Steady-state free precession sequences in myocardial first-pass perfusion MR imaging: comparison with TurboFLASH imaging

Hunold, Peter; Maderwald, Stefan; Eggebrecht, Holger; Vogt, Florian; Barkhausen, Jörg

doi:10.1007/s00330-003-2176-1

Cited by 49 publications

(37 citation statements)

References 27 publications

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“…Potential advantages and problems for myocardial perfusion imaging at 3 T Perfusion imaging at 1.5 T suffers from limited spatial resolution [21][22][23][24]; therefore it was our intention to utilize the gain in SNR at 3 T by increasing spatial resolution and thereby reducing partial volume effects and subendocardial dark rim artifacts.…”

Section: Discussionmentioning

confidence: 99%

High-resolution myocardial stress perfusion at 3 T in patients with suspected coronary artery disease

et al. 2007

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To implement a high-resolution first-pass myocardial perfusion imaging protocol (HRPI) at 3 T, and to evaluate the feasibility, image quality and accuracy of this approach prospectively in patients with suspected CAD. We hypothesized that utilizing the gain in SNR at 3 T to increase spatial resolution would reduce partial volume effects and subendocardial dark rim artifacts in comparison to 1.5 T. HRPI studies were performed on 60 patients using a segmented k-space gradient echo sequence (in plane resolution 1.97 x 1.94 mm(2)). Semiquantitative assessment of dark rim artifacts was performed for the stress studies on a slice-by-slice basis. Qualitative visual analysis was compared to quantitative coronary angiography (QCA) results; hemodynamically significant CAD was defined as stenosis >or=70% at QCA. Dark rim artifacts appeared in 108 of 180 slices (average extent 1.3 +/- 1.2 mm representing 11.8 +/- 10.8% of the transmural myocardial thickness). Sensitivity, specifity, and test accuracy for the detection of significant CAD were 89%,79%, and 85%. HRPI studies at 3 T are feasible in a clinical setting, providing good image quality and high accuracy for detection of significant CAD. The presence of dark rim artifacts does not appear to represent a diagnostic problem when using a HRPI approach.

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Section: Discussionmentioning

confidence: 99%

High-resolution myocardial stress perfusion at 3 T in patients with suspected coronary artery disease

et al. 2007

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“…With recent advances in MR imaging techniques, including saturation-recovery steady-state free precession sequence, the diagnostic capability of MR myocardial perfusion imaging has been proven to provide high signal-to-noise ratios and contrast-to-noise ratios (6, 7). Hunold et al (7) suggested that SR-SSFP sequence was better than fast gradient techniques for providing a delineation between ischemic and normally perfused myocardium because of higher signal-to-noise ratios . Previous studies using MRI have demonstrated that alterations in myocardial perfusion can be assessed by using MR imaging (13 15) using gradient echo sequence.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, stress perfusion MRI using saturation-recovery steady-state free precession sequence (SR-SSFP) has been proven to provide higher signal-to-noise and contrast-to-noise ratios than fast gradient techniques (6,7). Therefore, the purpose of this study is to evaluate the technical performance and assess the diagnostic accuracy of SENSE-accelerated myocardial perfusion cardiac MR imaging for the depiction of significant coronary artery stenosis.…”

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confidence: 99%

The Usefulness of Stress Perfusion MR using Steady State Free Precession Sequence for Depiction of Significant Coronary Artery Stenosis

Chung

Choi

Kim

et al. 2007

J Korean Radiol Soc

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Purpose: To evaluate the technical performance of stress myocardial perfusion magnetic resonance (MR) imaging using saturation-recovery steady-state free precession (SR-SSFP) and to assess the diagnostic accuracy of this examination for depiction of significant coronary artery stenosis. Materials and Methods: 167 patients underwent stress myocardial perfusion MR imaging at rest and adenosine-induced stress by using a 1.5-T cardiac MR imaging unit. The first-pass MR perfusion was performed using SR-SSFP sequence. Coronary angiography was performed in 113 patients. Image analysis was performed to compare the diagnostic accuracy of MR imaging with that of coronary angiography. Results: During the MR examination, minor side effects of adenosine-induced stress occurred, most commonly chest discomfort (29%), followed by dyspnea (4%), and facial flushing (0.8%). The overall sensitivity of MR imaging for depicting at least one coronary artery with significant stenosis was 91%. The sensitivities of MR imaging for depiction of stenoses were as follows: 80% for single-vessel stenosis, 81% for doublevessel stenosis, and 100% for triple-vessel stenosis.. The specificity of MR imaging for identification of patients with significant coronary artery stenosis was 78%. Conclusion: Stress myocardial magnetic resonance (MR) perfusion imaging using SR-SSFP sequence is safe and useful for the detection of significant coronary artery disease.

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“…The increased repetition time permits higher flip angles for potentially higher signal and CNR, while fast data acquisition permits comprehensive myocardial coverage with good spatiotemporal resolution, potentially reducing artifacts. The SSFP sequence reuses transverse magnetization, resulting in improved signal and CNR compared with GRE (14), although it may be more prone to artifacts.…”

Section: Cardiovascular Magnetic Resonance (Cmr)mentioning

confidence: 99%

Direct comparison of myocardial perfusion cardiovascular magnetic resonance sequences with parallel acquisition

Lyne

Gatehouse

Assomull

et al. 2007

Magnetic Resonance Imaging

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Purpose:To directly compare the three main myocardial perfusion cardiovascular magnetic resonance (CMR) sequences incorporating parallel acquisition methods. Materials and Methods:In 15 subjects (12 men, 57 Ϯ 15.7 years) referred for diagnostic coronary angiography, we acquired first-pass perfusion images (0.1 mmol/kg gadolinium-DTPA) at rest and during adenosine (140 g/kg/ min) on three separate occasions using three sequences incorporating parallel acquisition methods and approximately equivalent spatiotemporal resolution: hybrid echo planar imaging (hEPI), steady-state free precession (SSFP), and gradient echo imaging (GRE). We calculated the contrast-to-noise ratio (CNR) of each scan and blinded observers scored the presence and severity of artifacts (1, worst to 4, best), diagnostic confidence (0, low to 2, high), transmurality, area, and epicardial vessel territory of perfusion defects.Results: CNR was greatest with SSFP and least with hEPI (13.15 vs 7.85 P Ͻ 0.001). The most artifacts were recorded with SSFP and least with hEPI (2.00 vs 3.03 P Ͻ 0.001). Observers were significantly more confident in reporting hEPI images (1.6 hEPI vs 0.9 SSFP, P Ͻ 0.001). Results for GRE were intermediate for all assessments. Conclusion:The hEPI sequence scored best for diagnostic performance despite the SSFP sequence having greater CNR. This trial favors hEPI for clinical myocardial perfusion CMR and suggests CNR should not be the sole criterion used to gauge the best candidate sequence.

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Steady-state free precession sequences in myocardial first-pass perfusion MR imaging: comparison with TurboFLASH imaging

Cited by 49 publications

References 27 publications

High-resolution myocardial stress perfusion at 3 T in patients with suspected coronary artery disease

High-resolution myocardial stress perfusion at 3 T in patients with suspected coronary artery disease

The Usefulness of Stress Perfusion MR using Steady State Free Precession Sequence for Depiction of Significant Coronary Artery Stenosis

Direct comparison of myocardial perfusion cardiovascular magnetic resonance sequences with parallel acquisition

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