1
|
Laubrock K, von Loesch T, Steinmetz M, Lotz J, Frahm J, Uecker M, Unterberg-Buchwald C. Imaging of arrhythmia: Real-time cardiac magnetic resonance imaging in atrial fibrillation. Eur J Radiol Open 2022; 9:100404. [PMID: 35265735 PMCID: PMC8899235 DOI: 10.1016/j.ejro.2022.100404] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 01/02/2023] Open
Abstract
Objectives Quantitative evaluations of function, volume and mass are fundamental in the diagnostic workup of different cardiovascular diseases and can be exactly determined by CMRI in sinus rhythm. This does not hold true in arrhythmia as CMR is hampered by reconstruction artifacts caused by inconsistent data from multiple heartbeats. Real-time (RT) MRI at high temporal resolution might reduce these problems. Methods Consecutive patients with atrial fibrillation were prospectively included and underwent RT and conventional CINE CMR in randomized order. 29 patients were studied at 1.5 T and 30 patients at 3 T. At 3 T a group of 20 subjects in sinus rhythm served as controls. RT and CINE image quality was evaluated in different planes and for different wall sections using a Likert scale (from zero to four). Volumetric analysis was performed using two types of software and differences between RT and CINE CMR were evaluated. Results In patients with atrial fibrillation RT CMR short axis (SA) resulted in a significantly higher image quality compared to CINE imaging both at 1.5 T and 3 T (1.5 T: mid SA: 3.55 ± 0.5 RT vs 2.6 ± 0.9 CINE, p = 0.0001; 3 T: mid SA: 3.15 ± 0.9 RT vs 2.6 ±1.0 CINE, p = 0.03); This qualitative difference was more marked and significant for the long axis views (2CV and 4CV) at 1.5 T (1.5 T: 2CV: 3.2 ± 0.6 RT vs 2.65 ± 1.1 CINE; p = 0.011; 4CV: 2.9 ± 0.69 RT vs 2.4 ± 0.9 CINE; p = 0.0044). During sinus rhythm CINE images were superior concerning diagnostic quality (3 T mid SA: 3.35 ± 0.45 RT vs 3.8 ± 0.5 CINE, p = 0.008). Quantitative analysis was successful with both software packages and the results showed a good correlation (Pearson correlation between 0.679 and 0.921 for patients). RT CMR resulted in slightly lower functional volumes than CINE CMR (3 T: patients: EDVI 86 ± 29 ml/m2 RT vs 93 29 ml/m2± 29 CINE, Pearson r = 0.902) but similar ejection fractions (3 T: patients: EF 47 ± 16% RT vs 45 ± 13% CINE, Pearson r = 0679; controls: EF 63 ± 6 RT vs 63 ± 3 CINE, Pearson r = 0.695). Conclusion RT CMR improves image quality in arrhythmic patients and renders studies more comfortable. Volumetric analysis is feasible with slightly lower values relative to CINE CMR, while ejection fractions are comparable. Real time cardiac magnetic imaging is superior to conventional CINE in arrhythmias: concerning image quality. Volumetric and functional analysis of real time is comparable to CINE. Acquistion time is reduced in real time. Improvement of postprocessing software of real time imaging is mandatory.
Collapse
Affiliation(s)
- Kerstin Laubrock
- Departmentof Medicine II, St. Joseph Hospital, Wüsthoffstraße 15, 12101 Berlin, Germany
- Department of Cardiology and Pneumology, Georg-August University, Robert-Koch-Str. 40, 37075 Goettingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-AugustUniversity, Robert-Koch-Str.40, 37075 Goettingen, Germany
- Corresponding author at: Departmentof Medicine II, St. Joseph Hospital, Wüsthoffstraße 15, 12101 Berlin, Germany
| | - Thassilo von Loesch
- Institute for Diagnostic and Interventional Radiology, Georg-AugustUniversity, Robert-Koch-Str.40, 37075 Goettingen, Germany
- Doctor of Internal Medicine, Elise-Averdieck-Str. 17, 27356 Rotenburg,Wuemme Germany
| | - Michael Steinmetz
- DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen, Robert-Koch-Str.40, 37075 Goettingen, Germany
- Department of Pediatric Cardiology and Intensive Care Medicine,Georg-August University, Robert-Koch-Str. 40, 37075 Goettingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Georg-AugustUniversity, Robert-Koch-Str.40, 37075 Goettingen, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen, Robert-Koch-Str.40, 37075 Goettingen, Germany
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institute for Biophysical Chemistry, Am Faßberg 11, 37077 Goettingen, Germany
| | - Martin Uecker
- Institute for Diagnostic and Interventional Radiology, Georg-AugustUniversity, Robert-Koch-Str.40, 37075 Goettingen, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen, Robert-Koch-Str.40, 37075 Goettingen, Germany
- 7170 Institute of Biomedical Imaging, GrazUniversity of Technology, Stremayrgasse16/III, 8010 Graz, Austria
- Cluster of Excellence “Multiscale Bioimaging:from Molecular Machines to Networks of Excitable Cells” (MBExC) University ofGöttingen, Germany
| | - Christina Unterberg-Buchwald
- Department of Cardiology and Pneumology, Georg-August University, Robert-Koch-Str. 40, 37075 Goettingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-AugustUniversity, Robert-Koch-Str.40, 37075 Goettingen, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen, Robert-Koch-Str.40, 37075 Goettingen, Germany
- Correspondence to: Christina Unterberg-Buchwald, MD, Department of Cardiology and Pneumology, University Clinic Goettingen,Robert-Koch-Str. 40, 37075 Goettingen, Germany.
| |
Collapse
|