Jiachen Liu, Zihan Ning, Chenlin Du, Shuo Chen, Tao Wang, Jingli Cao, Ran Huo, Dongye Li, Dandan Yang, Rui Shen, Shuwan Yu, Chunjiang Hu, Shuhao Wang, Huiyu Qiao, Xihai Zhao
{"title":"Histological validation of three-dimensional variable flip angle turbo spin echo multi-contrast magnetic resonance vessel wall imaging in characterizing carotid vulnerable atherosclerotic plaques.","authors":"Jiachen Liu, Zihan Ning, Chenlin Du, Shuo Chen, Tao Wang, Jingli Cao, Ran Huo, Dongye Li, Dandan Yang, Rui Shen, Shuwan Yu, Chunjiang Hu, Shuhao Wang, Huiyu Qiao, Xihai Zhao","doi":"10.1016/j.jocmr.2024.101112","DOIUrl":"10.1016/j.jocmr.2024.101112","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of the vulnerability of carotid atherosclerotic plaques is crucial for stroke prevention. The three-dimensional (3D) magnetic resonance (MR) vessel wall imaging (VWI) has been increasingly employed to evaluate carotid plaques due to its extensive coverage and isotropic high spatial resolution. However, the accuracy of such techniques lacks validation by histology. Therefore, this study aims to validate the accuracy of 3D multi-contrast MR VWI with variable-flip-angle (VFA) and turbo spin echo (TSE) readout in identifying vulnerable carotid plaques, using histological analysis as a reference.</p><p><strong>Methods: </strong>Twenty-one male patients (mean age: 64.4 ± 7.2 years old) scheduled for carotid endarterectomy (CEA) were recruited in this study. All patients underwent carotid multi-contrast MR VWI, including 3D T1- and T2-weighted VFA-TSE sequences, as well as 3D time of flight (TOF) MR angiography (MRA), using a 3.0T MR system before surgery. Histological processing was performed for carotid plaque specimens. The presence or absence, along with the area measurements, of lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and calcifications (CA) were independently evaluated on both MR images and histological sections. Cohen's kappa (κ) analysis was utilized to determine the agreement between 3D multi-contrast MR VWI and histology in identifying carotid plaque compositions before and after excluding compositions bellow certain size threshold. Spearman's correlation analysis was also conducted to assess the agreement in quantifying plaque compositions.</p><p><strong>Results: </strong>A total of 81 slices of MR images were successfully matched with histological sections. Moderate to almost perfect agreements were observed between 3D MR VWI and histology in the identification of LRNC (κ: 0.85 and 0.89), IPH (κ: 0.65 and 0.69), and CA (κ: 0.46 and 0.62) before and after excluding compositions smaller than 0.79 mm<sup>2</sup>. Strong to very strong correlations were found in the quantification of plaque compositions including LRNC (r=0.88), IPH (r=0.80), and CA (r=0.74) between MR imaging and histology.</p><p><strong>Conclusion: </strong>The 3D VFA-TSE multi-contrast MR VWI is capable of accurately characterizing vulnerable carotid atherosclerotic plaques.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101112"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501117","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":"Easing the strain of fetal cardiovascular magnetic resonance: Editorial for \"Fetal cardiovascular magnetic resonance feature tracking myocardial strain analysis in congenital heart disease\".","authors":"Alex J Barker, Lorna P Browne, Richard M Friesen","doi":"10.1016/j.jocmr.2024.101115","DOIUrl":"10.1016/j.jocmr.2024.101115","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101115"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic value of global longitudinal strain in patients with preserved left ventricular systolic function: A cardiac magnetic resonance real-world study.","authors":"Preeyaporn Janwetchasil, Ahthit Yindeengam, Rungroj Krittayaphong","doi":"10.1016/j.jocmr.2024.101057","DOIUrl":"10.1016/j.jocmr.2024.101057","url":null,"abstract":"<p><strong>Background: </strong>Myocardial strain is a more sensitive parameter for cardiac function evaluation than left ventricular ejection fraction (LVEF). This study aimed to assess the predictive value of left ventricular global longitudinal strain (LV-GLS) by feature tracking-cardiac magnetic resonance (FT-CMR) imaging in patients with known or suspected coronary artery disease (CAD) with preserved left ventricular systolic function.</p><p><strong>Methods: </strong>This retrospective cohort analysis enrolled patients with known or suspected CAD who underwent cardiac magnetic resonance imaging from September 2017 to December 2019. LV-GLS was analyzed via feature-tracking analysis. Patients with LVEF <50% were excluded. The composite outcome comprised all-cause death, non-fatal myocardial infarction, and heart failure.</p><p><strong>Results: </strong>There was a total of 2613 patients. Mean follow-up duration was 39.7 ± 13.9 months. During follow-up, 194 patients (7.4%) experienced a composite outcome. The best cutoff of LV-GLS in the prediction of composite outcome from receiver operating characteristics was -14.4%. Patients were classified into 2 groups according to the LV-GLS; 1489 (57.0%) had LV-GLS <-14.4% and 1124 (43.0%) had LV-GLS ≥-14.4%. Patients with LV-GLS ≥-14.4% had a significantly higher rate of composite outcome than LV-GLS <-14.4% patients (3.59 vs. 1.39 per 100 person-years, respectively; p < 0.001). Multivariable analysis showed that patients with LV-GLS ≥-14.4% had a significantly higher risk of experiencing a composite outcome event compared to global longitudinal strain <-14.4% patients (adjusted hazard ratio: 1.83, 95% confidence interval: 1.28-2.61; p = 0.001).</p><p><strong>Conclusion: </strong>LV-GLS by FT-CMR was shown to be useful for predicting the prognosis of patients with known or suspected CAD with preserved left ventricular systolic function. LV-GLS -14.4% was the identified cutoff for prognostic determination.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101057"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544874","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}
Dongyue Si, Rui Guo, Lan Cheng, Xiangchuang Kong, Daniel A Herzka, Haiyan Ding
{"title":"Free-breathing three-dimensional simultaneous myocardial T<sub>1</sub> and T<sub>2</sub> mapping based on multi-parametric SAturation-recovery and Variable-flip-Angle.","authors":"Dongyue Si, Rui Guo, Lan Cheng, Xiangchuang Kong, Daniel A Herzka, Haiyan Ding","doi":"10.1016/j.jocmr.2024.101065","DOIUrl":"10.1016/j.jocmr.2024.101065","url":null,"abstract":"<p><strong>Background: </strong>Quantitative myocardial tissue characterization with T<sub>1</sub> and T<sub>2</sub> parametric mapping can provide an accurate and complete assessment of tissue abnormalities across a broad range of cardiomyopathies. However, current clinical T<sub>1</sub> and T<sub>2</sub> mapping tools rely predominantly on two-dimensional (2D) breath-hold sequences. Clinical adoption of three-dimensional (3D) techniques is limited by long scan duration. The aim of this study is to develop and validate a time-efficient 3D free-breathing simultaneous T<sub>1</sub> and T<sub>2</sub> mapping sequence using multi-parametric SAturation-recovery and Variable-flip-Angle (mSAVA).</p><p><strong>Methods: </strong>mSAVA acquires four volumes for simultaneous whole-heart T<sub>1</sub> and T<sub>2</sub> mapping. We validated mSAVA using simulations, phantoms, and in-vivo experiments at 3T in 11 healthy subjects and 11 patients with diverse cardiomyopathies. T<sub>1</sub> and T<sub>2</sub> values by mSAVA were compared with modified Look-Locker inversion recovery (MOLLI) and gradient and spin echo (GraSE), respectively. The clinical performance of mSAVA was evaluated against late gadolinium enhancement (LGE) imaging in patients.</p><p><strong>Results: </strong>Phantom T<sub>1</sub> and T<sub>2</sub> by mSAVA showed a strong correlation to reference sequences (R<sup>2</sup> = 0.98 and 0.99). In-vivo imaging with an imaging resolution of 1.5 × 1.5 × 8 mm<sup>3</sup> could be achieved. Myocardial T<sub>1</sub> and T<sub>2</sub> of healthy subjects by mSAVA were 1310 ± 46 and 44.6 ± 2.0 ms, respectively, with T<sub>1</sub> standard deviation higher than MOLLI (105 ± 12 vs 60 ± 16 ms) and T<sub>2</sub> standard deviation lower than GraSE (4.5 ± 0.8 vs 5.5 ± 1.0 ms). mSAVA T<sub>1</sub> and T<sub>2</sub> maps presented consistent findings in patients undergoing LGE. Myocardial T<sub>1</sub> and T<sub>2</sub> of all patients by mSAVA were 1421 ± 79 and 47.2 ± 3.3 ms, respectively.</p><p><strong>Conclusion: </strong>mSAVA is a fast 3D technique promising for clinical whole-heart T<sub>1</sub> and T<sub>2</sub> mapping.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101065"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766129","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}
Savine C S Minderhoud, Aïmane Arrouby, Allard T van den Hoven, Lidia R Bons, Raluca G Chelu, Isabella Kardys, Dimitris Rizopoulos, Suze-Anne Korteland, Annemien E van den Bosch, Ricardo P J Budde, Jolien W Roos-Hesselink, Jolanda J Wentzel, Alexander Hirsch
{"title":"Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve.","authors":"Savine C S Minderhoud, Aïmane Arrouby, Allard T van den Hoven, Lidia R Bons, Raluca G Chelu, Isabella Kardys, Dimitris Rizopoulos, Suze-Anne Korteland, Annemien E van den Bosch, Ricardo P J Budde, Jolien W Roos-Hesselink, Jolanda J Wentzel, Alexander Hirsch","doi":"10.1016/j.jocmr.2024.101070","DOIUrl":"10.1016/j.jocmr.2024.101070","url":null,"abstract":"<p><strong>Background: </strong>Aortic wall shear stress (WSS) is a known predictor of ascending aortic growth in patients with a bicuspid aortic valve (BAV). The aim of this study was to study regional WSS and changes over time in BAV patients.</p><p><strong>Methods: </strong>BAV patients and age-matched healthy controls underwent four-dimensional (4D) flow cardiovascular magnetic resonance (CMR). Regional, peak systolic ascending aortic WSS, aortic valve function, aortic stiffness measures, and aortic dimensions were assessed. In BAV patients, 4D flow CMR was repeated after 3 years of follow-up and both at baseline and follow-up computed tomography angiography (CTA) were acquired. Aortic growth (volume increase of ≥5%) was measured on CTA. Regional WSS differences within patients' aorta and WSS changes over time were analyzed using linear mixed-effect models and were associated with clinical parameters.</p><p><strong>Results: </strong>Thirty BAV patients (aged 34 years [interquartile range (IQR) 25-41]) were included in the follow-up analysis. Additionally, another 16 BAV patients and 32 healthy controls (aged 33 years [IQR 28-48]) were included for other regional analyses. Magnitude, axial, and circumferential WSS increased over time (all p < 0.001) irrespective of aortic growth. The percentage of regions exposed to a magnitude WSS >95th percentile of healthy controls increased from 21% (baseline 506/2400 regions) to 31% (follow-up 734/2400 regions) (p < 0.001). WSS angle, a measure of helicity near the aortic wall, decreased during follow-up. Magnitude WSS changes over time were associated with systolic blood pressure, peak aortic valve velocity, aortic valve regurgitation fraction, aortic stiffness indexes, and normalized flow displacement (all p < 0.05).</p><p><strong>Conclusion: </strong>An increase in regional WSS over time was observed in BAV patients, irrespective of aortic growth. The increasing WSSs, comprising a larger area of the aorta, warrant further research to investigate the possible predictive value for aortic dissection.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101070"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889371","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}
Kelly P H Nies, Mueez Aizaz, Dianne H K van Dam-Nolen, Timothy C D Goring, Tobien A H C M L Schreuder, Narender P van Orshoven, Alida A Postma, Daniel Bos, Jeroen Hendrikse, Paul Nederkoorn, Rob van der Geest, Robert J van Oostenbrugge, Werner H Mess, M Eline Kooi
{"title":"Signal intensity and volume of carotid intraplaque hemorrhage on magnetic resonance imaging and the risk of ipsilateral cerebrovascular events: The Plaque At RISK (PARISK) study.","authors":"Kelly P H Nies, Mueez Aizaz, Dianne H K van Dam-Nolen, Timothy C D Goring, Tobien A H C M L Schreuder, Narender P van Orshoven, Alida A Postma, Daniel Bos, Jeroen Hendrikse, Paul Nederkoorn, Rob van der Geest, Robert J van Oostenbrugge, Werner H Mess, M Eline Kooi","doi":"10.1016/j.jocmr.2024.101049","DOIUrl":"10.1016/j.jocmr.2024.101049","url":null,"abstract":"<p><strong>Background: </strong>The Plaque At RISK (PARISK) study demonstrated that patients with a carotid plaque with intraplaque hemorrhage (IPH) have an increased risk of recurrent ipsilateral ischemic cerebrovascular events. It was previously reported that symptomatic carotid plaques with IPH showed higher IPH signal intensity ratios (SIR) and larger IPH volumes than asymptomatic plaques. We explored whether IPH SIR and IPH volume are associated with future ipsilateral ischemic cerebrovascular events beyond the presence of IPH.</p><p><strong>Methods: </strong>Transient ischemic attack and ischemic stroke patients with mild-to-moderate carotid stenosis and an ipsilateral IPH-positive carotid plaque (n = 89) from the PARISK study were included. The clinical endpoint was a new ipsilateral ischemic cerebrovascular event during 5 years of follow-up, while the imaging-based endpoint was a new ipsilateral brain infarct on brain magnetic resonance imaging (MRI) after 2 years (n = 69). Trained observers delineated IPH, a hyperintense region compared to surrounding muscle tissue on hyper T<sub>1</sub>-weighted magnetic resonance images. The IPH SIR was the maximal signal intensity in the IPH region divided by the mean signal intensity of adjacent muscle tissue. The associations between IPH SIR or volume and the clinical and imaging-based endpoint were investigated using Cox proportional hazard models and logistic regression, respectively.</p><p><strong>Results: </strong>During 5.1 (interquartile range: 3.1-5.6) years of follow-up, 21 ipsilateral cerebrovascular ischemic events were identified. Twelve new ipsilateral brain infarcts were identified on the 2-year neuro MRI. There was no association for IPH SIR or IPH volume with the clinical endpoint (hazard ratio (HR): 0.89 [95% confidence interval: 0.67-1.10] and HR: 0.91 [0.69-1.19] per 100-µL increase, respectively) nor with the imaging-based endpoint (odds ratio (OR): 1.04 [0.75-1.45] and OR: 1.21 [0.87-1.68] per 100-µL increase, respectively).</p><p><strong>Conclusion: </strong>IPH SIR and IPH volume were not associated with future ipsilateral ischemic cerebrovascular events. Therefore, quantitative assessment of IPH of SIR and volume does not seem to provide additional value beyond the presence of IPH for stroke risk assessment.</p><p><strong>Trial registration: </strong>The PARISK study was registered on ClinicalTrials.gov with ID NCT01208025 on September 21, 2010 (https://clinicaltrials.gov/study/NCT01208025).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101049"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327538","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}
Tarek Alsaied, Runjia Li, Adam B Christopher, Mark Fogel, Timothy C Slesnick, Rajesh Krishnamurthy, Vivek Muthurangu, Adam L Dorfman, Christopher Z Lam, Justin D Weigand, Jong-Hyeon Jeong, Joshua D Robinson, Laura J Olivieri, Rahul H Rathod
{"title":"Characterization and z-score calculation of cardiovascular magnetic resonance imaging parameters in patients after the Fontan operation: A Fontan Outcome Registry using Cardiovascular Magnetic Resonance Examinations study.","authors":"Tarek Alsaied, Runjia Li, Adam B Christopher, Mark Fogel, Timothy C Slesnick, Rajesh Krishnamurthy, Vivek Muthurangu, Adam L Dorfman, Christopher Z Lam, Justin D Weigand, Jong-Hyeon Jeong, Joshua D Robinson, Laura J Olivieri, Rahul H Rathod","doi":"10.1016/j.jocmr.2024.101113","DOIUrl":"10.1016/j.jocmr.2024.101113","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance (CMR) offers valuable hemodynamic insights post-Fontan, but is limited by the absence of normative single ventricle data. The Fontan Outcomes Registry using CMR Examinations (FORCE) is a large international Fontan-specific CMR registry. This study used FORCE registry data to evaluate expected CMR ventricular size/function and create Fontan-specific z-scores adjusting for ventricular morphology (VM) in healthier Fontan patients.</p><p><strong>Methods: </strong>\"Healthier\" Fontan patients were defined as patients free of adverse outcomes, who are New York Heart Association class I, have mild or less valve disease, and <30% aortopulmonary collateral burden. General linear modeling was performed on 70% of the dataset to create z-scores for volumes and function. Models were tested using the remainder (30%) of the data. The z-scores were compared between children and adults. The z-scores were also compared between \"healthier\" Fontan and patients with adverse outcomes (death, listing for transplantation, or multiorgan disease).</p><p><strong>Results: </strong>The \"healthier\" Fontan population included 885 patients (15.0 ± 7.6 years) from 18 institutions with 1156 CMR examinations. Patients with left ventricle morphology had lower volume, mass and higher ejection fraction (EF) compared to right or mixed (two ventricles) morphology (p < 0.001 for all pairwise comparisons). Gender, body surface area, and VM were used in z-scores. Of the \"healthier\" Fontan patients, 647 were children <18 years and 238 were adults. Adults had lower ascending aorta flow (2.9 ± 0.7 vs 3.3 ± 0.8 L/min/m<sup>2</sup>, p < 0.001) and ascending aorta flow z-scores (-0.16 ± 1.23 vs 0.05 ± 0.95, 0.02) compared to children. Additionally, there were 1595 patients with adverse outcomes who were older (16.1 ± 9.3 vs 15.0 ± 7.6, p < 0.001) and less likely to have left VM (35 vs 47%, p < 0.001). Patients with adverse outcomes had higher z-scores for ventricular volume and mass and lower z-scores for EF and ascending aorta flow compared to the \"healthier\" Fontan cohort.</p><p><strong>Conclusion: </strong>This is the first study to generate CMR z-scores post-Fontan. Importantly, the z-scores were generated and tested in \"healthier\" Fontan patients and both pediatric and adult Fontan patients. These equations may improve CMR-based risk stratification after the Fontan operation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101113"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501115","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}
Jie Xiang, Rajiv Ramasawmy, Felicia Seemann, Dana C Peters, Adrienne E Campbell-Washburn
{"title":"Balanced steady-state free precession phase contrast at 0.55T applied to aortic flow.","authors":"Jie Xiang, Rajiv Ramasawmy, Felicia Seemann, Dana C Peters, Adrienne E Campbell-Washburn","doi":"10.1016/j.jocmr.2024.101098","DOIUrl":"10.1016/j.jocmr.2024.101098","url":null,"abstract":"<p><strong>Background: </strong>There is a growing interest in the development and application of mid-field (0.55T) for cardiovascular magnetic resonance (CMR), including flow imaging. However, aortic flow imaging at 0.55T has limited signal-to-noise ratio (SNR), especially in diastolic phases where there is reduced inflow-driven contrast for spoiled gradient recalled echo (GRE) sequences. The low SNR can limit the accuracy of flow and regurgitant fraction measurements.</p><p><strong>Methods: </strong>In this work, we developed a two-dimensional phase contrast (PC) acquisition with balanced steady-state free precession (bSSFP), termed PC-SSFP, for flow imaging and quantification at 0.55T. This PC-SSFP approach precisely nulls the zeroth and first gradient moments at both the echo time (TE) and repetition time, except for the flow-encoded acquisition, for which the first gradient moment at the TE is determined by the velocity encoding. Our proposed sequence was tested in both phantoms and in healthy volunteers (n = 11), to measure aortic flow. In volunteers, both a breath-hold (bh) and a free-breathing (fb) protocol, with averaging to increase SNR, were obtained. Total flow, peak flow, cardiac output, and SNR were compared for PC-SSFP and PC-GRE. Stroke volumes were also measured and compared to planimetry method.</p><p><strong>Results: </strong>In a phantom, SNR was significantly higher using PC-SSFP compared to PC-GRE (25.5 ± 9.6 vs 8.2 ± 2.9), and the velocity measurements agreed well (R = 1.00). In healthy subjects, for both bh and fb protocols, PC-SSFP measured accurate peak flow (fb: R = 0.99, bh: R = 0.96) and cardiac output (fb: R = 0.98, bh: R = 0.88), compared to PC-GRE, accurate stroke volume (fb: R = 0.94, bh: R = 0.97), compared to planimetry measurement, and offered constant high SNR (fb: 28 ± 9 vs 18 ± 6, bh: 24 ± 7 vs 11 ± 3) over the cardiac cycle in 11 subjects.</p><p><strong>Conclusion: </strong>PC-SSFP is a more reliable evaluation tool for aortic flow quantification, when compared to the conventional PC-GRE method at 0.55T, providing higher SNR, and thus potentially more accurate flows.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101098"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288034","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}
Robert R Edelman, Onural Ozturk, Amit Pursnani, Senthil Balasubramanian, Nondas Leloudas, Ioannis Koktzoglou
{"title":"Equilibrium phase contrast-enhanced magnetic resonance angiography of the thoracic aorta and heart using balanced T1 relaxation-enhanced steady-state.","authors":"Robert R Edelman, Onural Ozturk, Amit Pursnani, Senthil Balasubramanian, Nondas Leloudas, Ioannis Koktzoglou","doi":"10.1016/j.jocmr.2024.101046","DOIUrl":"10.1016/j.jocmr.2024.101046","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CEMRA) is routinely used for vascular evaluation. With existing techniques for CEMRA, diagnostic image quality is only obtained during the first pass of the contrast agent or shortly thereafter, whereas angiographic quality tends to be poor when imaging is delayed to the equilibrium phase. We hypothesized that prolonged blood pool contrast enhancement could be obtained by imaging with a balanced T1 relaxation-enhanced steady-state (bT1RESS) pulse sequence, which combines 3D balanced steady-state free precession (bSSFP) with a saturation recovery magnetization preparation to impart T1 weighting and suppress background tissues. An electrocardiographic-gated, two-dimensional-accelerated version with isotropic 1.1-mm spatial resolution was evaluated for breath-hold equilibrium phase CEMRA of the thoracic aorta and heart.</p><p><strong>Methods: </strong>The study was approved by the institutional review board. Twenty-one subjects were imaged using unenhanced 3D bSSFP, time-resolved CEMRA, first-pass gated CEMRA, followed by early and late equilibrium phase gated CEMRA and bT1RESS. Nine additional subjects were imaged using equilibrium phase 3D bSSFP and bT1RESS. Images were evaluated for image quality, aortic root sharpness, and visualization of the coronary artery origins, as well as using standard quantitative measures.</p><p><strong>Results: </strong>Equilibrium phase bT1RESS provided better image quality, aortic root sharpness, and coronary artery origin visualization than gated CEMRA (P < 0.05), and improved image quality and aortic root sharpness versus unenhanced 3D bSSFP (P < 0.05). It provided significantly larger apparent signal-to-noise and apparent contrast-to-noise ratio values than gated CEMRA and unenhanced 3D bSSFP (P < 0.05) and provided ninefold better fluid suppression than equilibrium phase 3D bSSFP. Aortic diameter and main pulmonary artery diameter measurements obtained with bT1RESS and first-pass gated CEMRA strongly correlated (P < 0.05).</p><p><strong>Conclusions: </strong>We found that using bT1RESS greatly prolongs the useful duration of blood pool contrast enhancement while improving angiographic image quality compared with standard CEMRA techniques. Although further study is needed, potential advantages for vascular imaging include eliminating the current requirement for first-pass imaging along with better reliability and accuracy for a wide range of cardiovascular applications.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101046"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175752","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}
Yaqi Du, Shuang Ding, Ce Li, Yun Bai, Xinrui Wang, Debiao Li, Yibin Xie, Guoguang Fan, Lian-Ming Wu, Guan Wang
{"title":"Coronary artery wall contrast enhancement imaging impact on disease activity assessment in IgG4-RD: a direct marker of coronary involvement.","authors":"Yaqi Du, Shuang Ding, Ce Li, Yun Bai, Xinrui Wang, Debiao Li, Yibin Xie, Guoguang Fan, Lian-Ming Wu, Guan Wang","doi":"10.1016/j.jocmr.2024.101047","DOIUrl":"10.1016/j.jocmr.2024.101047","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery wall contrast enhancement (CE) has been applied to non-invasive visualization of changes to the coronary artery wall in systemic lupus erythematosus (SLE). This study investigated the feasibility of quantifying CE to detect coronary involvement in IgG4-related disease (IgG4-RD), as well as the influence on disease activity assessment.</p><p><strong>Methods: </strong>A total of 93 subjects (31 IgG4-RD; 29 SLE; 33 controls) were recruited in the study. Coronary artery wall imaging was performed in a 3.0 T MRI scanner. Serological markers and IgG4-RD Responder Index (IgG4-RD-RI) scores were collected for correlation analysis.</p><p><strong>Results: </strong>Coronary wall CE was observed in 29 (94 %) IgG4-RD patients and 22 (76 %) SLE patients. Contrast-to-noise ratio (CNR) and total CE area were significantly higher in patient groups compared to controls (CNR: 6.1 ± 2.7 [IgG4-RD] v. 4.2 ± 2.3 [SLE] v. 1.9 ± 1.5 [control], P < 0.001; Total CE area: 3.0 [3.0-6.6] v. 1.7 [1.5-2.6] v. 0.3 [0.3-0.9], P < 0.001). In the IgG4-RD group, CNR and total CE area were correlated with the RI (CNR: r = 0.55, P = 0.002; total CE area: r = 0.39, P = 0.031). RI´ scored considering coronary involvement by CE, differed significantly from RI scored without consideration of CE (RI v. RI´: 15 ± 6 v. 16 ± 6, P < 0.001).</p><p><strong>Conclusions: </strong>Visualization and quantification of CMR coronary CE by CNR and total CE area could be utilized to detect subclinical and clinical coronary wall involvement, which is prevalent in IgG4-RD. The potential inclusion of small and medium-sized vessel involvements in the assessment of disease activity in IgG4-RD is worthy of further investigation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101047"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199848","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}