Ischemic Heart Disease: What You See is What You Get
Thursday 6 May 2010
Room A4 13:30-15:30 Moderators: Andrew E. Arai and Jeanette Schulz-Menger

13:30 582. 

Integrating High Spatial-Resolution, 3D Whole-Heart Viability Imaging and Coronary MRA at 3Tesla - not available
Qi Yang1, Kuncheng Li1, Xiaoming Bi2, Jing An3, Heng Ma1, Feng Huang4, Renate Jerecic3, Debiao Li5

1Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China; 2Siemens Medical Solutions; 3Siemens Healthcare, MR Collaboration NE Asia; 4Invivo Corporation; 5Radiology, Northwestern University, Chicago, IL, United States

Previous contrast-enhanced whole-heart coronary MRA(CMRA) studies at 3.0T have shown high sensitivity and moderate specificity for the detection of stenosis in patients suspected of coronary artery disease (CAD). However, a major advantage of 3.0T contrast-enhanced CMRA is the potential to combine lumenographic information and associated myocardial viability in the same setting. The feasibility of integrating high spatial-resolution, 3D whole-heart viability imaging and coronary MRA at 3 Tesla has been evaluated in volunteer studies. No clinical results using this technique at 3T were available so far.

13:42 583. 

Three-Dimensional Stress Cardiac Magnetic Resonance Perfusion Imaging for the Detection of Coronary Artery Disease
Robert Manka1, Cosima Jahnke2, Sebastian Kozerke1, Viton Vitanis1, Gerard Crelier1, Rolf Gebker2, Bernhard Schnackenburg2, Peter Boesiger1, Eckart Fleck2, Ingo Paetsch2
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; 2German Heart Institute, Berlin, Germany

Dynamic 3D-CMR stress perfusion imaging provides high image quality and high diagnostic accuracy for the detection of significant coronary artery disease.

13:54 584. 

Fully Quantitative Perfusion Pixel Maps of First-Pass Contrast-Enhanced MRI for Coronary Artery Disease Detection: A Preliminary Evaluation in Patients
Li-Yueh Hsu1, Peter Kellman1, Hui Xue2, Jens Guehring2, Sven Zuehlsdorff3, Sujata M. Shanbhag1, W Patricia Bandettini1, Marcus Y. Chen1, Andrew E. Arai1
Laboratory of Cardiac Energetics, National Heart Lung and Blood Institute / NIH, Bethesda, MD, United States; 2Imaging and Visualization, Siemens Corporate Research, Princeton, NJ, United States; 3CMR Research and Development, Siemens Medical Solutions, Chicago, NJ, United States

In this study we present an automated approach for generating fully quantitative myocardial blood flow (MBF) pixel maps from first-pass contrast-enhanced perfusion MR images. The results of the MBF pixel maps were evaluated in patients with known or suspected coronary artery disease and correlated with coronary angiography. Our results show that the performance of MBF pixel maps is comparable to clinical interpretation. This automated approach shows the feasibility of quantitative perfusion imaging for coronary artery disease detection.

14:06 585.  

Free-Breathing, Black-Blood Cardiac Imaging Using Single-Shot BSSFP Sequence: A Feasibility Study
Xiaoming Bi1, Jingsi Xie2, Christopher Glielmi1, James Carr2, Debiao Li2, Sven Zuehlsdorff1
Siemens Healthcare, Chicago, IL, United States; 2Northwestern University, Chicago, IL, United States

The goal of this work was to 1) investigate the feasibility of free-breathing BB cardiac imaging using a single-shot bSSFP sequence; 2) compare the efficacy of two BB methods: double inversion recovery (DIR) and T2IR for this application. Parameters for DIR and T2IR were optimized based on numerical simulations. Volunteer studies show that good quality 2D cardiac images can be consistently acquired with effective blood suppression. DIR preparation results in images with higher SNR and CNR while T2IR provides effective blood nulling regardless of blood flow direction at the cost of myocardium signal intensity.

14:18 586.

Balanced Steady-State Free Precession Magnetic Resonance Images Edema in Acute Reperfused Myocardial Infarction – a Translational Study in Animals and Humans
Andreas Kumar1, Nirat Beohar2, Jain Mangalathu Arumana3, Debiao Li3, Matthias G. Friedrich1, Rohan Dharmakumar3
Stephenson CMR Centre, University of Calgary, Calgary, AB, Canada; 2Dept. of Cardiology , Northwestern University, Chicago, IL, United States; 3Dept. of Radiology, Northwestern University, Chicago, IL, United States

We assessed the role of balanced steady-state free precession magnetic resonance for imaging of myocardial edema in acute reperfused myocardial infarction. In an experimental animal model as well as in patients with ST-elevation myocardial infarction, we found a close correlation of hyperintense b-SSFP signal areas with T2-STIR as a reference standard. Contrast-to-noise was not different between both sequences, and the area of b-SSFP hyperintensity was consistently larger than the area of irreversible injury on late contrast enhancement, consistent with b-SSFP reflecting the area-at-risk in acute ischemia-reperfusion injury. B-SSFP may evolve as a novel approach for myocardial edema imaging.

14:30 587. 

Myocardial T2 Using Single-Shot Turbo Spin Echo: Regional Trends in Healthy Controls and Myocardial Infarction
Kelvin Chow1, Jacqueline A. Flewitt2,3, Jordin D. Green4, Matthias G. Friedrich2,3, Richard B. Thompson1
1Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada; 2Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada; 3Radiology, University of Calgary, Calgary, Alberta, Canada; 4Siemens Healthcare, Calgary, Alberta, Canada

A modified single-shot turbo spin echo (HASTE) sequence was used to generate quantitative T2 maps in a single breath-hold per slice.  Whole heart T2 maps (3 short-axis slices) for a population of healthy subjects show regional variations in T2, with increased values at the apex and decreased values on the lateral wall of the basal slice.  T2 maps for a patient with acute myocardial infarction shows elevated T2 in inferoseptal regions overlapping with occluded artery perfusion territory and regions of late gadolinium enhancement.  11 patients showed abnormal (mean + 3SD) T2 in 33% of regions.

14:42 588. 

Heterogeneous Tissue Injury After AF Ablation Defined by LGE MRI
Christopher John McGann1, Eugene Kholmovski, Joshua Blauer, Akram Shaaban, Brent Wilson, Josh Bertola, Carl Bohman, Edward DiBella, Rob MacLeod, Dennis Parker, Nassir Marrouche
1Cardiology and Radiology, University of Utah Health Sciences Center, Salt Lake City, UT, United States

Late gadolinium enhancement (LGE) weeks to months post atrial fibrillation ablation injury shows left atrial (LA) wall enhancement due to scarring. LGE imaging has proven useful in guiding repeat procedures by identifying regions of viable tissue and incomplete pulmonary vein isolation.  Here we show heterogeneous LA tissue injury immediately post ablation with non-enhancing regions on LGE imaging.   These imaging findings have not previously been described and may be useful to further define tissue injury caused by RF energy delivery and help predict late scarring.

14:54 589. 

Cardiac  Fat -Water Imaging: Early Experience and Clinical Utility
Mark L. Schiebler1, Karl K. Vigen2, Christopher J. Francois2, Scott K. Nagle2, Ann Shimikawa3, Hanzhou Yu3, Jean H. Brittain4, Scott B. Reeder2
1Radiology, UW Madison , Madison, WI, United States; 2Radiology, UW Madison, Madison, WI, United States; 3Applied Science Lab, General Electric, Menlo Park, CA, United States; 4Applied Science Lab, General Electric, Madison, WI, United States

Cardiac imaging with fat water separation is useful in defining a number of cardiac and extracardiac disorders: pericarditis, mediatstinal masses, and myocardial viability all show improved detection with fat water separation techniques.

15:06 590.

Accurate Left Ventricular Chamber Quantification Is Feasible Using  Cardiovascular Magnetic Resonance at 7T
Florian von Knobelsdorff-Brenkenhoff1,2, Tobias Frauenrath3, Marcel Prothmann2, Matthias Dieringer2,3, Fabian Hezel3, Wolfgang Renz, 3,4, Kerstin Kretschel1,2, Thoralf Niendorf, 2,3, Jeanette Schulz-Menger1,2
1Franz-Volhard-Klinik for Cardiology, HELIOS Klinikum Berlin, Berlin, Germany; 2Experimental and Clinical Research Center (ECRC), Charité Campus Buch, Humboldt-University, Berlin, Germany; 3Berlin Ultrahigh Field Facility, Max-Delbrueck Center for Molecular Medicine, Berlin, Germany; 4Siemens Healthcare Sector, Erlangen, Germany

We explored the feasibility to accurately assess left ventricular (LV) dimensions and function at 7T by using 2D FGRE cine imaging and comparing the results to SSFP at 1.5T as the current gold standard. FGRE at 7.0T provided excellent blood/myocardium contrast and LV parameters with close agreement to SSFP. Thus, the combination of small slice thickness (4mm) and ultrahigh field together wit local TX/RX coils facilitated a sufficient SNR and CNR, which holds the promise for accurate functional cardiac imaging at 7T.

15:18 591

In Vivo Cardiac MR Elastography in a Single Breath Hold
Arunark Kolipaka1, Philip A. Araoz1, Kiaran P. McGee1, Armando Manduca1, Richard L. Ehman1
1Radiology, Mayo Clinic, Rochester, MN, United States

Current implementations of cardiac MRE are slow and require multiple breath holds to collect the data required for processing. This work shows an optimized MR elastography (MRE) acquisition strategy capable of obtaining 4 wave images of one polarization of motion in the diastolic and systolic phases of the cardiac cycle, each in one breath hold. The phase-difference SNR and stiffness measurements of the myocardium are comparable in volunteers at end-diastole and end-systole. This technique is also capable of acquiring multiple phases of the cardiac cycle in one breath hold.



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