MR assessment of left ventricular function: Quantitative comparison of fast imaging employing steady‐state acquisition (FIESTA) with fast gradient echo cine technique

Abstract

Purpose:To evaluate the agreement of fast imaging employing steady-state acquisition (FIESTA) cine technique with segmented k-space fast gradient echo (GRE) cine technique when using them for assessment of cardiac function. Materials and Methods:Eleven MR cine studies were performed on six healthy volunteers and five patients, using FIESTA and fast GRE techniques. The quantitative measurements of ventricular function obtained from the two techniques were compared. The data analysis was performed by two observers independently.Results: Compared to fast GRE cine technique, FIESTA cine technique consistently resulted in higher end-diastolic volume (10.2%) and end-systolic volume (21.6%), but lower myocardial mass of left ventricle (19.2%) and ejection fraction (9.9%). The stroke volume obtained from the two techniques was very close. The primary explanation for this variability is that the two techniques have different mechanisms on establishing signal contrast. Conclusion:Compared to fast GRE technique, FIESTA provides significantly different results when using it for assessment of left ventricular function. It is important to consider this difference in the assessment of cardiac function. CARDIAC MR IMAGING has been used as a non-invasive method for the assessment of ventricular function for over a decade (1-5). The segmented k-space fast gradient echo (GRE) sequence is commonly accepted as an accurate and reproducible technique for measuring ventricular volumes and masses (6 -10). With recent advances in MRI hardware and software, fast imaging employing steady-state acquisition (FIESTA) cine technique, also known as balanced fast field echo (FFE), true fast imaging with steady-state precession (True-FISP), or steady-state free precession (SSFP) cine technique by different manufacturers, has been increasingly applied for the assessment of ventricular function, because FIESTA techniques provide better blood-myocardial contrast, higher image quality, and shorter acquisition time (11-16). However, in selecting a new technique for measurement of LV volume and mass, it is crucial to compare the new technique with an established one to determine whether they agree sufficiently. If they do not agree, we need to assess how much the two methods differ. In this study, we compared the quantitative measurements of ventricular function obtained using FIESTA and fast GRE cine techniques to evaluate the agreement of the two. Five parameters, including end-diastolic volume (EDV), end-systolic volume (ESV), myocardial mass of left ventricle at enddiastole, stroke volume (SV), and ejection fraction (EF) were analyzed. MATERIALS AND METHODSEleven MR studies were performed on six healthy volunteers (three men, three women, average age 29.3, ranging from 20 to 42 years of age) and five patients (two men, three women, average age 59.2, ranging from 30 to 81 years of age). In the five patients, one with known atrial septal defect was imaged prior to surgical operation, two had known coronary artery disease, one had a suspected cardiac ...

Normal biventricular function, volumes, and mass in children aged 8 to 17 years

“…These variables also showed the smallest variation for interobserver variability. The results of intraand interobserver variability analysis in this study are comparable to the results of other studies with SSFP for all variables (6,(25)(26)(27)(28). Therefore, CMR imaging is an accurate and reliable method for follow-up of these variables and can adequately assess changes in ventricular size and global ventricular performance.…”

Assessment of left ventricular function by breath‐hold cine MR imaging: Comparison of different steady‐state free precession sequences

“…Their accuracy in determining left ventricular (LV) mass was also evaluated in animal experiments (10). Normal values were established for left and right ventricular volumes and function for both TGE as well as SSFP sequences, with SSFP sequences yielding significantly larger end-diastolic and end-systolic volumes (EDV and ESV, respectively) than TGE sequences (7,8,(11)(12)(13)(14)(15)(16)(17).Signal intensity in images acquired with SSFP sequences relies on T2/T1 ratio and does not depend on inflowing fresh blood, facilitating the delineation of papillary muscles and trabeculae as well as atrioventricular and semilunar valves (8). Contrast between intraventricular blood and myocardium as well as between myocardium and epicardial fat is significantly higher in images obtained with SSFP sequences compared to those acquired with TGE sequences (8,9), and thus…”

Influence of positional and angular variation of automatically planned short‐axis stacks on quantification of left ventricular dimensions and function with cardiovascular magnetic resonance

“…Planning variability is due to the positional variation and angular deviation of the imaging planes from the optimum, and is prominent only in automated CMR planning. Intraobserver variability (11)(12)(13)16,36,37) arises due to subjectivity in myocardial border tracing by the human observer. The decomposition of the total variation showed that the relative contribution of the interstudy variability factors was significantly larger than that of the intraobserver factor for all CMR measurements (Fig.…”

“…Indeed, the intraobserver variability accounted for the smallest part (15-29%) of the total variation and remained independent from the errors in placing the SA imaging planes. This contradiction can be partially explained by the fact that the BFFE sequence provides high-quality images with excellent contrast between blood and cardiac muscle (11,15,16,39). Thus, the slightly oblique orientation of the imaging planes with respect to the myocardial wall that arises in automated CMR planning does not affect the quantification of the LV dimensions and function.…”

“…A few steps have been taken in this direction. For example, recently introduced breath-hold imaging with segmented k-space (7,(11)(12)(13)(14) or steadystate (2,11,15,16) techniques has improved the image quality and shortened the examination time up to 10 -15 minutes. However, CMR planning is still performed manually in the clinical environment.…”