Myocardial Perfusion & Viability

Room 701 B


Chairs: Kerstin Bauner and Peter Kellman


Prog #

11:00 43

Text Box:  

Myocardial Perfusion MRI with Sliding Window and CG-HYPR

Lan Ge1, Aya Kino1, Natasha Berg1, Xin Liu1, Nicole Mascheri1, Mark Griswold2, Andrew Larson1, Charles Mistretta3, James Carr1, Debiao Li1

1Northwestern University, Chicago, Illinois, USA; 2Case Western Reserve University, USA; 3University of Wisconsin-Madison, Madison, Wisconsin, USA

Image quality and slice coverage for myocardial perfusion MRI are limited by the temporal resolution of current approaches. This work demonstrated the feasibility of sliding CG-HYPR for accelerated myocardial perfusion imaging with a temporal resolution of one time frame per cardiac cycle. Using this method, the acquisition time per cardiac cycle was reduced dramatically, which allows increasing the number of slices for myocardial perfusion imaging and reducing motion artifacts. The signal changes of left ventricle and myocardium were verified by the comparison to conventional methods. Mean correlation coefficients between sliding CG-HYPR and reference images are 0.9672, 0.9423 for blood and myocardial signals, respectively.

11:12  44 K-T-Space Accelerated Myocardial Perfusion

Bernd André Jung1, Matthias Honal1, Jürgen Hennig1, Michael Markl1

1University Hospital, Freiburg, Germany

Dynamic first-pass contrast-enhanced myocardial perfusion MRI is an important clinical tool that greatly benefits from acceleration in data acquisition in terms of spatial resolution or number of slices to acquire per heartbeat. Advanced dynamic parallel imaging techniques have been introduced such as k-t-SENSE and k-t-BLAST, k-t-GRAPPA, and PEAK-GRAPPA as an extension of k-t-GRAPPA to reduce total acquisition time or to increase spatiotemporal resolution. In a study with 11 patients an application of a k-t-space related GRAPPA technique to myocardial perfusion as non-periodic motion has been investigated.

11:24  45 Evaluation of Rigid and Non-Rigid Motion Compensation of Cardiac Perfusion MRI

Hui Xue1, 2, Jens Guehring2, Jo V. Hajnal1, Daniel Rueckert, Sven Zuehlsdorff3, Kinda Saddi2, Christophe Chefdhotel2

1Hammersmith Hospital, Imperial College London, London, UK; 2Siemens Corporate Research, Princeton, New Jersey, USA; 3Siemens Medical Solutions USA, Inc., Chicago, USA

Myocardial Perfusion MRI can be undermined by subject motion, which makes sequences of images acquired during contrast uptake inconsistent. In this work, the performance of rigid and non-rigid motion compensation techniques is evaluated on a multi-center perfusion dataset containing more than 500 individual time series, obtained under clinically relevant conditions.The results confirm that motion correction is a frequent requirement (67% of cases in this sample). The registration based methods we developed were found to be effective in 98.5% of the cases tested.

11:36 46 Investigating Myocardial Field Distortions During First Pass of a Gadolinium Based Contrast Agent in Perfusion Studies

Pedro Ferreira1, Peter Gatehouse2, David Firmin1, 2, Chiara Bucciarelli-Ducci1, 2, Ricardo Wage2

1Imperial College, London, UK; 2Royal Brompton Hospital, UK

Myocardial perfusion studies are often affected by the dark rim artifact, which mimics an under-perfused region. One of the possible origins pointed out in literature for this artifact is field distortion. In this work field distortions were measured during first pass of Gd-DTPA in the heart for 10 patients and compared to both phantom work and numerical simulations, which were found to agree well with the in-vivo data. Field distortions happen mainly in the myocardium wall, especially for more horizontal hearts, but appear to be too weak to cause any loss of signal.

11:48  47. Evaluation of Microvascular Function of Residual Viable Myocardium in Infarct Zone After Percutaneous Coronary Intervention: Quantitative Myocardial Blood Flow Measurement Using Magnetic Resonance

Mao-Yuan Su1, 2, Bai-Chien Lee3, Yen-Wen Wu3, Hsi-Yu Yu2, Woei-Chyn Chu4, Wen-Yih Isaac Tseng5, 6

1National Yang-Ming University, Taipei, Taiwan; 2National Taiwan University Hospital, taipei, Taiwan; 3National Taiwan University Hospital, Taipei, Taiwan; 4National Yang-Ming University, taipei, Taiwan; 5College of Medicine, National Taiwan University, Taipei, Taiwan; 6national Taiwan University Hospital, taipei, Taiwan

Left ventricular (LV) remodeling after acute myocardial infarction (AMI) is known to be associated with the size of the infarct myocardium. It has been reported that residual viable myocardium within the infarct zone plays a protective role against LV remodeling and is one of major determinants of regional functional recovery after AMI. In this study, we aimed to assess the microvascular function of the residual viable myocardium by using cardiovascular magnetic resonance (CMR) imaging to delineate the residual viable myocardium and quantify myocardial blood flow (MBF). Our results suggested that the microvascular function was generally impaired in the reperfused infarct zone, but more viability salvaged could preserve more microvascular function.

12:00  48 Balanced SSFP Myocardial BOLD Imaging: An Initial Evaluation in Patients with Known Coronary Artery Disease

Rohan Dharmakumar1, Jordin D. Green2, Jacqueline Flewitt3, Matthias Voehringer3, Neil G. Filipchuk3, Debiao Li1, 4, Matthias G. Friedrich3

1Northwestern University, Chicago, Illinois, USA; 2Siemens Medical Solutions, Calgary, Canada; 3University of Calgary, Calgary, Canada; 4Evanston, Illinois, USA

Oxygen-sensitive myocardial imaging may be an alternative to first-pass perfusion methods. This workdemonstrates that SSFP-based BOLD MRI can detect regional myocardial perfusion deficits in patientswith coronary artery disease.

12:12  49.   Pharmacokinetic Modelling of Delayed Gadolinium Enhancment in the Myocardium

Benjamin Richard Knowles1, Phillip G. Batchelor2, Victoria Parish1, Mathew Ginks2, Stephen Sinclair1, Sven Plein3, Reza Razavi2, Tobias Schaeffter2

1King's College London, London, UK; 2King's College London, UK; 3University of Leeds, Leeds, UK

Standard myocardial perfusion imaging in the myocardium uses a two compartmental model to quantify the related pharmacokinetic parameters; however, an accurate quantification of pharmacokinetics in areas of late enhancing myocardium requires the addition of a third compartment. We report the first use of such a model to describe the uptake of contrast agent in myocardial infarctions. We fitted a three compartment model to data from images acquired 1-20 minutes post contrast agent administration. Initial results show that this model successfully describes late enhancement and could potentially to be a valuable tool for the quantification of myocardial late enhancement

12:24  50. MR Quantification of Regional Myocardial Oxygen Consumption Rate

Kyle Stephan McCommis1, Haosen Zhang1, Robert J. Gropler1, Jie Zheng1

1Washington University School of Medicine, St. Louis, Missouri, USA

A cardiac MR method is demonstrated to quantify the regional myocardial oxygen consumption rate during hyperemia, by using the Fick’s principle. MRI data acquisition was performed in normal dogs, as well as dogs with a single vessel coronary stenosis. Each study session consisted of imaging at rest and pharmacologically-induced hyperemia. In normal dogs and normal myocardial regions of stenotic dogs, myocardial oxygen consumption rose similarly from the rest condition. However, the coronary artery stenosis attenuates the effect of hyperemia on the stenosis subtended region, which agrees well with other reports with human patients of coronary artery stenosis.

12:36 51 Quantified Delayed Enhancement in Myocardial Infarction Using Free Breathing Saturation Recovery SSFP

Christian Stehning1, Victoria Parish2, Stephen Sinclair2, Eike Nagel2, Hannes Dahnke1, Tobias Schaeffter2

1Philips Research, Hamburg, Germany; 2King's College, London, UK

We present a T1 mapping method allowing the quantification of contrast agent concentrations in infarcted myocardium is presented. A submillimeter spatial resolution allows to differentiate different infarct territories. The acquisition is performed during free breathing.

12:48 52. MRI for the Detection of Catheter Ablation Scars of the Right Atrial Isthmus in Patients with Atrial Flutter

David Maintz1, Murat Özgün1, Alexander Bunck1, Rene Botnar2, Walter Heindel1, Paulus Kirchhof1

1University of Münster, Münster, Germany; 2King's College, London, UK

In patients with atrial flutter, radiofrequency ablation of the isthmus between the inferior vena cava and the tricuspid valve is a common treatment procedure. In this study, we intended to investigate the feasibility to visualize ablation scars of the isthmus using MRI and to compare a standard breath-hold 2D scar imaging sequence with a high resolution free-breathing 3D scar sequence. 49 MR exams (28 before, 21 after RF ablation) were included. Sensitivity/specificity for the detection of ablation scars were 95%/79% (3D), 67%/89% (2D). We demonstrate that RF ablation scar can be visualized non-invasively with the use of T1w MRI. Visualization of scars of the isthmus in patients with atrial flutter may confirm procedural success of RF ablation and may correlate with clinical outcomes.