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Cardiovascular cine imaging and flow evaluation using Fast Interrupted Steady-State (FISS) magnetic resonance.

ABSTRACT: BACKGROUND:Existing cine imaging techniques rely on balanced steady-state free precession (bSSFP) or spoiled gradient-echo readouts, each of which has limitations. For instance, with bSSFP, artifacts occur from rapid through-plane flow and off-resonance effects. We hypothesized that a prototype cine technique, radial fast interrupted steady-state (FISS), could overcome these limitations. The technique was compared with standard cine bSSFP for cardiac function, coronary artery conspicuity, and aortic valve morphology. Given its advantageous properties, we further hypothesized that the cine FISS technique, in combination with arterial spin labeling (ASL), could provide an alternative to phase contrast for visualizing in-plane flow patterns within the aorta and branch vessels. MAIN BODY:The study was IRB-approved and subjects provided consent. Breath-hold cine FISS and bSSFP were acquired using similar imaging parameters. There was no significant difference in biplane left ventricular ejection fraction or cardiac image quality between the two techniques. Compared with cine bSSFP, cine FISS demonstrated a marked decrease in fat signal which improved conspicuity of the coronary arteries, while suppression of through-plane flow artifact on thin-slice cine FISS images improved visualization of the aortic valve. Banding artifacts in the subcutaneous tissues were reduced. In healthy subjects, dynamic flow patterns were well visualized in the aorta, coronary and renal arteries using cine FISS ASL, even when the slice was substantially thicker than the vessel diameter. CONCLUSION:Cine FISS demonstrates several benefits for cardiovascular imaging compared with cine bSSFP, including better suppression of fat signal and reduced artifacts from through-plane flow and off-resonance effects. The main drawback is a slight (~?20%) decrease in temporal resolution. In addition, preliminary results suggest that cine FISS ASL provides a potential alternative to phase contrast techniques for in-plane flow quantification, while enabling an efficient, visually-appealing, semi-projective display of blood flow patterns throughout the course of an artery and its branches.

SUBMITTER: Edelman RR

PROVIDER: S-EPMC5819298 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Cardiovascular cine imaging and flow evaluation using Fast Interrupted Steady-State (FISS) magnetic resonance.

Edelman Robert R RR Serhal Ali A Pursnani Amit A Pang Jianing J Koktzoglou Ioannis I

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20180219 1

<h4>Background</h4>Existing cine imaging techniques rely on balanced steady-state free precession (bSSFP) or spoiled gradient-echo readouts, each of which has limitations. For instance, with bSSFP, artifacts occur from rapid through-plane flow and off-resonance effects. We hypothesized that a prototype cine technique, radial fast interrupted steady-state (FISS), could overcome these limitations. The technique was compared with standard cine bSSFP for cardiac function, coronary artery conspicuity ...[more]

PMID: 29458384

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Project description:BackgroundCine fast interrupted steady-state in combination with arterial spin labeling is a recently described nonenhanced magnetic resonance angiography (MRA) technique that relies on bolus tracking for time-resolved digital subtraction angiography-like displays of blood flow patterns. We evaluated the feasibility of applying this technique to display in-plane flow patterns in two regions: the abdominal aorta and lower extremity peripheral arteries.MethodsWe performed an institutional review board-approved study in healthy subjects and patients. In 7 healthy subjects, in-plane flow was imaged at 4 stations ranging from the lower legs to the aorto-iliac bifurcation (junction of the distal thigh and upper calf, mid-thigh, junction of the upper thigh and pelvis, upper pelvis). In 5 healthy subjects and 6 patients without abdominal aortopathy, images were acquired through the suprarenal abdominal aorta. Ten patients with known peripheral arterial disease and two patients with stable disease of the abdominal aorta were also evaluated. Peak velocity was compared at each of the 4 stations for cine fast interrupted steady-state in combination with arterial spin labeling and two-dimensional cine phase contrast in patients with normal vessels.ResultsIn-plane flow patterns were well visualized in all peripheral arterial stations and in the abdominal aorta, providing a high quality display of hemodynamic patterns along extensive lengths of the vessels. There was very strong positive correlation (r = 0.952, P < 0.05) and excellent agreement (intraclass correlation coefficient, 0.935; 95% confidence interval, 0.812-0.972) between peak flow velocities measured by cine fast interrupted steady-state in combination with arterial spin labeling and two-dimensional cine phase contrast. In 10 patients with peripheral artery disease and 2 patients with aortic pathology, cine fast interrupted steady-state in combination with arterial spin labeling provided a visual demonstration of abnormal hemodynamics.ConclusionThis feasibility study suggests that cine fast interrupted steady-state in combination with arterial spin labeling provides an efficient, high quality and physiologically accurate display of in-plane flow patterns over extensive lengths of the lower extremity peripheral arteries, which can be difficult to achieve using other MRA techniques.

Dataset Information

Cardiovascular cine imaging and flow evaluation using Fast Interrupted Steady-State (FISS) magnetic resonance.

Publications

Cardiovascular cine imaging and flow evaluation using Fast Interrupted Steady-State (FISS) magnetic resonance.

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