Myocardial Perfusion
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Monday 7 May 2012
Room 212-213  16:30 - 18:30 Moderators: Rohan Dharmakumar, Krishna S. Nayak

16:30 0152.   Accuracy of CMR Arterial Spin labeling Method for Detecting Myocardial Ischemia: in Comparison with PET
Jie Zheng1, David Muccigrosso1, and Robert J. Gropler1
1Washington University, Saint Louis, Missouri, United States

The accuracy of a CMR ASL method was evaluated in a canine model of myocardial ischemia, in comparison with PET in the same subject. There is very strong agreement in myocardial blood flow between CMR ASL and PET, despite that resting blood flow was underestimated by CMR ASL. Myocardial flow reserve was comparable between two imaging modalities.

16:42 0153.   
Detecting ACS and Identifying Acute Ischemic Territories with Cardiac Phase-Resolved BOLD MRI at Rest
Sotirios Tsaftaris1,2, Xiangzhi Zhou2, Richard Tang3, James Min3, Debiao Li2,3, and Rohan Dharmakumar2,3
1IMT - Institutions Markets Technologies, Lucca, LU, Italy, 2Northwestern University, Evanston, IL, United States, 3Cedars-Sinai Medical Center, Los Angeles, CA, United States

Noninvasive imaging approaches that can rapidly assess an ongoing ischemia can be of great value in detecting and triaging patients experiencing acute coronary syndromes (ACS), particularly in cases of non ST elevation myocardial infarction. We rely on detecting systolic and diastolic SSFP signal changes related to perturbation in cardiac phase-dependent blood volume and oxygenation associated with severe coronary narrowing on the basis of cardiac phase-resolved Blood-Oxygen-Level-Dependent imaging. We show (in canines) that we can assess functional/volumetric status and non-invasively identify ischemic territories under resting conditions in a single scan without any exogenous contrast media.

16:54 0154.   
CAIPIRINHA accelerated Myocardial First-Pass Perfusion Imaging with High Resolution and Extended Coverage – A Patient Study
Daniel Stäb1, Felix A. Breuer2, Christian Oliver Ritter1, Dietbert Hahn1, and Herbert Köstler1
1Institute of Radiology, University of Würzburg, Würzburg, Germany, 2Research Center Magnetic Resonance Bavaria, Würzburg, Germany

Applying CAIPIRINHA with an acceleration factor higher than the number of simultaneously acquired slices allows accelerating the imaging procedure in slice and phase encoding direction. The concept facilitates myocardial first-pass perfusion imaging with high spatial resolution and extended anatomic coverage of 6 to 8 slices every heart beat. In-vivo volunteer and patient studies are presented showing excellent image quality at a high spatial resolution of 2.0 x 2.0 mm2. Being easy to implement and providing short reconstruction times, the technique is suitable for application in clinical routine.

17:06 0155.   
Three-Dimensional k-t PCA Cardiac Magnetic Resonance Perfusion Imaging for Quantification of Myocardial Ischemic Burden in Patients with Coronary Artery Disease
Robert Manka1,2, Ingo Paetsch3, Cosima Jahnke3, and Sebastian Kozerke1
1Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Zurich, Switzerland, 2Department of Cardiology, University Hospital Zurich, Zurich, Zurich, Switzerland, 3Department of Cardiology, University Hospital RWTH Aachen

Three-Dimensional Cardiac Magnetic Resonance Perfusion Imaging offers high diagnostic performance with accurate and reliable assessment of myocardial ischemic burden in patients with coronary artery disease as defined by fractional flow reserve measurements during invasive coronary angiography.

17:18 0156.   
Three-dimensional first-pass cardiac perfusion MRI using a stack-of-spirals aquisition
Taehoon Shin1, Krishna S Nayak2, Juan M Santos3, Dwight G Nishimura1, Bob S Hu3,4, and Michael V McConnell5
1Electrical Engineering, Stanford University, Stanford, CA, United States, 2Electrical Engineering, University of Southern California, Los Angeles, CA, United States, 3Heart Vista Inc., Palo Alto, CA, United States, 4Palo Alto Medical Foundation, Palo Alto, CA, United States, 5Cardiovascular Medicine, Stanford University, Stanford, CA, United States

Three-dimensional first-pass myocardial perfusion imaging (MPI) has shown great promise for precise sizing of defects and for providing high perfusion contrast. It remains an experimental approach primarily due to poor spatial resolution and issues with motion. We have developed a rapid 3D MPI method using a stack-of-spirals acquisition accelerated by k-t SENSE, which allows whole-heart coverage with 2.4x2.4x9 mm3 spatial resolution. This approach correlates well with standard 2DFT method in terms of overall temporal dynamics and upslope of time intensity curves.

17:30 0157.   Comparison of Quantitative Myocardial Perfusion from Self-gated and Gated Acquisitions
Edward DiBella1, Srikant K. Iyer1, Ganesh Adluru1, Brian Martin1, Devavrat Likhite1, Chris J. McGann2, and Alexis Harrison2
1UCAIR/Radiology, University of Utah, Salt Lake City, Utah, United States, 2Cardiology, University of Utah, Salt Lake City, Utah, United States

Dynamic contrast enhanced MRI for characterizing perfusion in the myocardium is becoming a more robust and useful clinical tool. Methods for ungated acquisitions and retrospective self-gating were recently introduced. Such ungated imaging could be valuable whenever ECG-gating is poor, and in particular in patients with arrhythmias. Here we compare a self-gated perfusion acquisition directly to a gated acquisition in subjects in sinus rhythm, to determine how well quantitative perfusion values in ml/min/g can be obtained with the self-gated approach.

17:42 0158.   Reperfusion Intramyocardial Hemorrhage Following Acute Myocardial Infarction: Assessment using Magnetic Resonance Susceptibility Weighted High-Pass Filtered (HPF) Phase Imaging
James Goldfarb1,2, Usama Hasan1,3, Wenguo Zhao1, and Jing Han1
1Research and Education, St Francis Hospital, Roslyn, New York, United States, 2Biomedical Engineering, SUNY Stony Brook, Stony Brook, NY, United States,3New York College of Ostopathic Medicine, Old Westbury, NY, United States

The major aim of this study was to quantitatively investigate LV myocardial HPF-phase in gradient echo images in normal subjects to determine normal ranges as a function of TE and anatomical position and then compare HPF-phase values in patients with myocardial infarction of varying ages with normal ranges. Myocardial high pass filtered myocardial phase is small and normally varies by anatomical myocardial segment. Myocardial hemorrhage causes a significant phase decrease beyond these normal variations. HPF-phase images represent a quantitative, high quality method for the detection of myocardial hemorrhage without the need for the presence or high quality visualization of myocardial edema.

17:54 0159.   Automated Area at Risk Detection using Myocardial T1 maps acquired pre- and post Contrast Agent Administration permission withheld
Tobias Voigt1, Zhong Chen2, Christian Buerger2,3, Valentina Puntmann2, Reza Razavi2, Tobias Schaeffter2, and Andrea J. Wiethoff2,4
1Philips Research, London, United Kingdom, 2King's College London, London, United Kingdom, 3Philips Research, Hamburg, Germany, 4Philips Healthcare, Guildford, United Kingdom

This study presents a new method for automated segmentation of blood pool, infarct area, healthy myocardium and grey zone. A clustering algorithm was implemented based on two quantitative T1 maps acquired before and after contrast agent administration. First in vivo results obtained in patients with known ischemic cardiomyopathy (ICM) are shown and compared to late enhancement images where good agreement was observed.

18:06 0160.   Simultaneous Acquisition of Quantitative ASL and T2* (SQUAB) for Characterization of Skeletal Muscle Hemodynamics.
Ronn P Walvick1, Ruth P Lim1, and Vivian S Lee2
1Radiology, New York University Langone Medical Center, New York, NY, United States, 2The University of Utah, Salt Lake City, Utah, United States

BOLD and perfusion change rapidly in skeletal muscle following exercise. In this work, we propose a sequence that allows for simultaneous quantification of T2* and ASL using a sequence featuring dual-echo EPI readouts, and saturation prepared FAIR prepulses for blood labeling. This sequence was tested in a cohort of volunteers and a patient with peripheral arterial disease. We show considerable increases in T2*and blood flow from baseline following exercise in volunteers and a blunted, delayed patient response. Our results show the feasibility of quickly acquiring simultaneous blood flow and T2* data and demonstrate sensitivity to disease

18:18 0161.   
Influence of Nitroglycerin for Combined Coronary Lumen and Vessel Wall Magnetic Resonance Imaging
Tarique Hussain1, Markus Henningsson1, Britta Butzbach1, Marcelo Andia1, and Rene Botnar1
1King's College London, London, England, United Kingdom