Radial-based acquisition strategies for pre-procedural non-contrast cardiovascular magnetic resonance angiography of the pulmonary veins.
Radial-based acquisition strategies for pre-procedural non-contrast cardiovascular magnetic resonance angiography of the pulmonary veins.
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DOI：
10.1186/s12968-020-00685-1
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发表时间：
2020-11-30
期刊：
影响因子：
--
通讯作者：
Edelman RR
中科院分区：
文献类型：
--
作者：
Aouad P;Koktzoglou I;Milani B;Serhal A;Nazari J;Edelman RR
在肺静脉（PV）隔离前接受评估的房颤患者中，通常会获得计算机断层扫描血管造影（CTA）或造影剂增强（CE）心血管磁共振血管造影（CMRA）。CTA的缺点包括辐射暴露和碘化造影剂给药的潜在风险。自由呼吸3D平衡稳态自由进动（bSSFP）非造影CMRA是一种潜在的成像选项，但由于笛卡尔k空间轨迹或在某些情况下不一致的呼吸门控往往会出现重影伪影和模糊，血管细节可能不理想。因此，我们探索了屏气和自由呼吸非造影CMRA的潜在效用，使用径向k空间轨迹，已知其对血流和运动伪影的敏感性低于笛卡尔。在6名健康受试者中比较了自由呼吸3D笛卡尔和径向星叠采集。此外，27例患者接受CTA和非造影CMRA进行PV标测。测试了三种径向CMR采集策略：（1）屏气（BH）2D径向bSSFP（BH-2D）;（2）屏气，多个薄板3D星状堆叠bSSFP（BH-SOS）;和（3）导航器门控自由呼吸（FB）使用空间非选择性RF激励的3D星星堆叠bSSFP（FB-NS-SOS）。使用非刚性配准算法来补偿屏气深度的变化。在健康受试者中，使用自由呼吸3D SOS采集的图像质量和血管清晰度明显优于自由呼吸（FB）笛卡尔3D。在患者中，使用所有三种径向CMRA技术获得诊断图像质量，BH-SOS和FB-NS-SOS优于BH-2D。BH-2D和CTA之间的PV最大直径总体相关性良好（两名阅片师的ICC = 0.87/0.83），BH-SOS和CTA之间的相关性极佳（ICC = 0.90/0.91），FB-NS-SOS和CTA之间的相关性良好至极佳（ICC = 0.87/0.94）。对于肺静脉面积，BH-2D与CTA之间的相关性总体良好（ICC = 0.79/0.83），BH-SOS与CTA之间的相关性良好至极好（ICC = 0.88/0.91），FB-NS-SOS与CTA之间的相关性极好（ICC = 0.90/0.95）。与BH-2D（平均值= 6.02; P = 0.007）和FB-NS-SOS（平均值= 5.29; P = 0.002）相比，BH-SOS（平均值= 11.04）的CNR显著更高。我们的研究结果表明，自由呼吸stack-of-stars bSSFP技术在提供准确的肺静脉解剖结构和开口测量方面是有利的，而不会因非共振伪影而显著退化，并且图像质量比笛卡尔3D更好。对于呼吸门控不成功的患者，屏气薄层星状堆叠技术结合回顾性运动校正可能是一种有用的替代方法。
Computed tomography angiography (CTA) or contrast-enhanced (CE) cardiovascular magnetic resonance angiography (CMRA) is often obtained in patients with atrial fibrillation undergoing evaluation prior to pulmonary vein (PV) isolation. Drawbacks of CTA include radiation exposure and potential risks from iodinated contrast agent administration. Free-breathing 3D balanced steady-state free precession (bSSFP) Non-contrast CMRA is a potential imaging option, but vascular detail can be suboptimal due to ghost artifacts and blurring that tend to occur with a Cartesian k-space trajectory or, in some cases, inconsistent respiratory gating. We therefore explored the potential utility of both breath-holding and free-breathing non-contrast CMRA, using radial k-space trajectories that are known to be less sensitive to flow and motion artifacts than Cartesian. Free-breathing 3D Cartesian and radial stack-of-stars acquisitions were compared in 6 healthy subjects. In addition, 27 patients underwent CTA and non-contrast CMRA for PV mapping. Three radial CMR acquisition strategies were tested: (1) breath-hold (BH) 2D radial bSSFP (BH-2D); (2) breath-hold, multiple thin-slab 3D stack-of-stars bSSFP (BH-SOS); and (3) navigator-gated free-breathing (FB) 3D stack-of-star bSSFP using a spatially non-selective RF excitation (FB-NS-SOS). A non-rigid registration algorithm was used to compensate for variations in breath-hold depth. In healthy subjects, image quality and vessel sharpness using a free-breathing 3D SOS acquisition was significantly better than free-breathing (FB) Cartesian 3D. In patients, diagnostic image quality was obtained using all three radial CMRA techniques, with BH-SOS and FB-NS-SOS outperforming BH-2D. There was overall good correlation for PV maximal diameter between BH-2D and CTA (ICC = 0.87/0.83 for the two readers), excellent correlation between BH-SOS and CTA (ICC = 0.90/0.91), and good to excellent correlation between FB-NS-SOS and CTA (ICC = 0.87/0.94). For PV area, there was overall good correlation between BH-2D and CTA (ICC = 0.79/0.83), good to excellent correlation between BH-SOS and CTA (ICC = 0.88/0.91) and excellent correlation between FB-NS-SOS and CTA (ICC = 0.90/0.95). CNR was significantly higher with BH-SOS (mean = 11.04) by comparison to BH-2D (mean = 6.02; P = 0.007) and FB-NS-SOS (mean = 5.29; P = 0.002). Our results suggest that a free-breathing stack-of-stars bSSFP technique is advantageous in providing accurate depiction of PV anatomy and ostial measurements without significant degradation from off-resonance artifacts, and with better image quality than Cartesian 3D. For patients in whom respiratory gating is unsuccessful, a breath-hold thin-slab stack-of-stars technique with retrospective motion correction may be a useful alternative.
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影响因子：
2.8
作者：
Hamdan, Ashraf;Charalampos, Kriatselis;Fleck, Eckart
通讯作者：
Fleck, Eckart
影响因子：
5.9
作者：
Blanke, Philipp;Baumann, Tobias;Pache, Gregor
通讯作者：
Pache, Gregor
影响因子：
6.7
作者：
Krishnam, Mayil S.;Tomasian, Anderanik;Ruehm, Stefan
通讯作者：
Ruehm, Stefan
影响因子：
4.4
作者：
Hu, Peng;Stoeck, Christian T.;Smink, Jouke;Peters, Dana C.;Ngo, Long;Goddu, Beth;Kissinger, Kraig V.;Goepfert, Lois A.;Chan, Jonathan;Hauser, Thomas H.;Rofsky, Neil M.;Manning, Warren J.;Nezafat, Reza
通讯作者：
Nezafat, Reza
DOI：
10.1002/jmri.1880010303
发表时间：
1991-05-01
期刊：
JMRI-JOURNAL OF MAGNETIC RESONANCE IMAGING
影响因子：
--
作者：
WRIGHT, GA;HU, BS;MACOVSKI, A
通讯作者：
MACOVSKI, A