Reproducibility of left ventricular mass measurement using a half-Fourier black-blood single-shot fast spin-echo sequence within a single breath hold: comparison with a conventional multiple breath-hold segmented gradient echo technique in patients

Robust automated bolus tracker positioning for MRI liver scans

PURPOSE

To improve the workflow of MRI abdominal scans by reducing the examination time and operator skill dependence related to bolus tracker positioning.

METHODS

Ten or more axial images of two-dimensional scout scan were analyzed to identify the aorta and detect its center position using the mean shift to allow automated bolus tracker placement. Adaptive boosting (AdaBoost) classifier was used to identify the aorta rotating a sub-window around the cerebrospinal fluid (CSF), the location of which was detected in each axial image in advance. The search region of the aorta in the next inferior axial image was restricted to half to reduce computation time. Tests were conducted using the proposed method with a 1.5T scanner in 31 volunteers.

RESULTS

The success rate of aorta detection was 98.4%, and the accuracy of center location was around 0 - 5mm shift from the true center. The computation time was 30s on MATLAB, which was half that required for non-restrictive search.

CONCLUSION

The proposed algorithm was able to accurately detect the aorta in all volunteers with practical computation time so that the automated bolus tracker placement improved the workflow of MRI abdominal scans.

Refinement of cardiac NMR imaging in awake hamsters: proof of feasibility and characterization of cardiomyopathy

The goal of this study was to demonstrate the feasibility of cardiac NMR imaging in conscious hamsters and its usefulness in evaluating cardiac abnormalities in a small-animal model of cardiomyopathy. Awake hamsters, controls and cardiomyopathic ones (CHF 147), were immobilized in a dedicated holder. Half-Fourier single-shot FSE imaging, with outer-volume suppression and 'black-blood' contrast provided images free from motion artifact with good visualization of cardiac anatomy at any point in the cardiac cycle. Series of double-oblique views were acquired with or without electrocardiograph gating. Image acquisition time was 55 ms, with an in-plane resolution of 470 x 625 microm2. Left ventricular volumes, ejection fraction, and myocardium NMR signal heterogeneity were compared in CHF 147 and control hearts. Left ventricles of CHF 147 hamsters were dilated, as indicated by the increase in end-diastolic cavity volume (299 +/- 79 mm3 compared with the controls (141 +/- 39 mm3; P = 0.0002). Left ventricular ejection fraction was largely reduced (45 +/- 9% vs 86 +/- 4%; P < 0.0001). The NMR signal distribution at an effective echo time of 41 ms was more heterogeneous in the myocardial wall of CHF 147 hamsters than in controls (1.87 +/- 0.37 a.u. vs 0.98 +/- 0.12 a.u., respectively; P = 0.0002). This study is a refinement of animal experimentation, as it demonstrates for the first time that characteristic features of cardiac pathology can be evaluated with ultra-fast NMR imaging in conscious small rodents.

CMR of Ventricular Function

Cardiovascular magnetic resonance (CMR) is the reference standard for the assessment of ventricular dimensions, function, and mass in terms of accuracy and reproducibility. It has been thoroughly validated both ex vivo and against other imaging techniques. Measurements are highly accurate and no geometrical assumptions need to be made about the ventricle. A routine ventricular dataset of images can be acquired in less than 5 minutes and analyzed in about the same time. The field is rapidly advancing with increasing automation and simplification in both image acquisition and analysis. Using parallel and real time imaging techniques, good quality data can be obtained even in patients who are unable to hold their breath. While providing useful information in all patients with suspected heart failure, CMR should particularly be considered in those with poor echo windows, where it can also be combined with myocardial stress. Tagging techniques can provide highly detailed information about myocardial torsion and strain for individual myocardial segments. In a research environment, the very high degree of interscan reproducibility can dramatically reduce the number of patients needed to perform clinical trials.

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

PURPOSE

To theoretically and experimentally investigate the influence of the automated cardiovascular magnetic resonance (CMR) scan planning pitfalls, namely inaccurate positioning and tilting of short-axis (SA) imaging planes, on quantification of the left ventricular (LV) dimensions and function.

MATERIALS AND METHODS

Eleven healthy subjects and eight patients underwent CMR. Manually and automatically planned SA sets were acquired. To obtain the quantitative measurements of LV function, one observer performed image analysis twice. The agreement between planning methods, as well as the decomposition of the total variation into interstudy and intraobserver components was measured.

RESULTS

The decomposition of the total variation showed that the interstudy factor accounts for 70-85% of the total variation, while the rest is due to the intraobserver factor. Moreover, the relative contribution of the interstudy factor remains independent from errors in slice positioning and small angular deviation of SA stacks from the optimal orientation. Good agreement between the theoretical and measured variability factors was observed.

CONCLUSION

Global LV function derived from the automatically planned CMR acquisitions yield accurate quantification of the human cardiovascular system. Inaccurate positioning and tilting of SA images does not affect the quantitative measurements of LV function. The computer-aided system for automated CMR has proven clinical applicability.

Fast Measurement of Left Ventricular Mass With Real-Time Three-Dimensional Echocardiography

BACKGROUND

Left ventricular (LV) mass is an important predictor of morbidity and mortality, especially in patients with systemic hypertension. However, the accuracy of 2D echocardiographic LV mass measurements is limited because acquiring anatomically correct apical views is often difficult. We tested the hypothesis that LV mass could be measured more accurately from real-time 3D (RT3D) data sets, which allow offline selection of nonforeshortened apical views, by comparing 2D and RT3D measurements against cardiac MR (CMR) measurements.

METHODS AND RESULTS

Echocardiographic imaging was performed (Philips 7500) in 21 patients referred for CMR imaging (1.5 T, GE). Apical 2- and 4-chamber views and RT3D data sets were acquired and analyzed by 2 independent observers. The RT3D data sets were used to select nonforeshortened apical 2- and 4-chamber views (3DQ-QLAB, Philips). In both 2D and RT3D images, LV long axis was measured; endocardial and epicardial boundaries were traced, and mass was calculated by use of the biplane method of disks. CMR LV mass values were obtained through standard techniques (MASS Analysis, GE). The RT3D data resulted in significantly larger LV long-axis dimensions and measurements of LV mass that correlated with CMR better (r=0.90) than 2D (r=0.79). The 2D technique underestimated LV mass (bias, 39%), whereas RT3D measurements showed only minimal bias (3%). The 95% limits of agreement were significantly wider for 2D (52%) than RT3D (28%). Additionally, the RT3D technique reduced the interobserver variability (37% to 7%) and intraobserver variability (19% to 8%).

CONCLUSIONS

RT3D imaging provides the basis for accurate and reliable measurement of LV mass.

Assessing gene and cell therapies applied in striated skeletal and cardiac muscle: is there a role for nuclear magnetic resonance?

Gene and cell therapies convey high hopes for treatment of skeletal and heart muscle diseases. In the experimental protocols under development as well as in the first clinical trials, longitudinal control by an atraumatic procedure is needed. Nuclear magnetic resonance (NMR), via its two modalities, imaging or spectroscopy, should play a major role both for in vivo animal and human studies, because of the great number of parameters that can be measured, sequentially or simultaneously, and because of its aptitude to monitor several steps of protocols, in particular to detect physiological modifications induced by therapies. We review here the many possible applications of nuclear magnetic resonance in gene/cell therapies where muscle is the target organ, with emphasis on the application of nuclear magnetic resonance to functional studies.

Ultrafast multiplanar determination of left ventricular hypertrophy in spontaneously hypertensive rats with single-shot spin-echo nuclear magnetic resonance imaging

OBJECTIVE

To determine whether left ventricular hypertrophy can be correctly evaluated in hypertensive rats with a new nuclear magnetic resonance (NMR) imaging modality that is relatively simple to operate and provides results of constant quality while offering a high signal-to-noise ratio. DESIGN Left ventricular mass as calculated from the NMR imaging analysis was compared with the actual left ventricular mass measured by gravimetry.

METHODS

Single-shot ultrafast spin-echo (SSFSE) imaging of hearts of Wistar-Kyoto rats and spontaneously hypertensive rats was performed at 4 T. Left ventricular mass was determined by using Simpson's rule on stacks of images acquired in systole and diastole.

RESULTS

SSFSE NMR imaging performed in systole or in diastole evaluated and quantified left ventricular hypertrophy in hearts of spontaneously hypertensive rats very similarly to gravimetry. The left ventricular mass as determined by NMR was in good accordance with the actual left ventricular weight (SEE: 30.39 and 35.86 mg for the systolic and diastolic NMR acquisitions, respectively).

CONCLUSION

Using an SSFSE sequence, high-quality NMR images of the rat heart can be generated very reliably with sufficient contrast and temporal and spatial resolution, and allow precise, non-invasive and fast characterization of left ventricular hypertrophy in a hypertensive rat model.