Xianling Qian, Yali Wu, Peter Speier, Caixia Fu, Yunzhu Wu, Lude Cheng, Yinyin Chen, Shiyu Wang, Caizhong Chen, Kai Liu, Ling Chen, Hang Jin, Mengsu Zeng
{"title":"导频触发和心电图触发心脏MRI的比较：一项前瞻性临床可行性研究。","authors":"Xianling Qian, Yali Wu, Peter Speier, Caixia Fu, Yunzhu Wu, Lude Cheng, Yinyin Chen, Shiyu Wang, Caizhong Chen, Kai Liu, Ling Chen, Hang Jin, Mengsu Zeng","doi":"10.1016/j.jocmr.2025.101925","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Electrocardiogram (ECG)-triggered cardiovascular magnetic resonance (CMR) can be challenging in patients with ECG unreliability. Pilot tone (PT)-triggered CMR may offer a reliable alternative.</p><p><strong>Purpose: </strong>To evaluate the feasibility of PT-triggered CMR and compare its performance with ECG-triggered imaging across various sequences in patients with common cardiovascular diseases.</p><p><strong>Methods: </strong>This prospective study included 50 participants (26 males, 24 females; mean age 46.0±19.0y), including 15 with normal CMR findings and 35 with various cardiovascular diseases. All participants underwent both PT-triggered and ECG-triggered CMR on a 3T MRI system. Imaging included T2-weighted imaging (T2WI), T1-mapping, T2-mapping, cine, late gadolinium enhancement (LGE), and post-contrast T1-mapping sequences. Image quality and quantitative measurements were evaluated, including T2WI signal intensity, native T1-mapping, T2-mapping, and extracellular volume fraction (ECV) values, and comparative signal-to-noise ratio (compSNR) and comparative contrast-to-noise ratio (compCNR) of cine and LGE images, left/right ventricular function. Inter-reader agreement was evaluated using the intraclass correlation coefficient (ICC). Comparisons between the two methods were performed using paired t-test or the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>No significant differences were observed in scanning times (p=.253-.864) or image quality (ICC: .589-1.000, p=.057-1.000) between PT- and ECG-triggered scans and images. Quantitative assessments showed good to excellent consistency (ICC=.843-.987). While PT-triggered LGE images showed higher compCNR (14.14±7.68 vs. 13.24±7.52, p=.016), other quantitative parameters showed no significant differences between PT- and ECG-triggered images. Six participants with hypertrophic cardiomyopathy or heart valve disease experienced false R-wave triggering during ECG gating, leading to motion artifacts, which were not visible in PT-triggered images.</p><p><strong>Conclusion: </strong>PT-triggered cardiac MRI provides comparable image quality and quantitative assessments to ECG-triggered sequences and may offer advantages in minimizing motion artifacts, particularly in patients with conditions affecting ECG reliability, making it a promising alternative for cardiac MRI synchronization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101925"},"PeriodicalIF":6.1000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of pilot tone-triggered and electrocardiogram-triggered cardiac magnetic resonance imaging: a prospective clinical feasibility study.\",\"authors\":\"Xianling Qian, Yali Wu, Peter Speier, Caixia Fu, Yunzhu Wu, Lude Cheng, Yinyin Chen, Shiyu Wang, Caizhong Chen, Kai Liu, Ling Chen, Hang Jin, Mengsu Zeng\",\"doi\":\"10.1016/j.jocmr.2025.101925\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Electrocardiogram (ECG)-triggered cardiovascular magnetic resonance (CMR) can be challenging in patients with ECG unreliability. Pilot tone (PT)-triggered CMR may offer a reliable alternative.</p><p><strong>Purpose: </strong>To evaluate the feasibility of PT-triggered CMR and compare its performance with ECG-triggered imaging across various sequences in patients with common cardiovascular diseases.</p><p><strong>Methods: </strong>This prospective study included 50 participants (26 males, 24 females; mean age 46.0±19.0y), including 15 with normal CMR findings and 35 with various cardiovascular diseases. All participants underwent both PT-triggered and ECG-triggered CMR on a 3T MRI system. Imaging included T2-weighted imaging (T2WI), T1-mapping, T2-mapping, cine, late gadolinium enhancement (LGE), and post-contrast T1-mapping sequences. Image quality and quantitative measurements were evaluated, including T2WI signal intensity, native T1-mapping, T2-mapping, and extracellular volume fraction (ECV) values, and comparative signal-to-noise ratio (compSNR) and comparative contrast-to-noise ratio (compCNR) of cine and LGE images, left/right ventricular function. Inter-reader agreement was evaluated using the intraclass correlation coefficient (ICC). Comparisons between the two methods were performed using paired t-test or the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>No significant differences were observed in scanning times (p=.253-.864) or image quality (ICC: .589-1.000, p=.057-1.000) between PT- and ECG-triggered scans and images. Quantitative assessments showed good to excellent consistency (ICC=.843-.987). While PT-triggered LGE images showed higher compCNR (14.14±7.68 vs. 13.24±7.52, p=.016), other quantitative parameters showed no significant differences between PT- and ECG-triggered images. 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Comparison of pilot tone-triggered and electrocardiogram-triggered cardiac magnetic resonance imaging: a prospective clinical feasibility study.
Background: Electrocardiogram (ECG)-triggered cardiovascular magnetic resonance (CMR) can be challenging in patients with ECG unreliability. Pilot tone (PT)-triggered CMR may offer a reliable alternative.
Purpose: To evaluate the feasibility of PT-triggered CMR and compare its performance with ECG-triggered imaging across various sequences in patients with common cardiovascular diseases.
Methods: This prospective study included 50 participants (26 males, 24 females; mean age 46.0±19.0y), including 15 with normal CMR findings and 35 with various cardiovascular diseases. All participants underwent both PT-triggered and ECG-triggered CMR on a 3T MRI system. Imaging included T2-weighted imaging (T2WI), T1-mapping, T2-mapping, cine, late gadolinium enhancement (LGE), and post-contrast T1-mapping sequences. Image quality and quantitative measurements were evaluated, including T2WI signal intensity, native T1-mapping, T2-mapping, and extracellular volume fraction (ECV) values, and comparative signal-to-noise ratio (compSNR) and comparative contrast-to-noise ratio (compCNR) of cine and LGE images, left/right ventricular function. Inter-reader agreement was evaluated using the intraclass correlation coefficient (ICC). Comparisons between the two methods were performed using paired t-test or the Wilcoxon signed-rank test.
Results: No significant differences were observed in scanning times (p=.253-.864) or image quality (ICC: .589-1.000, p=.057-1.000) between PT- and ECG-triggered scans and images. Quantitative assessments showed good to excellent consistency (ICC=.843-.987). While PT-triggered LGE images showed higher compCNR (14.14±7.68 vs. 13.24±7.52, p=.016), other quantitative parameters showed no significant differences between PT- and ECG-triggered images. Six participants with hypertrophic cardiomyopathy or heart valve disease experienced false R-wave triggering during ECG gating, leading to motion artifacts, which were not visible in PT-triggered images.
Conclusion: PT-triggered cardiac MRI provides comparable image quality and quantitative assessments to ECG-triggered sequences and may offer advantages in minimizing motion artifacts, particularly in patients with conditions affecting ECG reliability, making it a promising alternative for cardiac MRI synchronization.
期刊介绍：
Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to:
New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system.
New methods to enhance or accelerate image acquisition and data analysis.
Results of multicenter, or larger single-center studies that provide insight into the utility of CMR.
Basic biological perceptions derived by CMR methods.
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