Contrast-free high-resolution 3D magnetization transfer imaging for simultaneous myocardial scar and cardiac vein visual
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RESEARCH ARTICLE
Contrast‑free high‑resolution 3D magnetization transfer imaging for simultaneous myocardial scar and cardiac vein visualization Karina López1 · Radhouene Neji1,2 · Rahul K. Mukherjee1 · John Whitaker1 · Alkystis Phinikaridou1 · Reza Razavi1 · Claudia Prieto1 · Sébastien Roujol1 · René Botnar1 Received: 30 July 2019 / Revised: 27 January 2020 / Accepted: 29 January 2020 © The Author(s) 2020
Abstract Objective To develop a three-dimensional (3D) high-resolution free-breathing magnetization transfer ratio (MTR) sequence for contrast-free assessment of myocardial infarct and coronary vein anatomy. Materials and methods Two datasets with and without off-resonance magnetization transfer preparation were sequentially acquired to compute MTR. 2D image navigators enabled beat-to-beat translational and bin-to-bin non-rigid motion correction. Two different imaging sequences were explored. MTR scar localization was compared against 3D late gadolinium enhancement (LGE) in a porcine model of myocardial infarction. MTR variability across the left ventricle and vessel sharpness in the coronary veins were evaluated in healthy human subjects. Results A decrease in MTR was observed in areas with LGE in all pigs (non-infarct: 25.1 ± 1.7% vs infarct: 16.8 ± 1.9%). The average infarct volume overlap on MTR and LGE was 62.5 ± 19.2%. In humans, mean MTR in myocardium was between 37 and 40%. Spatial variability was between 15 and 20% of the mean value. 3D whole heart MT-prepared datasets enabled coronary vein visualization with up to 8% improved vessel sharpness for non-rigid compared to translational motion correction. Discussion MTR and LGE showed agreement in infarct detection and localization in a swine model. Free-breathing 3D MTR maps are feasible in humans but high spatial variability was observed. Further clinical studies are warranted. Keywords Fibrosis · Coronary vessels · Magnetic resonance imaging
Introduction MRI plays an important role for non-invasive assessment of myocardial fibrosis in patients with ischemic and nonischemic cardiomyopathies. Myocardial scar assessment has been shown to have important prognostic value [1–3]. Furthermore, in patients requiring cardiac resynchronization therapy, detection of focal fibrosis and coronary sinus/ vein anatomy may help to guide the intervention [4]. In Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10334-020-00833-9) contains supplementary material, which is available to authorized users. * Karina López [email protected] 1
School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital, 3rd Floor Lambeth Wing, London SE1 7EH, UK
MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK
2
these applications, the accurate discrimination of fibrotic or scarred tissue from surrounding healthy myocardium is crucial. Late gadolinium enhancement (LGE) MRI is the gold standard for the assessment of myocardial fibrosis [5]. LGE shows enhanced signal inte
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