Time-resolved spin-labeled balanced SSFP cineangiography of the heart: a novel approach for visualizing intracardiac shu
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BioMed Central
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Time-resolved spin-labeled balanced SSFP cineangiography of the heart: a novel approach for visualizing intracardiac shunt Federico E Mordini*, Ioannis Koktzoglou and Robert R Edelman Address: NorthShore University HealthSystem, Evanston, IL, USA * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P71
doi:10.1186/1532-429X-12-S1-P71
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P71 © 2010 Mordini et al; licensee BioMed Central Ltd.
Introduction Present methods for intracardiac shunt evaluation have important technical limitations. For example, phase contrast imaging (PC) is sensitive to velocity encoding setting and angle of imaging plane. PC can also be difficult to interpret due to complex flow patterns and separation of morphologic from velocity images. Cine GRE sequences that involve saturation of inflowing blood have poor SNR. Methods requiring gadolinium have limited use within a single exam and in patients with renal insufficiency. A method that circumvents these technical limitations in shunt visualization is desirable.
Purpose We sought to develop a time-resolved spin-labeled technique (TRSL) to image tagged blood within the heart for visualization of intracardiac shunt.
nary veins to tag left atrial blood and in the inferior/superior vena cava to tag right atrial blood.
Results Tagged inflowing blood was depicted with high signal intensity (SI) while non-tagged blood was suppressed. In ASD patients, tagged blood with high SI in the left atrium (LA) was visualized crossing the atrial septum demonstrating left-to-right flow (white arrows, panel A). Nontagged blood with low SI is seen simultaneously in the right atrium (RA), right ventricle (RV), and left ventricle (LV). Mean CNR of shunt to RA blood was 19.4 (range 8.6-34.6). Flow was visualized both inplane (long/short axis) and throughplane (en face). Panel B shows the crosssectional (en face) view of a large ASD with white crosshairs defining its size and shape. Flow was visualized while maintaining good morphological assessment of
Methods Background signal was suppressed with a non-selective inversion radiofrequency pulse. Slice-selective inversion slabs were applied immediately thereafter to remagnetize the labeled blood pool. Remagnetized blood within the heart was visualized using an ECG gated, segmented, bSSFP readout at sequential inversion times. General parameters were FOV 340, matrix 128 × 100, slice thickness 6-8 mm, TR 46 ms, TE 1.3 ms, 30-40 phases reconstructed, breathhold time 12-14 seconds. The sequence was implemented on a 1.5 T Siemens Avanto scanner.
Figure 1
Six subjects with known atr
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