Functional cardiac MR imaging with true fast imaging with steady-state free precession before and after intravenous injection of contrast medium: comparison of image quality and accuracy

Krombach, Gabriele A.; Plum, Thorsten; Koos, Ralf; Hoffmann, Rainer; Altiok, Ertunc; Krämer, Nils; Günther, Rolf W.; Schoth, Felix

doi:10.1007/s00330-010-1969-2

Cited by 10 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has already been suggested to take advantage of this impregnation time to acquire the cine images, so as to shorten the total examination time. If at 1.5T, some authors [ 15 , 16 ] have demonstrated that LV delineation remains accurate enough to correctly assess wall motion and LVEF, it has not yet been proven that b-TFE cine sequences obtained at 3T could be acquired after gadolinium injection, all the more since the difference in T1 between the blood pool and the myocardium is decreased when increasing the field strength [ 16 ]. If post-contrast is currently a common practice in many 1.5T CMR sites, its generalization to 3T sites is not yet supported by the current literature.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Function Evaluation on a 3T MR Scanner with Parallel RF Transmission Technique: Prospective Comparison of Cine Sequences Acquired before and after Gadolinium Injection

et al. 2016

View full text Add to dashboard Cite

ObjectivesTo compare cine MR b-TFE sequences acquired before and after gadolinium injection, on a 3T scanner with a parallel RF transmission technique in order to potentially improve scanning time efficiency when evaluating LV function.Methods25 consecutive patients scheduled for a cardiac MRI were prospectively included and had their b-TFE cine sequences acquired before and right after gadobutrol injection. Images were assessed qualitatively (overall image quality, LV edge sharpness, artifacts and LV wall motion) and quantitatively with measurement of LVEF, LV mass, and telediastolic volume and contrast-to-noise ratio (CNR) between the myocardium and the cardiac chamber. Statistical analysis was conducted using a Bayesian paradigm.ResultsNo difference was found before or after injection for the LVEF, LV mass and telediastolic volume evaluations. Overall image quality and CNR were significantly lower after injection (estimated coefficient cine after > cine before gadolinium: -1.75 CI = [-3.78;-0.0305], prob(coef>0) = 0% and -0.23 CI = [-0.49;0.04], prob(coef>0) = 4%) respectively), but this decrease did not affect the visual assessment of LV wall motion (cine after > cine before gadolinium: -1.46 CI = [-4.72;1.13], prob(coef>0) = 15%).ConclusionsIn 3T cardiac MRI acquired with parallel RF transmission technique, qualitative and quantitative assessment of LV function can reliably be performed with cine sequences acquired after gadolinium injection, despite a significant decrease in the CNR and the overall image quality.

show abstract

Section: Introductionmentioning

confidence: 99%

Left Ventricular Function Evaluation on a 3T MR Scanner with Parallel RF Transmission Technique: Prospective Comparison of Cine Sequences Acquired before and after Gadolinium Injection

et al. 2016

View full text Add to dashboard Cite

show abstract

“…However in clinical routine examination time is critical. To shorten the study duration standard cine steady-state free precession (SSFP) MRI imaging can be obtained after injection of contrast medium without loss of accuracy for regional and global LV ventricular function [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Determining Microvascular Obstruction and Infarct Size with Steady-State Free Precession Imaging Cardiac MRI

et al. 2015

View full text Add to dashboard Cite

PurposeIn cardiac MRI (cMRI) injection of contrast medium may be performed prior to the acquisition of cine steady-state free precession (SSFP) imaging to speed up the protocol and avoid delay before late Gadolinium enhancement (LGE) imaging. Aim of this study was to evaluate whether a condensed clinical protocol with contrast cine SSFP imaging is able to detect early microvascular obstruction (MO) and determine the infarct size compared to the findings of LGE inversion recovery sequences.Materials and MethodsThe study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. 68 consecutive patients (14 females/54 males) with acute ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary revascularization were included in this study. CMRI was performed 6.6±2 days after symptom onset and MO and infarct size in early contrast SSFP cine imaging were compared to LGE imaging.ResultsMO was detected in 47/68 (69%) patients on cine SSFP and in 41/68 (60%) patients on LGE imaging. In 6 patients MO was found on cine SSFP imaging but was not detectable on LGE imaging. Infarct size on cine SSFP showed a strong agreement to LGE imaging (intraclass correlation coefficient [ICC] of 0.96 for enddiastolic, p<0.001 and 0.96 for endsystolic, p<0.001 respectively). Significant interobserver agreement was found measuring enddiastolic and endsystolic infarct size on cine SSFP imaging (p<0.01).ConclusionsIn patients after STEMI infarct size and presence of MO can be detected with contrast cine SSFP imaging. This could be an option in patients who are limited in their ability to comply with the demands of a cMRI protocol.

show abstract

“…Although extracellular contrast agents decrease the blood‐myocardium interface contrast in bSSFP images, in clinical practice bSSFP images are typically acquired following the application of extracellular contrast agents . This, however, results in suboptimal automatic myocardial segmentation as well as restricted visual functional assessment .…”

mentioning

confidence: 99%

“…6 As the T 2 /T 1 ratio is high for blood and low for myocardium, there is a high contrast between blood and myocardium, which not only enables automatic myocardial segmentation but is also essential for the application of sophisticated image postprocessing, eg, strain analysis with feature-tracking software. [7][8][9] Although extracellular contrast agents decrease the blood-myocardium interface contrast in bSSFP images, 10 in clinical practice bSSFP images are typically acquired following the application of extracellular contrast agents. 11 This, however, results in suboptimal automatic myocardial segmentation as well as restricted visual functional assessment.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Flip angle optimization for balanced SSFP: Cardiac cine imaging following the application of standard extracellular contrast agent (gadobutrol)

Kuetting

Dabir

Luetkens

et al. 2017

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose: To investigate the effect of the flip angle (FA) on the blood-myocardium contrast and to define the FA leading to highest image quality in contrast-enhanced balanced steady-state free precession (bSSFP) images. bSSFP images provide excellent contrast between myocardium and blood with high signal-to-noise and contrast-to-noise ratios (SNR, CNR). In clinical practice, bSSFP images are typically acquired following the injection of extracellular contrast agents (ECAs), although ECAs decrease the blood-myocardium contrast. Materials and Methods: First, a theoretical optimization was performed to determine the FA that maximizes CNR in bSSFP imaging 2-20 minutes after application of ECA. Second signal-ratios, contrast, SNR, and CNR were assessed in vivo in 25 patients in bSSFP images at 1.5T acquired before (FA 5 508) and 10-15 minutes after (FAs 5 508, 808, 908, 1008) application of a double-dose contrast agent. Image quality was assessed by two readers. Results: Simulations yielded FAs in the range of 85-1008 for optimal CNR in contrast-enhanced images. In vivo comparison of conventionally acquired cine images (FA 508) showed an increase in CNR between blood and myocardium by 57% in diastole and 78% in systole in adapted contrast-enhanced bSSFP images (FA 1008). Contrast-enhanced images with an FA of 1008 were rated highest in image quality assessment. Conclusion: By means of FA adaptation a similar blood-myocardium contrast can be achieved in contrast-enhanced bSSFP as in unenhanced bSSFP imaging with an increase in CNR. 1 Cardiac functional assessment is typically performed based on bright-blood cine images. Most commonly a steady-state free precession sequence with balanced gradients (bSSFP) is used for this purpose. 2 Balanced SSFP sequences are employed due to their high signal-to-noise ratio (SNR) and high blood-myocardium contrast-to-noise ratio (CNR), and are currently considered the method of choice for assessing cardiac function at 1.5T. 3,4Image contrast in bSSFP sequences depends primarily on the T 2 /T 1 ratio of the relaxation times, but the signal intensities are also influenced by inflow and out-of-slice effects.5 Furthermore, the signal intensity also varies with the applied flip angle (FA), which is typically set in the range of 50-608. 6 As the T 2 /T 1 ratio is high for blood and low for myocardium, there is a high contrast between blood and myocardium, which not only enables automatic myocardial segmentation but is also essential for the application of sophisticated image postprocessing, eg, strain analysis with feature-tracking software. 7-9Although extracellular contrast agents decrease the blood-myocardium interface contrast in bSSFP images, 10 in clinical practice bSSFP images are typically acquired followingView this article online at wileyonlinelibrary.com.

show abstract

Functional cardiac MR imaging with true fast imaging with steady-state free precession before and after intravenous injection of contrast medium: comparison of image quality and accuracy

Abstract: Cine SSFP can be obtained after injection of contrast medium without loss of accuracy for regional and global LV ventricular function. This protocol can be used to decrease imaging time for thorough cardiac examination.

Cited by 10 publications

References 28 publications

Left Ventricular Function Evaluation on a 3T MR Scanner with Parallel RF Transmission Technique: Prospective Comparison of Cine Sequences Acquired before and after Gadolinium Injection

Left Ventricular Function Evaluation on a 3T MR Scanner with Parallel RF Transmission Technique: Prospective Comparison of Cine Sequences Acquired before and after Gadolinium Injection

Determining Microvascular Obstruction and Infarct Size with Steady-State Free Precession Imaging Cardiac MRI

Flip angle optimization for balanced SSFP: Cardiac cine imaging following the application of standard extracellular contrast agent (gadobutrol)

Contact Info

Product

Resources

About