Combined saturation/inversion recovery sequences for improved evaluation of scar and diffuse fibrosis in patients with arrhythmia or heart rate variability

Weingärtner, Sebastian; Akçakaya, Mehmet; Basha, Tamer; Kissinger, Kraig V.; Goddu, Beth; Berg, Sophie; Manning, Warren J.; Nezafat, Reza

doi:10.1002/mrm.24761

Cited by 159 publications

(180 citation statements)

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“…Additional cardiac MR imaging sequences, including saturation recovery single-shot acquisition (SASHA) (30) and saturation pulse prepared heart-rate-independent inversion recovery (SAP-PHIRE) sequences (31), are actively being studied but are not commonly used in clinical practice and are beyond the scope of this article.…”

Section: Other Sequences Under Investigationmentioning

confidence: 99%

Mapping the Future of Cardiac MR Imaging: Case-based Review of T1 and T2 Mapping Techniques

Hamlin¹,

Henry²,

Little³

et al. 2014

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Cardiac magnetic resonance (MR) imaging has grown over the past several decades into a validated, noninvasive diagnostic imaging tool with a pivotal role in cardiac morphologic and functional assessment and tissue characterization. With traditional cardiac MR imaging sequences, assessment of various pathologic conditions ranging from ischemic and nonischemic cardiomyopathy to cardiac involvement in systemic diseases (eg, amyloidosis and sarcoidosis) is possible; however, these sequences are most useful in focal myocardial disease, and image interpretation relies on subjective qualitative analysis of signal intensity. Newer T1 and T2 myocardial mapping techniques offer a quantitative assessment of the myocardium (by using T1 and T2 relaxation times), which can be helpful in focal disease, and demonstrate special utility in the evaluation of diffuse myocardial disease (eg, edema and fibrosis). Altered T1 and T2 relaxation times in disease states can be compared with published ranges of normal relaxation times in healthy patients. In conjunction with traditional cardiac MR imaging sequences, T1 and T2 mapping can limit the interpatient and interstudy variability that are common with qualitative analysis and may provide clinical markers for long-term follow-up.

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Section: Other Sequences Under Investigationmentioning

confidence: 99%

Mapping the Future of Cardiac MR Imaging: Case-based Review of T1 and T2 Mapping Techniques

Hamlin¹,

Henry²,

Little³

et al. 2014

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“…The modified Look-Locker inversion recovery (MOLLI) sequence [4] and variations thereof, like the shortened MOLLI (ShMOLLI) [5], are commonly used for myocardial T 1 -mapping. However, confounding factors to the method’s quantification accuracy including heart rate [6], T 2 relaxation time [7], and magnetization transfer [8] lead to underestimation of the T 1 -time of the healthy myocardium by ~20 % at 1.5T [9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Myocardial T1-mapping at 3T using saturation-recovery: reference values, precision and comparison with MOLLI

Weingärtner

Meßner

Budjan

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundMyocardial T1-mapping recently emerged as a promising quantitative method for non-invasive tissue characterization in numerous cardiomyopathies. Commonly performed with an inversion-recovery (IR) magnetization preparation at 1.5T, the application at 3T has gained due to increased quantification precision. Alternatively, saturation-recovery (SR) T1-mapping has recently been introduced at 1.5T for improved accuracy.Thus, the purpose of this study is to investigate the robustness and precision of SR T1-mapping at 3T and to establish accurate reference values for native T1-times and extracellular volume fraction (ECV) of healthy myocardium.MethodsBalanced Steady-State Free-Precession (bSSFP) Saturation-Pulse Prepared Heart-rate independent Inversion-REcovery (SAPPHIRE) and Saturation-recovery Single-SHot Acquisition (SASHA) T1-mapping were compared with the Modified Look-Locker inversion recovery (MOLLI) sequence at 3T. Accuracy and precision were studied in phantom. Native and post-contrast T1-times and regional ECV were determined in 20 healthy subjects (10 men, 27 ± 5 years). Subjective image quality, susceptibility artifact rating, in-vivo precision and reproducibility were analyzed.ResultsSR T1-mapping showed <4 % deviation from the spin-echo reference in phantom in the range of T1 = 100–2300 ms. The average quality and artifact scores of the T1-mapping methods were: MOLLI:3.4/3.6, SAPPHIRE:3.1/3.4, SASHA:2.9/3.2; (1: poor - 4: excellent/1: strong - 4: none). SAPPHIRE and SASHA yielded significantly higher T1-times (SAPPHIRE: 1578 ± 42 ms, SASHA: 1523 ± 46 ms), in-vivo T1-time variation (SAPPHIRE: 60.1 ± 8.7 ms, SASHA: 70.0 ± 9.3 ms) and lower ECV-values (SAPPHIRE: 0.20 ± 0.02, SASHA: 0.21 ± 0.03) compared with MOLLI (T1: 1181 ± 47 ms, ECV: 0.26 ± 0.03, Precision: 53.7 ± 8.1 ms). No significant difference was found in the inter-subject variability of T1-times or ECV-values (T1: p = 0.90, ECV: p = 0.78), the observer agreement (inter: p > 0.19; intra: p > 0.09) or consistency (inter: p > 0.07; intra: p > 0.17) between the three methods.ConclusionsSaturation-recovery T1-mapping at 3T yields higher accuracy, comparable inter-subject, inter- and intra-observer variability and less than 30 % precision-loss compared to MOLLI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0302-x) contains supplementary material, which is available to authorized users.

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“…A hybrid sequence combining inversion and saturation preparation pulses have been recently introduced-the saturation pulse prepared heart rate independent inversion recovery (SAPPHIRE) sequence applies an initial saturation and a subsequent inversion pulse followed by bSSFP readout [21]. Both the saturation and inversion delay times vary in the subsequent cardiac cycles but the total of the two delay times is kept constant to ensure that image readout is always timed to the same cardiac phase.…”

Section: Hybrid Inversion and Saturation Recovery Based Pulse Sequencesmentioning

confidence: 99%

Overview of Myocardial T1 Mapping Applications

et al. 2015

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T1 mapping with cardiac MRI has gained an important role in myocardial tissue characterization over the past decade as emerging technological developments enable reliable myocardial T1 assessment with a reasonably short acquisition time. Fast mapping approaches can acquire a single-slice T1 map in a single breath-hold even in patients with low compliance and low breath-holding capacity. Improvements in T1 mapping sequences have extended the clinical utility of this technique to a broad range of myocardial diseases. Indeed, native T1 mapping and extracellular volume fraction mapping seem to have superior value over conventional late gadolinium enhancement techniques in assessing certain myocardial diseases. Ongoing studies look to establish inter-vendor reference values, to further shorten the acquisition time, to develop 3D T1 mapping, and to improve reliability and reproducibility.

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Combined saturation/inversion recovery sequences for improved evaluation of scar and diffuse fibrosis in patients with arrhythmia or heart rate variability

Abstract: The proposed sequences are insensitive to heart rate variability, yield improved LGE images in the presence of arrhythmias, as well as T1 mapping with shorter scan times.

Cited by 159 publications

References 40 publications

Mapping the Future of Cardiac MR Imaging: Case-based Review of T1 and T2 Mapping Techniques

Mapping the Future of Cardiac MR Imaging: Case-based Review of T1 and T2 Mapping Techniques

Myocardial T1-mapping at 3T using saturation-recovery: reference values, precision and comparison with MOLLI

Overview of Myocardial T1 Mapping Applications

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