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Whole-heart spiral simultaneous multi-slice first-pass myocardial perfusion imaging.

ABSTRACT: PURPOSE:To develop and evaluate a simultaneous multislice (SMS) spiral perfusion pulse sequence with whole-heart coverage. METHODS:An orthogonal set of phase cycling angles following a Hadamard pattern was incorporated into a golden-angle (GA) variable density spiral perfusion sequence to perform SMS imaging at different multiband (MB) factors. Images were reconstructed using an SMS extension of L1-SPIRiT that we have termed SMS-L1-SPIRiT. The proposed sequence was evaluated in 40 subjects (10 each for MB factors of 1, 2, 3, and 4). Images were blindly graded by 2 cardiologists on a 5-point scale (5, excellent). To quantitatively evaluate the reconstruction performance against images acquired without SMS, the MB =1 data were used to retrospectively simulate data acquired at MB factors of 2 to 4. RESULTS:Analysis of the SMS point-spread function for the desired slice showed that the proposed sampling strategy significantly canceled the main-lobe energy of the other slices and has low side-lobe energy resulting in an incoherent temporal aliasing pattern when rotated by the GA. Retrospective experiments demonstrated the SMS-L1-SPIRiT method removed aliasing from the interfering slices and showed excellent agreement with the ground-truth MB =1 images. Clinical evaluation demonstrated high-quality perfusion images with average image-quality scores of 4.3 ± 0.5 (MB =2), 4.2 ± 0.5 (MB =3), and 4.4 ± 0.4 (MB =4) with no significant quality difference in image quality between MB factors (P = 0.38). CONCLUSION:SMS spiral perfusion at MB factors 2, 3, and 4 produces high-quality perfusion images with whole-heart coverage in a clinical setting with high sampling efficiency.

SUBMITTER: Yang Y

PROVIDER: S-EPMC6289615 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Whole-heart spiral simultaneous multi-slice first-pass myocardial perfusion imaging.

Yang Yang Y Meyer Craig H CH Epstein Frederick H FH Kramer Christopher M CM Salerno Michael M

Magnetic resonance in medicine 20181012 2

<h4>Purpose</h4>To develop and evaluate a simultaneous multislice (SMS) spiral perfusion pulse sequence with whole-heart coverage.<h4>Methods</h4>An orthogonal set of phase cycling angles following a Hadamard pattern was incorporated into a golden-angle (GA) variable density spiral perfusion sequence to perform SMS imaging at different multiband (MB) factors. Images were reconstructed using an SMS extension of L1-SPIRiT that we have termed SMS-L1-SPIRiT. The proposed sequence was evaluated in 40 ...[more]

PMID: 30311689

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Project description:PurposeTo enable all-systolic first-pass rest myocardial perfusion with long saturation times. To investigate the change in perfusion contrast and dark rim artefacts through simulations and surrogate measurements.MethodsSimulations were employed to investigate optimal saturation time for myocardium-perfusion defect contrast and blood-to-myocardium signal ratios. Two saturation recovery blocks with long/short saturation times (LTS/STS) were employed to image 3 slices at end-systole and diastole. Simultaneous multi-slice balanced steady state free precession imaging and compressed sensing acceleration were combined. The sequence was compared to a 3 slice-by-slice clinical protocol in 10 patients. Quantitative assessment of myocardium-peak pre contrast and blood-to-myocardium signal ratios, as well as qualitative assessment of perceived SNR, image quality, blurring, and dark rim artefacts, were performed.ResultsSimulations showed that with a bolus of 0.075 mmol/kg, a LTS of 240-470 ms led to a relative increase in myocardium-perfusion defect contrast of 34% ± 9%-28% ± 27% than a STS = 120 ms, while reducing blood-to-myocardium signal ratio by 18% ± 10%-32% ± 14% at peak myocardium. With a bolus of 0.05 mmol/kg, LTS was 320-570 ms with an increase in myocardium-perfusion defect contrast of 63% ± 13%-62% ± 29%. Across patients, LTS led to an average increase in myocardium-peak pre contrast of 59% (P < .001) at peak myocardium and a lower blood-to-myocardium signal ratio of 47% (P < .001) and 15% (P < .001) at peak blood/myocardium. LTS had improved motion robustness (P = .002), image quality (P < .001), and decreased dark rim artefacts (P = .008) than the clinical protocol.ConclusionAll-systolic rest perfusion can be achieved by combining simultaneous multi-slice and compressed sensing acceleration, enabling 3-slice cardiac coverage with reduced motion and dark rim artefacts. Numerical simulations indicate that myocardium-perfusion defect contrast increases at LTS.

Project description:PURPOSE:Dynamic contrast enhanced MRI of the heart typically acquires 2-4 short-axis (SA) slices to detect and characterize coronary artery disease. This acquisition scheme is limited by incomplete coverage of the left ventricle. We studied the feasibility of using radial simultaneous multi-slice (SMS) technique to achieve SA, 2-chamber and/or 4-chamber long-axis (2CH LA and/or 4CH LA) coverage with and without electrocardiography (ECG) gating using a motion-robust reconstruction framework. METHODS:12 subjects were scanned at rest and/or stress, free breathing, with or without ECG gating. Multiple sets of radial SMS k-space were acquired within each cardiac cycle, and each SMS set sampled 3 parallel slices that were either SA, 2CH LA, or 4CH LA slices. The radial data was interpolated onto Cartesian space using an SMS GRAPPA operator gridding method. Self-gating and respiratory states binning of the data were done. The binning information as well as a pixel tracking spatiotemporal constrained reconstruction method were applied to obtain motion-robust image reconstructions. Reconstructions with and without the pixel tracking method were compared for signal-to-noise ratio and contrast-to-noise ratio. RESULTS:Full coverage of the heart (at least 3 SA and 3 LA slices) during the first pass of contrast at every heartbeat was achieved by using the radial SMS acquisition. The proposed pixel tracking reconstruction improves the average SNR and CNR by 21% and 30% respectively, and reduces temporal blurring for both gated and ungated acquisitions. CONCLUSION:Acquiring simultaneous multi-slice SA, 2CH LA and/or 4CH LA myocardial perfusion images in every heartbeat is feasible in both gated and ungated acquisitions. This can add confidence when detecting and characterizing coronary artery disease by revealing ischemia in different views, and by providing apical coverage that is improved relative to SA slices alone. The proposed pixel tracking framework improves the reconstruction while adding little computational cost.

Project description:PurposeTo develop a whole-heart, free-breathing, non-electrocardiograph (ECG)-gated, cardiac-phase-resolved myocardial perfusion MRI framework (CRIMP; Continuous Radial Interleaved simultaneous Multi-slice acquisitions at sPoiled steady-state) and test its quantification feasibility.MethodsCRIMP used interleaved radial simultaneous multi-slice (SMS) slice groups to cover the whole heart in 9 or 12 short-axis slices. The sequence continuously acquired data without magnetization preparation, ECG gating or breath-holding, and captured multiple cardiac phases. Images were reconstructed by a motion-compensated patch-based locally low-rank reconstruction. Bloch simulations were performed to study the signal-to-noise ratio/contrast-to-noise ratio (SNR/CNR) for CRIMP and to study the steady-state signal under motion. Seven patients were scanned with CRIMP at stress and rest to develop the sequence. One human and two dogs were scanned at rest with a dual-bolus method to test the quantification feasibility of CRIMP. The dual-bolus scans were performed using both CRIMP and an ungated radial SMS saturation recovery (SMS-SR) sequence with injection dose = 0.075 mmol/kg to compare the sequences in terms of SNR, cardiac phase resolution and quantitative myocardial blood flow (MBF).ResultsPerfusion images with multiple cardiac phases in all image slices with a temporal resolution of 72 ms/frame were obtained. Simulations and in-vivo acquisitions showed CRIMP kept the inner slices in steady-state regardless of motion. CRIMP outperformed SMS-SR in slice coverage (9 over 6), SNR (mean 20% improvement), and provided cardiac phase resolution. CRIMP and SMS-SR sequences provided comparable MBF values (rest systolic CRIMP = 0.58 ± 0.07, SMS-SR = 0.61 ± 0.16).ConclusionCRIMP allows for whole-heart, cardiac-phase-resolved myocardial perfusion images without ECG-gating or breath-holding. The sequence can provide MBF if an accurate arterial input function is obtained separately.

Dataset Information

Whole-heart spiral simultaneous multi-slice first-pass myocardial perfusion imaging.

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Whole-heart spiral simultaneous multi-slice first-pass myocardial perfusion imaging.

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