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Three-dimensional free breathing whole heart cardiovascular magnetic resonance T1 mapping at 3 T.

ABSTRACT: This study demonstrates a three-dimensional (3D) free-breathing native myocardial T1 mapping sequence at 3 T.The proposed sequence acquires three differently T1-weighted volumes. The first two volumes receive a saturation pre-pulse with different recovery time. The third volume is acquired without magnetization preparation and after a significant recovery time. Respiratory navigator gating and volume-interleaved acquisition are adopted to mitigate misregistration. The proposed sequence was validated through simulation, phantom experiments and in vivo experiments in 12 healthy adult subjects.In phantoms, good agreement on T1 measurement was achieved between the proposed sequence and the reference inversion recovery spin echo sequence (R2?=?0.99). Homogeneous 3D T1 maps were obtained from healthy adult subjects, with a T1 value of 1476?±?53 ms and a coefficient of variation (CV) of 6.1?±?1.4% over the whole left-ventricular myocardium. The averaged septal T1 was 1512?±?60 ms with a CV of 2.1?±?0.5%.Free-breathing 3D native T1 mapping at 3 T is feasible and may be applicable in myocardial assessment. The proposed 3D T1 mapping sequence is suitable for applications in which larger coverage is desired beyond that available with single-shot parametric mapping, or breath-holding is unfeasible.

SUBMITTER: Guo R

PROVIDER: S-EPMC6139904 | biostudies-other | 2018 Sep

REPOSITORIES: biostudies-other

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Three-dimensional free breathing whole heart cardiovascular magnetic resonance T<sub>1</sub> mapping at 3 T.

Guo Rui R Chen Zhensen Z Wang Yishi Y Herzka Daniel A DA Luo Jianwen J Ding Haiyan H

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20180917 1

<h4>Background</h4>This study demonstrates a three-dimensional (3D) free-breathing native myocardial T<sub>1</sub> mapping sequence at 3 T.<h4>Methods</h4>The proposed sequence acquires three differently T<sub>1</sub>-weighted volumes. The first two volumes receive a saturation pre-pulse with different recovery time. The third volume is acquired without magnetization preparation and after a significant recovery time. Respiratory navigator gating and volume-interleaved acquisition are adopted to ...[more]

PMID: 30220254

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Project description:BackgroundEndogenous contrast T1? cardiovascular magnetic resonance (CMR) can detect scar or infiltrative fibrosis in patients with ischemic or non-ischemic cardiomyopathy. Existing 2D T1? techniques have limited spatial coverage or require multiple breath-holds. The purpose of this project was to develop an accelerated, free-breathing 3D T1? mapping sequence with whole left ventricle coverage using a multicoil, compressed sensing (CS) reconstruction technique for rapid reconstruction of undersampled k-space data.MethodsWe developed a cardiac- and respiratory-gated, free-breathing 3D T1? sequence and acquired data using a variable-density k-space sampling pattern (A?=?3). The effect of the transient magnetization trajectory, incomplete recovery of magnetization between T1?-preparations (heart rate dependence), and k-space sampling pattern on T1? relaxation time error and edge blurring was analyzed using Bloch simulations for normal and chronically infarcted myocardium. Sequence accuracy and repeatability was evaluated using MnCl2 phantoms with different T1? relaxation times and compared to 2D measurements. We further assessed accuracy and repeatability in healthy subjects and compared these results to 2D breath-held measurements.ResultsThe error in T1? due to incomplete recovery of magnetization between T1?-preparations was T1?healthy =?6.1% and T1?infarct =?10.8% at 60?bpm and T1?healthy =?13.2% and T1?infarct =?19.6% at 90?bpm. At a heart rate of 60?bpm, error from the combined effects of readout-dependent magnetization transients, k-space undersampling and reordering was T1?healthy =?12.6% and T1?infarct =?5.8%. CS reconstructions had improved edge sharpness (blur metric?=?0.15) compared to inverse Fourier transform reconstructions (blur metric?=?0.48). There was strong agreement between the mean T1? estimated from the 2D and accelerated 3D data (R2 =?0.99; P <?0.05) acquired on the MnCl2 phantoms. The mean R1? estimated from the accelerated 3D sequence was highly correlated with MnCl2 concentration (R2 =?0.99; P?<?0.05). 3D T1? acquisitions were successful in all human subjects. There was no significant bias between undersampled 3D T1? and breath-held 2D T1? (mean bias?=?0.87) and the measurements had good repeatability (COV2D =?6.4% and COV3D =?7.1%).ConclusionsThis is the first report of an accelerated, free-breathing 3D T1? mapping of the left ventricle. This technique may improve non-contrast myocardial tissue characterization in patients with heart disease in a scan time appropriate for patients.

Project description:BACKGROUND:T1 mapping based on cardiovascular magnetic resonance (CMR) is a novel approach using the magnetic relaxation T1 time as a quantitative marker for myocardial tissue composition. Various T1 mapping sequences are being used, with different strengths and weaknesses. Data comparing different sequences head to head however are sparse. METHODS:We compared three T1 mapping sequences, ShMOLLI, MOLLI and SASHA in phantoms and in a mid-ventricular slice of 40 healthy individuals (mean age 59?±?7 years, 45 % male) with low (68 %) or moderate cardiovascular risk. We calculated global and segmental T1 in vivo through exponential curve fitting and subsequent parametric mapping. We also analyzed image quality and inter-observer reproducibility. RESULTS:There was no association of T1 with cardiovascular risk groups. T1 however differed significantly depending on the sequence, with SASHA providing consistently higher mean values than ShMOLLI and MOLLI (1487?±?36 ms vs. 1174?±?37 ms and 1199?±?28 ms, respectively; p?<?0.001). This difference between sequences was much smaller in phantom measurements. In patients, segmental values were lower in the anterior wall for all sequences. Image quality, in general good for the steady-state-free-precession readouts in all sequences, was lower for SASHA parametric maps. On multivariate regression analysis, a longer T1 measured by MOLLI was correlated with lower ejection fraction and female gender. Inter-observer variability as assessed by intra-class correlation coefficients was excellent for all sequences (ShMOLLI: 0.995; MOLLI: 0.991; SASHA: 0.961; all p?<?0.001). CONCLUSION:In a cross-sectional population with low to moderate cardiovascular risk, we observed a variation in T1 mapping results between inversion-recovery vs. saturation-recovery sequences in vivo, which were less evident in phantom images, despite a small interobserver variability. Thus, physiological factors, most likely related to B1 inhomogeneities, and tissue-specific properties, like magnetization transfer, that impact T1 values in vivo, render phantom validation insufficient, and have to be further investigated for a better understanding of the clinical utility of different T1 mapping approaches. TRIAL REGISTRATION:"Canadian Alliance For Healthy Hearts and Minds" - ClinicalTrials.gov NCT02220582 ; registered August 18, 2014.

Project description:BackgroundThe free-breathing 3D whole-heart T2-prepared Bright-blood and black-blOOd phase SensiTive inversion recovery (BOOST) cardiovascular magnetic resonance (CMR) sequence was recently proposed for simultaneous bright-blood coronary CMR angiography and black-blood late gadolinium enhancement (LGE) imaging. This sequence enables simultaneous visualization of cardiac anatomy, coronary arteries and fibrosis. However, high-resolution (< 1.4 × 1.4 × 1.4 mm3) fully-sampled BOOST requires long acquisition times of ~ 20 min.MethodsIn this work, we propose to extend a highly efficient respiratory-resolved motion-corrected reconstruction framework (XD-ORCCA) to T2-prepared BOOST to enable high-resolution 3D whole-heart coronary CMR angiography and black-blood LGE in a clinically feasible scan time. Twelve healthy subjects were imaged without contrast injection (pre-contrast BOOST) and 10 patients with suspected cardiovascular disease were imaged after contrast injection (post-contrast BOOST). A quantitative analysis software was used to compare accelerated pre-contrast BOOST against the fully-sampled counterpart (vessel sharpness and length of the left and right coronary arteries). Moreover, three cardiologists performed diagnostic image quality scoring for clinical 2D LGE and both bright- and black-blood 3D BOOST imaging using a 4-point scale (1-4, non-diagnostic-fully diagnostic). A two one-sided test of equivalence (TOST) was performed to compare the pre-contrast BOOST images. Nonparametric TOST was performed to compare post-contrast BOOST image quality scores.ResultsThe proposed method produces images from 3.8 × accelerated non-contrast-enhanced BOOST acquisitions with comparable vessel length and sharpness to those obtained from fully- sampled scans in healthy subjects. Moreover, in terms of visual grading, the 3D BOOST LGE datasets (median 4) and the clinical 2D counterpart (median 3.5) were found to be statistically equivalent (p < 0.05). In addition, bright-blood BOOST images allowed for visualization of the proximal and middle left anterior descending and right coronary sections with high diagnostic quality (mean score > 3.5).ConclusionsThe proposed framework provides high-resolution 3D whole-heart BOOST images from a single free-breathing acquisition in ~ 7 min.

Project description:PURPOSE:To develop an accelerated motion corrected 3D whole-heart imaging approach (qBOOST-T2) for simultaneous high-resolution bright- and black-blood cardiac MR imaging and quantitative myocardial T2 characterization. METHODS:Three undersampled interleaved balanced steady-state free precession cardiac MR volumes were acquired with a variable density Cartesian trajectory and different magnetization preparations: (1) T2-prepared inversion recovery (T2prep-IR), (2) T2-preparation, and (3) no preparation. Image navigators were acquired prior the acquisition to correct for 2D translational respiratory motion. Each 3D volume was reconstructed with a low-rank patch-based reconstruction. The T2prep-IR volume provides bright-blood anatomy visualization, the black-blood volume is obtained by means of phase sensitive reconstruction between first and third datasets, and T2 maps are generated by matching the signal evolution to a simulated dictionary. The proposed sequence has been evaluated in simulations, phantom experiments, 11 healthy subjects and compared with 3D bright-blood cardiac MR and standard 2D breath-hold balanced steady-state free precession T2 mapping. The feasibility of the proposed approach was tested on 4 patients with suspected cardiovascular disease. RESULTS:High linear correlation (y = 1.09 × -0.83, R2 = 0.99) was found between the proposed qBOOST-T2 and T2 spin echo measurements in phantom experiment. Good image quality was observed in vivo with the proposed 4x undersampled qBOOST-T2. Mean T2 values of 53.1 ± 2.1 ms and 55.8 ± 2.7 ms were measured in vivo for 2D balanced steady-state free precession T2 mapping and qBOOST-T2, respectively, with linear correlation of y = 1.02x+1.46 (R2 = 0.61) and T2 bias = 2.7 ms. CONCLUSION:The proposed qBOOST-T2 sequence allows the acquisition of 3D high-resolution co-registered bright- and black-blood volumes and T2 maps in a single scan of ~11 min, showing promising results in terms of T2 quantification.

Project description:BACKGROUND:Myocardial recovery after primary percutaneous coronary intervention in acute myocardial infarction is variable and the extent and severity of injury are difficult to predict. We sought to investigate the role of cardiovascular magnetic resonance T1 mapping in the determination of myocardial injury very early after treatment of ST-segment elevation myocardial infarction (STEMI). METHODS:STEMI patients underwent 3?T cardiovascular magnetic resonance (CMR), within 3?h of primary percutaneous intervention (PPCI). T1 mapping determined the extent (area-at-risk as %left ventricle, AAR) and severity (average T1 values of AAR) of acute myocardial injury, and related these to late gadolinium enhancement (LGE), and microvascular obstruction (MVO). The characteristics of myocardial injury within 3?h was compared with changes at 24-h to predict final infarct size. RESULTS:Forty patients were included in this study. Patients with average T1 values of AAR ?1400?ms within 3?h of PPCI had larger LGE at 24-h (33% ±14 vs. 18% ±10, P?=?0.003) and at 6-months (27% ±9 vs. 12% ±9; P?<?0.001), higher incidence and larger extent of MVO (85% vs. 40%, P?=?0.016) & [4.0 (0.5-9.5)% vs. 0 (0-3.0)%, P?=?0.025]. The average T1 value was an independent predictor of acute LGE (? 0.61, 95%CI 0.13 to 1.09; P?=?0.015), extent of MVO (? 0.22, 95%CI 0.03 to 0.41, P?=?0.028) and final infarct size (? 0.63, 95%CI 0.21 to 1.05; P?=?0.005). Receiver-operating-characteristic analysis showed that T1 value of AAR obtained within 3-h, but not at 24-h, predicted large infarct size (LGE >?9.5%) with 100% positive predictive value at the optimal cut-off of 1400?ms (area-under-the-curve, AUC 0.88, P?=?0.006). CONCLUSION:Hyper-acute T1 values of the AAR (within 3?h post PPCI, but not 24?h) predict a larger extent of MVO and infarct size at both 24?h and 6?months follow-up. Delayed CMR scanning for 24?h could not substitute the significant value of hyper-acute average T1 in determining infarct characteristics.

Project description:BackgroundNative T1 may be a sensitive, contrast-free, non-invasive cardiovascular magnetic resonance (CMR) marker of myocardial tissue changes in patients with pulmonary artery hypertension. However, the diagnostic and prognostic value of native T1 mapping in this patient group has not been fully explored. The aim of this work was to determine whether elevation of native T1 in myocardial tissue in pulmonary hypertension: (a) varies according to pulmonary hypertension subtype; (b) has prognostic value and (c) is associated with ventricular function and interaction.MethodsData were retrospectively collected from a total of 490 consecutive patients during their clinical 1.5 T CMR assessment at a pulmonary hypertension referral centre in 2015. Three hundred sixty-nine patients had pulmonary hypertension [58 ± 15 years; 66% female], an additional 39 had pulmonary hypertension due to left heart disease [68 ± 13 years; 60% female], 82 patients did not have pulmonary hypertension [55 ± 18; 68% female]. Twenty five healthy subjects were also recruited [58 ±4 years); 51% female]. T1 mapping was performed with a MOdified Look-Locker Inversion Recovery (MOLLI) sequence. T1 prognostic value in patients with pulmonary arterial hypertension was assessed using multivariate Cox proportional hazards regression analysis.ResultsPatients with pulmonary artery hypertension had elevated T1 in the right ventricular (RV) insertion point (pulmonary hypertension patients: T1 = 1060 ± 90 ms; No pulmonary hypertension patients: T1 = 1020 ± 80 ms p < 0.001; healthy subjects T1 = 940 ± 50 ms p < 0.001) with no significant difference between the major pulmonary hypertension subtypes. The RV insertion point was the most successful T1 region for discriminating patients with pulmonary hypertension from healthy subjects (area under the curve = 0.863) however it could not accurately discriminate between patients with and without pulmonary hypertension (area under the curve = 0.654). T1 metrics did not contribute to prediction of overall mortality (septal: p = 0.552; RV insertion point: p = 0.688; left ventricular free wall: p = 0.258). Systolic interventricular septal angle was a significant predictor of T1 in patients with pulmonary hypertension (p < 0.001).ConclusionsElevated myocardial native T1 was found to a similar extent in pulmonary hypertension patient subgroups and is independently associated with increased interventricular septal angle. Native T1 mapping may not be of additive value in the diagnostic or prognostic evaluation of patients with pulmonary artery hypertension.

Dataset Information

Three-dimensional free breathing whole heart cardiovascular magnetic resonance T1 mapping at 3 T.

Publications

Three-dimensional free breathing whole heart cardiovascular magnetic resonance T<sub>1</sub> mapping at 3 T.

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