in patients with clinically suspected myocarditis due to active systemic autoimmune disease.</p><p><strong>Methods: </strong>Patients with clinically active autoimmune rheumatic disease, symptoms of myocarditis, and elevated troponin levels were recruited and compared with controls with autoimmune rheumatic disease but no suspicion of autoimmune myocarditis. All patients underwent CMR at 1.5T including T1 and T2 mapping.</p><p><strong>Results: </strong>Thirty-seven patients with suspected myocarditis due to an active autoimmune rheumatic disease were recruited with a median (interquartile [IQR]) troponin level of 121 ng/L (72-318 ng/L). Overall, 65% (24/37) of patients met either of the two revised LLC resulting in a sensitivity (95% confidence interval) of 65% (49-78%) and specificity of 76% (57-89%). Only 32% (12/37) of patients fulfilled both of the main LLC (i.e., non-ischemic myocardial injury/edema with elevated T1 values or presence of late gadolinium enhancement and myocardial edema detected by increased T2 values or positive T2-STIR), resulting in a sensitivity of 32% (20-49%) and specificity of 100% (87-100%). Among controls, 24% (6/25) of patients had elevated native T1 values, but all had normal T2.</p><p><strong>Conclusion: </strong>In patients with suspected myocarditis due to autoimmune rheumatic disease, who are receiving immunosuppressive therapy, the LLC have a high specificity, but a lower sensitivity than in patients with viral myocarditis. Additional tests should therefore be used to improve disease detection in this population. Where the pre-test probability is high, in patients with suspected myocarditis due to autoimmune rheumatic disease who are undergoing immunosuppression, there may need to be greater reliance on one T1-based criterion rather than both LLC, with the recognition that there is an appreciable rate of raised T1 in controls without myocarditis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101916"},"PeriodicalIF":6.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225564","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":"Referenceless 4D flow cardiovascular magnetic resonance with deep learning.","authors":"Chiara Trenti, Erik Ylipää, Tino Ebbers, Carl-Johan Carlhäll, Jan Engvall, Petter Dyverfeldt","doi":"10.1016/j.jocmr.2025.101920","DOIUrl":"10.1016/j.jocmr.2025.101920","url":null,"abstract":"<p><strong>Background: </strong>Despite its potential to improve the assessment of cardiovascular diseases, four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is hampered by long scan times. 4D flow CMR is conventionally acquired with three motion encodings and one reference encoding, as the three-dimensional velocity data are obtained by subtracting the phase of the reference from the phase of the motion encodings. In this study, we aim to use deep learning to predict the reference encoding from the three motion encodings for cardiovascular 4D flow.</p><p><strong>Methods: </strong>A U-Net was trained with adversarial learning (U-Net_ADV) and with a velocity frequency-weighted loss function (U-Net_VEL) to predict the reference encoding from the three motion encodings obtained with a non-symmetric velocity-encoding scheme. Whole-heart 4D flow datasets from 126 patients with different types of cardiomyopathies were retrospectively included. The models were trained on 113 patients with a 5-fold cross-validation, and tested on 13 patients. Flow volumes in the aorta and pulmonary artery, mean and maximum velocity, total and maximum turbulent kinetic energy at peak systole in the cardiac chambers and main vessels were assessed.</p><p><strong>Results: </strong>Three-dimensional velocity data reconstructed with the reference encoding predicted by deep learning agreed well with the velocities obtained with the reference encoding acquired at the scanner for both models. U-Net_ADV performed more consistently throughout the cardiac cycle and across the test subjects, while U-Net_VEL performed better for systolic velocities. Comprehensively, the largest error for flow volumes, maximum and mean velocities was -6.031% for maximum velocities in the right ventricle for the U-Net_ADV, and -6.92% for mean velocities in the right ventricle for U-Net_VEL. For total turbulent kinetic energy, the highest errors were in the left ventricle (-77.17%) for the U-Net_ADV, and in the right ventricle (24.96%) for the U-Net_VEL, while for maximum turbulent kinetic energy were in the pulmonary artery for both models, with a value of -15.5% for U-Net_ADV and 15.38% for the U-Net_VEL.</p><p><strong>Conclusion: </strong>Deep learning-enabled referenceless 4D flow CMR permits velocities and flow volumes quantification comparable to conventional 4D flow. Omitting the reference encoding reduces the amount of acquired data by 25%, thus allowing shorter scan times or improved resolution, which is valuable for utilization in the clinical routine.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101920"},"PeriodicalIF":4.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225565","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}