Gadolinium free cardiovascular magnetic resonance with 2-point Cine balanced steady state free precession View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-12

AUTHORS

Tori A. Stromp, Steve W. Leung, Kristin N. Andres, Linyuan Jing, Brandon K. Fornwalt, Richard J. Charnigo, Vincent L. Sorrell, Moriel H. Vandsburger

ABSTRACT

BACKGROUND: Cardiovascular magnetic resonance (CMR) of ventricular structure and function is widely performed using cine balanced steady state free precession (bSSFP) MRI. The bSSFP signal of myocardium is weighted by magnetization transfer (MT) and T1/T2-relaxation times. In edematous and fibrotic tissues, increased T2 and reduced MT lead to increased signal intensity on images acquired with high excitation flip angles. We hypothesized that acquisition of two differentially MT-weighted bSSFP images (termed 2-point bSSFP) can identify tissue that would enhance with gadolinium similar to standard of care late gadolinium enhancement (LGE). METHODS: Cine bSSFP images (flip angles of 5° and 45°) and native-T1 and T2 maps were acquired in one mid-ventricular slice in 47 patients referred for CMR and 10 healthy controls. Afterwards, LGE images and post-contrast T1 maps were acquired and gadolinium partition coefficient (GPC) was calculated. Maps of ΔS/So were calculated as (S45-S5)/S5*100 (%), where Sflip_angle is the voxel signal intensity. RESULTS: Twenty three patients demonstrated areas of myocardial hyper-enhancement with LGE. In enhanced regions, ΔS/So, native-T1, T2, and GPC were heightened (p < 0.05 vs. non-enhanced tissues). ΔS/So, native-T1, and T2 all demonstrated association with GPC, however the association was strongest for ΔS/So. Bland-Altman analysis revealed a slight bias towards larger volume of enhancement with ΔS/So compared to LGE, and similar transmurality. Subjective analysis with 2-blinded expert readers revealed agreement between ΔS/So and LGE of 73.4 %, with false positive detection of 16.7 % and false negative detection of 15.2 %. CONCLUSIONS: Gadolinium free 2-point bSSFP identified tissue that enhances at LGE with strong association to GPC. Our results suggest that with further development, MT-weighted CMR could be used similar to LGE for diagnostic imaging. More... »

PAGES

90

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12968-015-0194-1

DOI

http://dx.doi.org/10.1186/s12968-015-0194-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1034330828

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26520782


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    "description": "BACKGROUND: Cardiovascular magnetic resonance (CMR) of ventricular structure and function is widely performed using cine balanced steady state free precession (bSSFP) MRI. The bSSFP signal of myocardium is weighted by magnetization transfer (MT) and T1/T2-relaxation times. In edematous and fibrotic tissues, increased T2 and reduced MT lead to increased signal intensity on images acquired with high excitation flip angles. We hypothesized that acquisition of two differentially MT-weighted bSSFP images (termed 2-point bSSFP) can identify tissue that would enhance with gadolinium similar to standard of care late gadolinium enhancement (LGE).\nMETHODS: Cine bSSFP images (flip angles of 5\u00b0 and 45\u00b0) and native-T1 and T2 maps were acquired in one mid-ventricular slice in 47 patients referred for CMR and 10 healthy controls. Afterwards, LGE images and post-contrast T1 maps were acquired and gadolinium partition coefficient (GPC) was calculated. Maps of \u0394S/So were calculated as (S45-S5)/S5*100 (%), where Sflip_angle is the voxel signal intensity.\nRESULTS: Twenty three patients demonstrated areas of myocardial hyper-enhancement with LGE. In enhanced regions, \u0394S/So, native-T1, T2, and GPC were heightened (p\u2009<\u20090.05 vs. non-enhanced tissues). \u0394S/So, native-T1, and T2 all demonstrated association with GPC, however the association was strongest for \u0394S/So. Bland-Altman analysis revealed a slight bias towards larger volume of enhancement with \u0394S/So compared to LGE, and similar transmurality. Subjective analysis with 2-blinded expert readers revealed agreement between \u0394S/So and LGE of 73.4\u00a0%, with false positive detection of 16.7\u00a0% and false negative detection of 15.2\u00a0%.\nCONCLUSIONS: Gadolinium free 2-point bSSFP identified tissue that enhances at LGE with strong association to GPC. Our results suggest that with further development, MT-weighted CMR could be used similar to LGE for diagnostic imaging.", 
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