Dataset Information

On the optimal temporal resolution for phase contrast cardiovascular magnetic resonance imaging: establishment of baseline values.

ABSTRACT:

Background

The aim of this study is to quantify the frequency content of the blood velocity waveform in different body regions by means of phase contrast (PC) cardiovascular magnetic resonance (CMR) and Doppler ultrasound. The highest frequency component of the spectrum is inversely proportional to the ideal temporal resolution to be used for the acquisition of flow-sensitive imaging (Shannon-Nyquist theorem).

Methods

Ten healthy subjects (median age 33y, range 24-40) were scanned with a high-temporal-resolution PC-CMR and with Doppler ultrasound on three body regions (carotid arteries, aorta and femoral arteries). Furthermore, 111 patients (median age 61y) with mild to moderate arterial hypertension and 58 patients with aortic aregurgitation, atrial septal defect, or repaired tetralogy of Fallot underwent aortic CMR scanning. The frequency power distribution was calculated for each location and the maximum frequency component, f_max, was extracted and expected limits for the general population were inferred.

Results

In the healthy subject cohort, significantly different f_max values were found across the different body locations, but they were nonsignificant across modalities. No significant correlation was found with heart rate. The measured f_max ranged from 7.7?±?1.1?Hz in the ascending aorta, up to 12.3?±?5.1?Hz in the femoral artery (considering PC-CMR data). The calculated upper boundary for the general population ranged from 11.0?Hz to 27.5?Hz, corresponding to optimal temporal resolutions of 45?ms and 18?ms, respectively. The patient cohort exhibited similar values for the frequencies in the aorta, with no correlation between blood pressure and frequency content.

Conclusions

The temporal resolution of PC-CMR acquisitions can be adapted based on the scanned body region and in the adult population, should approach approximately 20?ms in the peripheral arteries and 40?ms in the aorta.

Trial registration

This study presents results from a restrospective analysis of the clinical study NCT01870739 (ClinicalTrials.gov).

SUBMITTER: Santini F

PROVIDER: S-EPMC7534161 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

On the optimal temporal resolution for phase contrast cardiovascular magnetic resonance imaging: establishment of baseline values.

Santini Francesco F Pansini Michele M Hrabak-Paar Maja M Yates Denise D Langenickel Thomas H TH Bremerich Jens J Bieri Oliver O Schubert Tilman T

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20201005 1

<h4>Background</h4>The aim of this study is to quantify the frequency content of the blood velocity waveform in different body regions by means of phase contrast (PC) cardiovascular magnetic resonance (CMR) and Doppler ultrasound. The highest frequency component of the spectrum is inversely proportional to the ideal temporal resolution to be used for the acquisition of flow-sensitive imaging (Shannon-Nyquist theorem).<h4>Methods</h4>Ten healthy subjects (median age 33y, range 24-40) were scanned ...[more]

PMID: 33012283

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Project description:BackgroundWave intensity analysis, traditionally derived from pressure and velocity data, can be formulated using velocity and area. Flow-velocity and area can both be derived from high-resolution phase-contrast cardiovascular magnetic resonance (PC-CMR). In this study, very high temporal resolution PC-CMR data is processed using an integrated and semi-automatic technique to derive wave intensity.MethodsWave intensity was derived in terms of area and velocity changes. These data were directly derived from PC-CMR using a breath-hold spiral sequence accelerated with sensitivity encoding (SENSE). Image processing was integrated in a plug-in for the DICOM viewer OsiriX, including calculations of wave speed and wave intensity. Ascending and descending aortic data from 15 healthy volunteers (30?±?6?years) data were used to test the method for feasibility, and intra- and inter-observer variability. Ascending aortic data were also compared with results from 15 patients with coronary heart disease (61?±?13?years) to assess the clinical usefulness of the method.ResultsRapid image acquisition (11?s breath-hold) and image processing was feasible in all volunteers. Wave speed was physiological (5.8?±?1.3?m/s ascending aorta, 5.0?±?0.7?m/s descending aorta) and the wave intensity pattern was consistent with traditionally formulated wave intensity. Wave speed, peak forward compression wave in early systole and peak forward expansion wave in late systole at both locations exhibited overall good intra- and inter-observer variability. Patients with coronary heart disease had higher wave speed (p <0.0001), and lower forward compression wave (p <0.0001) and forward expansion wave (p <0.0005) peaks. This difference is likely related to the older age of the patients' cohort, indicating stiffer aortas, as well as compromised ventricular function due to their underlying condition.ConclusionA non-invasive, semi-automated and reproducible method for performing wave intensity analysis is presented. Its application is facilitated by the use of a very high temporal resolution spiral sequence. A formulation of wave intensity based on area change has also been proposed, involving no assumptions about the cross-sectional shape of the vessel.

Project description:BACKGROUND:Cardiovascular magnetic resonance (CMR) allows for non-invasive assessment of arterial stiffness by means of measuring pulse wave velocity (PWV). PWV can be calculated from the time shift between two time-resolved flow curves acquired at two locations within an arterial segment. These flow curves can be derived from two-dimensional CINE phase contrast CMR (2D CINE PC CMR). While CMR-derived PWV measurements have proven to be accurate for the aorta, this is more challenging for smaller arteries such as the carotids due to the need for both high spatial and temporal resolution. In this work, we present a novel method that combines retrospectively gated 2D CINE PC CMR, high temporal binning of data and compressed sensing (CS) reconstruction to accomplish a temporal resolution of 4 ms. This enables accurate flow measurements and assessment of PWV in regional carotid artery segments. METHODS:Retrospectively gated 2D CINE PC CMR data acquired in the carotid artery was binned into cardiac frames of 4 ms length, resulting in an incoherently undersampled ky-t-space with a mean undersampling factor of 5. The images were reconstructed by a non-linear CS reconstruction using total variation over time as a sparsifying transform. PWV values were calculated from flow curves by using foot-to-foot and cross-correlation methods. Our method was validated against ultrasound measurements in a flow phantom setup representing the carotid artery. Additionally, PWV values of two groups of 23 young (30 ± 3 years, 12 [52%] women) and 10 elderly (62 ± 10 years, 5 [50%] women) healthy subjects were compared using the Wilcoxon rank-sum test. RESULTS:Our proposed method produced very similar flow curves as those measured using ultrasound at 1 ms temporal resolution. Reliable PWV estimation proved possible for transit times down to 7.5 ms. Furthermore, significant differences in PWV values between healthy young and elderly subjects were found (4.7 ± 1.0 m/s and 7.9 ± 2.4 m/s, respectively; p < 0.001) in accordance with literature. CONCLUSIONS:Retrospectively gated 2D CINE PC CMR with CS allows for high spatiotemporal resolution flow measurements and accurate regional carotid artery PWV calculations. We foresee this technique will be valuable in protocols investigating early development of carotid atherosclerosis.

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Project description:BackgroundFunctional assessments of the heart by dynamic cardiovascular magnetic resonance (CMR) commonly rely on (i) electrocardiographic (ECG) gating yielding pseudo real-time cine representations, (ii) balanced gradient-echo sequences referred to as steady-state free precession (SSFP), and (iii) breath holding or respiratory gating. Problems may therefore be due to the need for a robust ECG signal, the occurrence of arrhythmia and beat to beat variations, technical instabilities (e.g., SSFP "banding" artefacts), and limited patient compliance and comfort. Here we describe a new approach providing true real-time CMR with image acquisition times as short as 20 to 30 ms or rates of 30 to 50 frames per second.MethodsThe approach relies on a previously developed real-time MR method, which combines a strongly undersampled radial FLASH CMR sequence with image reconstruction by regularized nonlinear inversion. While iterative reconstructions are currently performed offline due to limited computer speed, online monitoring during scanning is accomplished using gridding reconstructions with a sliding window at the same frame rate but with lower image quality.ResultsScans of healthy young subjects were performed at 3 T without ECG gating and during free breathing. The resulting images yield T1 contrast (depending on flip angle) with an opposed-phase or in-phase condition for water and fat signals (depending on echo time). They completely avoid (i) susceptibility-induced artefacts due to the very short echo times, (ii) radiofrequency power limitations due to excitations with flip angles of 10 degrees or less, and (iii) the risk of peripheral nerve stimulation due to the use of normal gradient switching modes. For a section thickness of 8 mm, real-time images offer a spatial resolution and total acquisition time of 1.5 mm at 30 ms and 2.0 mm at 22 ms, respectively.ConclusionsThough awaiting thorough clinical evaluation, this work describes a robust and flexible acquisition and reconstruction technique for real-time CMR at the ultimate limit of this technology.

Project description:BACKGROUND: Cine cardiovascular magnetic resonance (CMR) is challenging in patients who cannot perform repeated breath holds. Real-time, free-breathing acquisition is an alternative, but image quality is typically inferior. There is a clinical need for techniques that achieve similar image quality to the segmented cine using a free breathing acquisition. Previously, high quality retrospectively gated cine images have been reconstructed from real-time acquisitions using parallel imaging and motion correction. These methods had limited clinical applicability due to lengthy acquisitions and volumetric measurements obtained with such methods have not previously been evaluated systematically. METHODS: This study introduces a new retrospective reconstruction scheme for real-time cine imaging which aims to shorten the required acquisition. A real-time acquisition of 16-20s per acquired slice was inputted into a retrospective cine reconstruction algorithm, which employed non-rigid registration to remove respiratory motion and SPIRiT non-linear reconstruction with temporal regularization to fill in missing data. The algorithm was used to reconstruct cine loops with high spatial (1.3-1.8?×?1.8-2.1 mm²) and temporal resolution (retrospectively gated, 30 cardiac phases, temporal resolution 34.3?±?9.1 ms). Validation was performed in 15 healthy volunteers using two different acquisition resolutions (256?×?144/192?×?128 matrix sizes). For each subject, 9 to 12 short axis and 3 long axis slices were imaged with both segmented and real-time acquisitions. The retrospectively reconstructed real-time cine images were compared to a traditional segmented breath-held acquisition in terms of image quality scores. Image quality scoring was performed by two experts using a scale between 1 and 5 (poor to good). For every subject, LAX and three SAX slices were selected and reviewed in the random order. The reviewers were blinded to the reconstruction approach and acquisition protocols and scores were given to segmented and retrospective cine series. Volumetric measurements of cardiac function were also compared by manually tracing the myocardium for segmented and retrospective cines. RESULTS: Mean image quality scores were similar for short axis and long axis views for both tested resolutions. Short axis scores were 4.52/4.31 (high/low matrix sizes) for breath-hold vs. 4.54/4.56 for real-time (paired t-test, P?=?0.756/0.011). Long axis scores were 4.09/4.37 vs. 3.99/4.29 (P?=?0.475/0.463). Mean ejection fraction was 60.8/61.4 for breath-held acquisitions vs. 60.3/60.3 for real-time acquisitions (P?=?0.439/0.093). No significant differences were seen in end-diastolic volume (P?=?0.460/0.268) but there was a trend towards a small overestimation of end-systolic volume of 2.0/2.5 ml, which did not reach statistical significance (P?=?0.052/0.083). CONCLUSIONS: Real-time free breathing CMR can be used to obtain high quality retrospectively gated cine images in 16-20s per slice. Volumetric measurements and image quality scores were similar in images from breath-held segmented and free breathing, real-time acquisitions. Further speedup of image reconstruction is still needed.

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Dataset Information

On the optimal temporal resolution for phase contrast cardiovascular magnetic resonance imaging: establishment of baseline values.

Background

Methods

Results

Conclusions

Trial registration

Publications

On the optimal temporal resolution for phase contrast cardiovascular magnetic resonance imaging: establishment of baseline values.

Similar Datasets

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