Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"High Resolution Isotropic 'Pseudo' 3D Cine imaging with Automated Segmentation using Concatenated 2D Real-time Imaging and Deep Learning.","authors":"Mark Wrobel, Tina Yao, Ruaraidh Campbell, Rebecca Baker, Elena Milano, Catherine Beattie, Michael Quail, Francesca Raimondi, Yue-Hin Loke, Rajesh Puranik, Mehdi Moghari, Jennifer Steeden, Vivek Muthurangu","doi":"10.1016/j.jocmr.2026.102780","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102780","url":null,"abstract":"<p><strong>Background: </strong>Conventional cardiovascular magnetic resonance (CMR) in pediatric and congenital heart disease uses 2D, breath-hold (BH), balanced steady state free precession (bSSFP) cine imaging for assessment of function, in addition to cardiac-gated, respiratory-navigated, static 3D bSSFP whole-heart imaging for anatomical assessment. Our aim is to concatenate a stack of 2D free-breathing real-time cines and use Deep Learning (DL) to create an isotropic fully segmented 'pseudo' 3D-cine dataset from these images.</p><p><strong>Methods: </strong>Four DL models were trained on open-source data that performed: a) Interslice signal-correction; b) Interslice respiratory-correction; c) Super-resolution in the slice direction; and d) Segmentation of right and left atria and ventricles (RA, LA, RV, and LV), thoracic aorta (Ao) and pulmonary arteries (PA). Our method was validated in 20 patients undergoing routine cardiovascular examination, by converting prospectively acquired sagittal stacks of real-time cine images to segmented, isotropic pseudo 3D-cine data. Quantitative metrics (ventricular volumes and vessel diameters) and image quality of the DL pseudo-3D-cines were compared to reference-standard breath-hold cine and whole-heart imaging.</p><p><strong>Results: </strong>All real-time data were successfully transformed into pseudo 3D-cines with a total offline reconstruction and post-processing time of <1min in all cases. There were no significant biases in any left ventricular (LV) or right ventricular (RV) metrics (bias ± standard deviation in ml, LV end diastolic volume (EDV): 0.7 ± 8.8, LV end systolic volume (ESV): -1.7 ± 7.1, RV EDV: 1.9 ± 12.4, RV ESV: -1.5 ± 10.7) with reasonable limits of agreement and correlation. There is also reasonable agreement for all vessel diameters, although there was a small but significant overestimation (p<0.05) of right PA (RPA) and main PA (MPA) diameter (RPA: bias = -1.0mm. MPA: bias = -1.1mm). The DL pseudo-3D-cine data were assessed to be of adequate diagnostic quality unlike the unprocessed 2D real-time data.</p><p><strong>Conclusion: </strong>We have demonstrated the potential of creating a pseudo 3D-cine data from concatenated 2D real-time cine images using a series of DL models. Our method has short acquisition and reconstruction times with fully segmented data being available in less than one minute. Our models are trained from fully open-source datasets, allowing our technique to be easily shared with other clinical centers. The agreement with reference-standard imaging suggests that our method could help to significantly speed up CMR in clinical practice.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102780"},"PeriodicalIF":5.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603375","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":"Myocardial Native T1 Mapping in the German National Cohort (NAKO): Associations with Age, Sex, and Cardiometabolic Risk Factors.","authors":"Clemens Ammann, Jan Gröschel, Hadil Saad, Susanne Rospleszcz, Christopher Schuppert, Thomas Hadler, Richard Hickstein, Thoralf Niendorf, Janis M Nolde, Matthias B Schulze, Karin H Greiser, Hermann Brenner, Ute Mons, Josua A Decker, Thomas Kröncke, Thomas Küstner, Konstantin Nikolaou, Stefan N Willich, Thomas Keil, Marcus Dörr, Robin Bülow, Fabian Bamberg, Tobias Pischon, Christopher L Schlett, Jeanette Schulz-Menger","doi":"10.1016/j.jocmr.2026.102781","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102781","url":null,"abstract":"<p><strong>Background: </strong>In cardiovascular magnetic resonance (CMR), myocardial native T₁ mapping enables quantitative, non-invasive tissue characterization and is sensitive to subclinical changes in myocardial structure and composition. However, data on the association between cardiometabolic risk and myocardial alterations are still limited. We therefore investigated how age, sex, and cardiometabolic risk factors are associated with myocardial T₁ as a potential imaging marker of myocardial target-organ involvement in a population-based analysis within the German National Cohort (NAKO).</p><p><strong>Methods: </strong>This cross-sectional study included 29,573 prospectively enrolled participants who underwent midventricular T₁ mapping using 3.0T CMR along with deep clinical phenotyping. After artificial intelligence-assisted myocardial segmentation, a subset of 9,162 outlier cases was subjected to manual quality control according to clinical evaluation standards. Cardiometabolic risk factors were identified through self-reported, physician-diagnosed medical history, clinical chemistry, and blood pressure measurements. Associations with myocardial T₁ were evaluated using multiple linear regression models adjusted for age, sex, heart rate, imaging site, and comorbidities.</p><p><strong>Results: </strong>After quality control, 27,794 participants (12,401 [44.6%] women; 20-75 years) were included. Mean T₁ was overall higher in women (1,231 ± 33 ms) than in men (1,209 ± 34 ms), with differences progressively declining with age. The sex difference was confirmed in a healthy subcohort (n = 3,910), whilst age interaction was less pronounced. In adjusted analyses, T₁ was significantly higher in individuals with diabetes, kidney disease, and current smoking. Conversely, hyperlipidaemia was significantly associated with lower T₁. Associations with hypertension showed strongly sex-specific patterns: women had lower T₁ values, while T₁ increased with hypertension severity in men.</p><p><strong>Conclusions: </strong>Myocardial native T₁ varies by sex and age and shows distinct sex-specific associations with major cardiometabolic risk factors, supporting its role as a sensitive imaging marker of subtle myocardial alterations. Unexpectedly lower T₁ times in participants with hyperlipidaemia suggest a potential direct effect of blood lipids on the heart, which warrants further investigation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102781"},"PeriodicalIF":5.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578728","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":"SCMR Survey of Centers Performing CMR in Pediatric/Congenital Heart Disease: 2024 Update.","authors":"Sujatha Buddhe, Brian D Soriano, Hunter C Wilson, Adam L Dorfman, Tobias Rutz, Priya Chudgar, Franz Gerald Greil, Carlos-Eduardo Guerrero-Chalela, Nazia Husain, Michael Cheung, Yu-Min Zhong, Andrew J Powell","doi":"10.1016/j.jocmr.2026.102779","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102779","url":null,"abstract":"<p><strong>Background: </strong>Few data exist on practice trends for cardiovascular magnetic resonance (CMR) in pediatric and congenital heart disease (CHD). The Society for Cardiovascular Magnetic Resonance addressed this gap by conducting an international survey of CMR sites in 2014 and 2018. We now report the most recent survey results from 2024.</p><p><strong>Methods: </strong>Surveys with 31 (2014), 33 (2018), and 41 (2024) items were sent to all SCMR members. One response per center was collected.</p><p><strong>Results: </strong>There were 93 centers that responded in 2014, 83 in 2018, and 124 in 2024. The following results are per center and data from 2014, 2018, and 2024 are separated by dashes. The median annual number of pediatric/CHD CMR cases was 183-209-250. The median number of CMR scanners was 2-2-2 (range, 1-8) with 58-63-53% using only 1.5T scanners and 4-4-3% using only 3T. CMR examinations were performed in infants (<1 year old) in 74%-76%-90% and sedation and/or anesthesia was used in 84%-86%-94% of the centers. The mean number of attendings/staff reading CMRs was 3.7-2.6-2.9. Combining attending/staff physicians from all centers, 52-61-62% were pediatric or adult cardiologists, and 47-38-37% were pediatric or adult radiologists. The median annual case volume per physician per center was 54-86-76. The median number of technologists was 4-5-4. The median scanner time allocated for a non-sedated examination was 75-75-75minutes (range, 30-120minutes). Among the 14 centers responding to all 3 surveys, the mean annual case volume was 380-500-588, with 82% of centers experiencing a sequential increase in volume with each survey. All of these 14 centers were in the United States and for them, the mean time for an attending/staff physician to perform a typical CMR examination, including supervision and reporting, was 150-153-154minutes, and the median scanner time allocated per ex per year was 92 in the amination for non-sedation cases remained unchanged at 90-90-90minutes.</p><p><strong>Conclusion: </strong>These survey data provide a unique and comprehensive view of CMR practice in pediatric and CHD across centers worldwide. This information is useful for internal benchmarking, resource allocation, addressing practice variation, quality improvement initiatives, and identifying unmet needs.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102779"},"PeriodicalIF":5.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562213","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":"Identifying abnormal patterns of wall shear stress in mild-to-moderate aortic dilation and tricuspid valves using permutation tests.","authors":"Chiara Trenti, Deneb Boito, Filip Hammaréus, Jennifer Suhil Habib, Marcus Lindenberger, Eva Swahn, Lena Jonasson, Bertil Wegmann, Petter Dyverfeldt","doi":"10.1016/j.jocmr.2026.102778","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102778","url":null,"abstract":"<p><strong>Background: </strong>Aortic wall shear stress (WSS) maps allow three-dimensional visualization and quantification of WSS patterns in the aorta and can be used to identify patch-wise differences between cohorts. However, a method addressing the multiplicity of the testing should be considered when investigating patch-wise differences. In this study, we sought to explore the capability of permutation tests in addressing the regional statistical differences in WSS values between patients with mild-to-moderate aortic dilation with tricuspid valves and age- and sex- matched controls.</p><p><strong>Methods: </strong>4D Flow MRI-derived WSS parameters were computed in a cohort of 46 patients with mild-to-moderate ascending aortic dilation (\"cases\") and a cohort of 51 age- and sex-matched individuals without dilation (\"controls\"). The 3D WSS maps were mapped to a shared geometry where the ascending aorta was divided into 40×40 surface patches. Synthetic data were created and used to assess the false positive and false negative rates for permutation tests with threshold-free cluster enhancement (TFCE) and, for comparison, for statistical tests common in cardiovascular studies, namely the Student's t-test (with and without Bonferroni correction and Benjamin-Hochberg procedure), and the Wilcoxon rank sum test.</p><p><strong>Results: </strong>Significance maps obtained from synthetic data showed that permutation tests had lower false positive rates compared to the uncorrected Student's t-test and the Wilcoxon rank sum test, lower false negative rates compared to the Student's t-test with Bonferroni correction, but higher false negative rates compared to the Student's t-test with the Benjamin-Hochberg procedure. However, the false negatives were concentrated near the boundary of regions of no difference between the groups. On the real data, several regions, indicated as significant by the non-corrected Student's t-test, were not significant when statistical testing was corrected for multiple comparisons. Significance maps created with TFCE-based permutation tests reveal that individuals with mild-to-moderate aortic dilation and tricuspid valves have lower peak WSS, higher OSI, and higher WSS in diastole.</p><p><strong>Conclusion: </strong>Permutation tests applied to 4D Flow-derived WSS parameters are suitable for the local analysis of WSS differences between cohorts, correcting for the family-wise error rate while accounting for spatial relationships between WSS values.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102778"},"PeriodicalIF":5.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536006","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":"Fully Automatic Left Atrial Strain Quantification via Multi-task Learning on Cardiac Cine MRI.","authors":"Yichen Zhao, Haiyang Chen, Yiwen Gong, Zhuo Chen, Juan Gao, Fan Yang, Zhihao Xue, Zeping Qiu, Ji Zhao, Qing Li, Chengyan Wang, Yucheng Chen, Liang Zhong, Wei Jin, Sha Hua, Chenxi Hu","doi":"10.1016/j.jocmr.2026.102777","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102777","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance feature tracking (CMR-FT) of left atrial (LA) strain is hindered by thin-wall contouring errors, motion heterogeneity, and temporal drift, while manual or landmark-based methods lack reproducibility and scalability.</p><p><strong>Methods: </strong>We retrospectively collected a multi-center, two-vendor cine MRI dataset. A multi-task learning model was developed to quantify LA strain directly from two-chamber and four-chamber cine images, by coupling a groupwise registration network with a segmentation network through a spatiotemporal cross-attention module and synergistic losses. Performance was benchmarked against common feature tracking algorithms, including optical flow, pairwise registration, and VoxelMorph, via various metrics such as mean-squared error, contour distance, mitral annular tracking accuracy, and drift error. Diagnostic performance to distinguish healthy from diseased subjects was assessed by ROC analysis.</p><p><strong>Results: </strong>546 subjects (142 healthy; age 49±18 years; 343 male) were included for method development and internal/external testing. The proposed method outperformed all other methods in tracking accuracy and reduced the drift effect commonly observed in optical flow and pairwise registration to a level comparable to fixed-reference learning-based registration. Inference required half a second. Automatic strains agreed closely with manual-segmentation-derived values (reservoir r=0.95, conduit r=0.96, booster r=0.92; all p<0.001). In the external dataset, all three strain components were lower in diseased subjects than normal controls (reservoir 24.4±13.2% vs 45.7±12.6%, conduit 14.1±8.8% vs 31.1±10.2%, and booster 10.3±6.4% vs 14.6±5.1%, all p<0.001). Compared with alternative methods, the automatic reservoir strain achieved the highest discriminative power across multiple diseased groups (AUC: 0.81-0.97).</p><p><strong>Conclusion: </strong>A fully automatic, multi-task learning framework for LA strain quantification, validated in multi-center two-vendor data, enhances tracking accuracy and speed over prior methods, enabling rapid, scalable atrial function assessment in routine care. Source code is available at SJTU-CMRLab/Dual_Task_LA_Strain_Quantification.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102777"},"PeriodicalIF":5.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470847","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":"Advancing Heart Ageing in Ischemic Heart Disease: Insights from CMR and ECG Analysis.","authors":"Ahmed M Salih, Elisa Rauseo, Ilaria Boscolo Galazzo, Esmeralda Ruiz Pujadas, Víctor M Campello, Karim Lekadir, Nay Aung, Gregory G Slabaugh, Ghaith Sharaf Dabbagh, Anwar A Chahal, Gloria Menegaz, Steffen E Petersen","doi":"10.1016/j.jocmr.2026.102776","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102776","url":null,"abstract":"<p><strong>Aims: </strong>Ischemic heart disease (IHD) patients undergo cardiovascular alterations that can accelerate heart ageing. Estimating biological heart age using advanced cardiac magnetic resonance (CMR) and electrocardiogram (ECG)-derived phenotypes provides a biomarker for heart ageing. We investigated the relationship of IHD and heart ageing using biological age estimation biomarkers, and the contribution of conventional cardiac imaging indices and vascular risk factors (VRFs).</p><p><strong>Methods and results: </strong>Heart age was estimated in prevalent IHD cases (n = 2,142) incorporating CMR radiomics and ECG features. Heart age gap (HAG), representing the disparity between predicted and actual heart age, was calculated. IHD subjects had significantly higher heart age compared to those without the disease (HAG: 1.55 years ± 5.66; p <0.001). The main radiomics and ECG features linked to heart ageing in IHD delineated a phenotype of structural and electrical remodelling not typically seen in the ageing heart. Conventional CMR indices accounted for only a negligible fraction of the association between IHD and HAG. Among the VRFs, adiposity and hypertension were significantly associated with increasing HAG in IHD.</p><p><strong>Conclusion: </strong>Individuals with IHD showed higher estimated heart ageing than controls, consistent with greater deviation from normal heart ageing, and this was associated with selected VRFs. This relationship was only minimally explained by conventional CMR indices, suggesting that the heart age model captures additional imaging and electrical features beyond standard CMR measures. HAG may offer an exploratory framework for characterising phenotypic heterogeneity in IHD and contextualising cardiovascular risk; however, prospective validation is required prior to clinical application.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102776"},"PeriodicalIF":5.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470904","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":"Impact of transcatheter aortic valve replacement on blood flow in the ascending aorta and brachiocephalic artery.","authors":"Koji Yamasaki, Satonori Tsuneta, Motoma Kanaya, So Sasaki, Takeshi Hamaya, Suguru Ishizaka, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai, Kohsuke Kudo","doi":"10.1016/j.jocmr.2026.102775","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102775","url":null,"abstract":"<p><strong>Background: </strong>Although transcatheter aortic valve replacement (TAVR) can improve cerebral blood flow (CBF) in patients with aortic stenosis (AS), the effect of pre-TAVR flow rate on post-TAVR flow rate increase is unclear. We aimed to evaluate blood flow changes before and after TAVR in the ascending aorta (AAo) and brachiocephalic artery (BCA) using four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) and assess whether the post-TAVR flow response depends on the pre-TAVR flow rate.</p><p><strong>Methods: </strong>This prospective study included patients who underwent TAVR for AS at our institution between January 2022 and December 2023 and who underwent 4D flow CMR before and after TAVR. Patients were divided into two groups, normal-flow (NF) and low-flow (LF) groups, using a cutoff value of 35mL/beat/m² for the ratio of pre-TAVR AAo flow rate per beat to body surface area. Flow rates in the AAo and BCA were analyzed.</p><p><strong>Results: </strong>Sixty-one patients were enrolled. The median age was 84 (82-87) years, and twenty-three patients (38%) were men. The net flow rates in the AAo and BCA increased after TAVR, but the changes were not statistically significant (AAo, 3206 (2499-3975) mL/min vs. 3591 (2880-4419) mL/min, p = 0.23; BCA, 435 (302-560) mL/min vs. 512 (377-666) mL/min, p = 0.06). In the analysis of the NF and LF groups, the LF group demonstrated significant increases in net flow after TAVR (AAo, 2598 (1972-3079) vs. 3468 (2900-4131) mL/min, p < 0.001; BCA, 365 (230-529) vs. 522 (377-659) mL/min, p = 0.006).</p><p><strong>Conclusion: </strong>4D flow CMR revealed that TAVR significantly increased the AAo and BCA flow rates in patients with LF AS. (274 words / 350 limit).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102775"},"PeriodicalIF":5.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470911","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":"Clinical Feasibility of Free-Breathing Volumetric Comprehensive Tissue Characterization via the Multi-parametric SAVA Technique.","authors":"Yifei Jiang, Dongyue Si, Qizhe Cai, Bowei Liu, Yu Lian, Jingjing Xiao, Haiyan Ding, Xiangchuang Kong, Rui Guo","doi":"10.1016/j.jocmr.2026.102774","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102774","url":null,"abstract":"<p><strong>Background: </strong>Volumetric, one-stop cardiovascular magnetic resonance parametric mapping techniques have been developed and continue to evolve; however, clinical adoption remains limited by insufficient evidence supporting their feasibility in routine practice and the need to demonstrate agreement with established standard techniques.</p><p><strong>Purpose: </strong>To validate three-dimensional free-breathing mSAVA for comprehensive myocardial tissue characterization, including pre-/post-contrast T₁, T₂, ECV, and synthesized bright-blood (BB-) and dark-blood (DB-) LGE in patients, and to compare its performance with conventional T₁ mapping, T₂ mapping, and phase-sensitive inversion recovery (PSIR) techniques.</p><p><strong>Methods: </strong>We deployed mSAVA in a clinical hospital setting and had it operated by radiologists. A total of 40 patients (22 males, age range: 17-67 years) with various cardiac diseases referred for CMR evaluation underwent mSAVA imaging along with standard clinical sequences, including MOLLI for native/post-contrast T₁ mapping, mGraSE for T₂ mapping, and PSIR. The study was approved by the institutional review board, and written informed consent was obtained from all participants before imaging. We evaluated the clinical feasibility of mSAVA, its agreement with established conventional techniques, and its ability to synthesize LGE.</p><p><strong>Results: </strong>Of 40 enrolled patients, 2 had non-diagnostic mSAVA images and 7 lacked post-contrast scans or had atypical cardiac anatomy. In the remaining 31 patients (17 male; age range, 17-67 years), mSAVA required 6.1±1.7min of free-breathing acquisition to obtain whole-heart joint T₁/T₂ maps, compared with 1.5min for MOLLI T₁ mapping and 1.7min for mGraSE T₂ mapping over three slices. mSAVA showed strong correlation for post-contrast T₁ and ECV, and moderate correlation for native T₁ and T₂ with conventional clinical standards, and similarly characterized scar-remote tissue differences. The 3D post-contrast T₁/T₂ maps also enabled retrospective synthesis of bright-blood and dark-blood LGE. Synthesized BB-LGE demonstrated good accuracy for detecting enhancement compared with PSIR, whereas synthesized DB-LGE showed moderate precision and variable scar depiction.</p><p><strong>Conclusion: </strong>This initial clinical study suggests that free-breathing, one-stop mSAVA is a promising technique for comprehensive CMR tissue characterization, particularly in patients unable to perform breath-holds, in scenarios requiring multiple quantitative measurements, or when whole-heart coverage is desired. Further clinical studies are warranted to establish its references and its clinical value.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102774"},"PeriodicalIF":5.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404865","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":"CE-MRA-FLOWnet: Fast and Accurate Generative AI-Based Aortic Hemodynamic Mapping from Contrast-Enhanced MRA.","authors":"David Dushfunian, Haben Berhane, Ethan Johnson, Aniket Dehaidrai, Michael Markl, Bradley D Allen","doi":"10.1016/j.jocmr.2026.102773","DOIUrl":"10.1016/j.jocmr.2026.102773","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;4D flow MRI hemodynamic biomarkers (e.g. peak velocity and wall shear stress [WSS]) have shown promise for improved risk-stratification in patients with thoracic aortic disease (TAD). However, lengthy 4D flow scan times, complex data analysis and need for dedicated expertise limit clinical translation. In this study, we developed a fluid-physics informed deep generative adversarial neural network, CE-MRA-FLOWnet, to predict aortic hemodynamics directly from standard-of-care contrast-enhanced magnetic resonance angiography (CE-MRA) images.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively identified 1392 patients (age: 52±12years, 1011 male, 954 with bicuspid aortic valve, BAV; 438 with tricuspid aortic valve, TAV) who underwent paired clinical 4D flow MRI and CE-MRA between 2011 and 2020 for suspected TAD. The CE-MRA-FLOWnet used CE-MRA data (1127 for network training, 265 for testing) to generate a prediction of aortic hemodynamics. 4D flow-measured aortic systolic 3D blood flow velocity vector fields served as ground truth. Analysis included comparison of AI-derived and ground truth aortic systolic peak velocity (PV) and WSS, the relative area of the AAo (%) exposed to elevated WSS, and aortic valve stenosis severity grading. The predictive value of CE-MRA-FLOWnet hemodynamics metrics was assessed in a subgroup of 133 BAV patients with known multi-year adverse outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CE-MRA-FLOWnet training time was 8100mins; inference time per CE-MRA was 0.88±0.05seconds. AI-derived PV showed strong regional agreement and low biases with ground truth 4D flow (0.00-0.04m/s), and relative differences within 10.6%-12.7%. Aortic WSS also demonstrated minimal bias (-0.01-0.04Pa) and close alignment of the area of elevate WSS between AI and 4D flow (19.6±15.1% vs. 19.3±16.2%, p=0.84). AS severity was accurately classified in 88% of cases, with all grading errors limited to a one-grade difference (Kappa 0.84). ROC analysis showed that CE-MRA-FLOWnet derived hemodynamic metrics outperformed diameter alone for predicting adverse outcomes (PV AUC = 0.73-0.76; WSS = 0.83-0.88; diameter = 0.52-0.62).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CE-MRA-FLOWnet accurately predicts aortic hemodynamics in TAD patients using standard-of-care CE-MRA images. Our results demonstrate potential for clinical integration by providing physicians with near real-time hemodynamic data from widely available clinical CE-MRA images.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical perspective: &lt;/strong&gt;Approximately 3% of the population has or is at risk for thoracic aortic disease (TAD) which can result in significant complications including progressive aortic dilation and dissection. Historically, aortic diameter measured on CT angiography or MR angiography (MRA) has been the primary marker of risk and TAD patients undergo frequent surveillance imaging to evaluate aortic size and growth. However, it is well established that aortic diameter is an imperfect ","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102773"},"PeriodicalIF":5.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404870","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":"Imaging post-reperfusion metabolism in porcine myocardial infarction with hyperpolarized ¹³C pyruvate MRI.","authors":"Nikolaj Bøgh, Esben Søvsø Szocska Hansen, Jakob Lindhardt, Rasmus Stilling Tougaard, Christoffer Laustsen, Won Yong Kim","doi":"10.1016/j.jocmr.2026.102772","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102772","url":null,"abstract":"<p><strong>Background: </strong>Reperfusion injury after primary percutaneous coronary intervention is a potential target for improving treatment of myocardial infarction. Reperfusion represents a sudden metabolic challenge of the ischemic myocardial tissue, which is thought to be a driver of reperfusion injury that is difficult to evaluate with current technologies.</p><p><strong>Methods: </strong>We investigated the use of metabolic magnetic resonance imaging with hyperpolarized [1-¹³C]pyruvate for investigation of post-reperfusion metabolism in a pig model of acute myocardial infarction. To induce ischemia, 15 pigs had a coronary balloon placed in the left anterior descendent for one hour. Seven animals underwent mechanical preload reduction in effort to investigate the effects of increased salvage. After three hours of reperfusion, the animals were scanned with hyperpolarized [1-¹³C]pyruvate MRI to image the balance between mitochondrial and glycolytic metabolism.</p><p><strong>Results: </strong>Larger conversion from [1-¹³C]pyruvate to [1-¹³C]lactate, representing glycolytic metabolism, was observed in the area-at-risk (P <.001). Similar, but non-significant, hypermetabolism was observed for conversion of [1-¹³C]pyruvate to [¹³C]bicarbonate (P =.07), representing mitochondrial metabolism. Conversion from [1-¹³C]pyruvate to [1-¹³C]alanine seemed to decrease in the group with preload reduction but increase in the sham group. The observed hypermetabolism correlated with the amount of salvaged myocardium (r =.7, P <.01), but not with the size of the area-at-risk.</p><p><strong>Conclusion: </strong>This study shows that the salvaged myocardium becomes hypermetabolic and glycolytic after reperfusion, and that a metabolic MRI may be a valuable tool in attempts to modulate post-reperfusion metabolism in preclinical and clinical research alike.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102772"},"PeriodicalIF":5.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381941","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}