ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Novel Techniques for Cardiac Perfusion & Function

Friday 5 June 2015

Room 714 A/B

08:00 - 10:00


Vincent B. Ho, M.D., M.B.A., T.B.A.

08:00 1003.   Multi-center Evaluation of Accelerated 3D Magnetic Resonance Perfusion Imaging for Assessing Myocardial Ischemic Burden to Detect Coronary Heart Disease
Robert Manka1,2, Lukas Wissmann2, Rolf Gebker3, Roy Jogiya4, Manish Motwani5, Michael Frick6, Sebastian Reinartz6, Bernhard Schnackenburg3, Markus Niemann2, Alexander Gotschy1, Christiane Kuhl6, Eike Nagel4, Eckart Fleck3, Thomas F Luescher1, Sven Plein5, and Sebastian Kozerke2,4
1University Hospital Zurich, Zurich, Switzerland, 2University and ETH Zurich, Zurich, Switzerland, 3German Heart Institute, Berlin, Germany, 4King's College London, United Kingdom, 5University of Leeds, United Kingdom, 6University Hospital Aachen, Germany

In this multi-center study the diagnostic performance of accelerated 3D myocardial perfusion imaging to detect functionally relevant coronary heart disease (CAD) was assessed relative to the invasive fractional flow reserve (FFR) reference standard. The sensitivity and specificity of myocardial ischemic burden as a metric to assess severity of CAD were 84.7% and 92.3% relative to the FFR reference confirming excellent diagnostic yield of 3D perfusion imaging in a multi-center setting.

08:12 1004.   
Quantification of Myocardial Blood Flow using Non-ECG-Triggered MR Imaging with 3 Slice Coverage
David Chen1,2, Behzad Sharif1, Xiaoming Bi3, Janet Wei4, Louise E.J. Thomson4,5, C. Noel Bairey Merz5, Daniel S Berman1,4, and Debiao Li1,6
1Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, United States, 2Biomedical Engineering, Northwestern University, Evanston, IL, United States, 3MR R&D, Siemens Healthcare, Los Angeles, CA, United States, 4S. Mark Taper Foundation Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, United States, 5Barbara Streisand Women's Center, Cedars Sinai Medical Center, Los Angeles, CA, United States, 6David Geffen School of Medicine, University of California, Los Angeles, CA, United States

A single-bolus non-ECG-triggered method for quantifying myocardial blood flow is described. Beat-by-beat T1 mapping is used to derive the true arterial input function, eliminating the need for an additional scan. The imaging workflow is further simplified by retrospectively determining the proper reconstruction window, eliminating the dependency on ECG triggering. MBF values were validated compared to conventional dual-bolus ECG-triggered method. Stress studies were also performed to identify feasibility at elevated heart rates.

08:24 1005.   
Reduced Field-of-view Single-shot Spiral Perfusion Imaging
Yang Yang1, Li Zhao2, Xiao Chen1, Peter Shaw3, Jorge Gonzalez3, Frederick Epstein1,4, Craig Meyer1,4, Christopher Kramer3,4, and Michael Salerno3,4
1Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, 2Radiology, Harvard University, Boston, MA, United States, 3Medicine, University of Virginia, Charlottesville, VA, United States, 4Radiology, University of Virginia, Charlottesville, VA, United States

As the heart occupies only a small fraction of the chest, it is inefficient to support a FOV that covers the whole chest. We developed an outer-volume suppressed single-shot spiral perfusion sequence to achieve whole heart coverage with high spatial and temporal resolution with a FOV that only included the heart. We demonstrate the successful application of reduced FOV single-shot perfusion imaging which improves sampling efficiently, and reduces residual aliasing artifacts resulting in high quality perfusion images with very high temporal (8ms) and spatial (2mm) resolution.

08:36 1006.   Towards a synergistic application of multimodal MR/PET myocardial perfusion imaging: Measuring capillary transit time heterogeneity with MRI and blood flow with simultaneous N-13 Ammonia PET
Karl Philipp Kunze1, Christoph Rischpler1, Shelley Zhang2, Carmel Hayes3, Markus Schwaiger1, and Stephan Nekolla1
1Klinikum rechts der Isar der Technischen Universität München, München, Bayern, Germany, 2Brigham and Women's Hospital, Boston, MA, United States,3Siemens Medical Solutions, Erlangen, Bayern, Germany

This study aims to present a first synergistic approach to simultaneous MR/PET myocardial perfusion imaging. On the MR side, a new method to assess vascular dynamics by quantifying capillary transit time heterogeneity in different vasodilatation states is introduced. The advantages of transit time related perfusion parameters concerning quantification with MRI as compared to volume-related parameters such as flow are exploited for the first time with a specific physiological interpretation (oxygen extraction efficacy). MRI results are combined with an established method for flow quantification on the PET side, with patient data exemplifying the synergistic potential of the combined approach.

08:48 1007.   
Quantitative Dynamic Contrast Enhanced MRI in Acute ST-Elevated Myocardial Infarction: Blood Flow, Microvascular Permeability and Interstitial Volume in Infarct and Peri-Infarct Edema
David A Broadbent1,2, Ananth Kidambi2, Sven Plein2, and David L Buckley1,2
1Division of Medical Physics, University of Leeds, Leeds, West Yorkshire, United Kingdom, 2Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, West Yorkshire, United Kingdom

Dynamic Contrast Enhanced MRI has been used to quantify relative and absolute myocardial blood flow in health and disease. Measurement of additional parameters, including microvascular permeability and contrast agent distribution volumes, through application of a distributed parameter model, has also previously been reported. In this work these methods were applied in a cohort of patients with acute ST-Elevation Myocardial Infarction (STEMI) to allow assessment of these physiological parameters in infarcted and peri-infarct edematous myocardium.

09:00 1008.   
Accelerated Three-Dimensional Cine DENSE Strain Imaging in Three Minutes
Xiao Chen1, Daniel Auger1, Michael Salerno2,3, Craig H. Meyer1, Kenneth C. Bilchick4, and Frederick H. Epstein1
1Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, 2Radiology, University of Virginia, Charlottesville, VA, United States,3Cardiology, University of Virginia, Charlottesville, VA, United States, 4Medicine, Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States

3D Cine DENSE (Displacement ENcoding with Stimulated Echoes) imaging can offer, compared to tagging, high spatial resolution, equivalent accuracy and better reproducibility, and where strain analysis is less time consuming. However, the scan time is approximately 25 minutes, which is too long for routine clinical use. In the present study, we accelerated 3D spiral cine DENSE and shortened the scan time to ~3 minutes. High image quality was achieved and strain analysis showed expected values for normal subjects.

09:12 1009.   New Possibilities for Myocardial Strain Imaging using Acceleration and Iterative Reconstruction
Andreas Greiser1, Christoph Forman1, Jens Wetzel2, Michael Zenge3, Marie-Pierre Jolly4, and Edgar Mueller1
1Siemens AG, Healthcare, Imaging & Therapy Systems, Magnetic Resonance, Erlangen, Bavaria, Germany, 2Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nuernberg, Pattern Recognition Lab, Erlangen, Bavaria, Germany, 3Siemens Healthcare, NY, United States, 4Imaging and Computer Vision, Siemens Corporate Technology, Princeton, NJ, United States

Myocardial strain imaging (MSI) using higher PAT acceleration in combination with iterative reconstruction was explored. Using a speed-up factor of 4, we propose A) multiple incremental applications of the tag preparation in different cardiac phases to increase the tag contrast, B) to cover two heartbeats after tag application to include a later heartbeat with virtually no tagging contrast to improve the quantitative strain analysis and C) to enable the estimation of a global T1 value from a tagging image series enabled by covering multiple heartbeats. Iterative reconstruction significantly improved the image appearance and tag visibility in accelerated MSI.

09:24 1010.   Feasibility study of a novel acquisition technique of cardiac cine magnetic resonance imaging in patients with atrial fibrillation
Jian Cao1, Yining Wang1, Lingyan Kong1, Lu Lin1, Yan Yi1, Jing An2, Tianjing Zhang2, Michaela Schmidt3, Michael Zenge3, and Edgar Mueller3
1Radiology, Peking Union Medical College Hospital, Beiing, Beijing, China, 2MR Collaborations NE Asia, Siemens Healthcare, Beijing, Beijing, China, 3Siemens AG, Allee am Röthelheimpark, Erlangen, 91052, Germany
We implemented a newly developed prototype sequence in patients with atrial fibrillation, which promises to achieve high acceleration factors which enable triggered 2D real-time CINE MRI with significantly improved spatial and/or temporal resolution.With the application of new sequence, we could acquire high-quality cardiac cine images while greatly reduce the scan time. In future, it could be applied in more clinical patients.

09:36 1011.   
Isotropic 3-D CINE Imaging with Sub-2mm Resolution in a Single Breath-Hold
Jens Wetzl1,2, Michaela Schmidt3, Michael O. Zenge3, Felix Lugauer1, Laszlo Lazar4, Mariappan Nadar5, Andreas Maier1,2, Joachim Hornegger1,2, and Christoph Forman3
1Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 2Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 3Siemens AG, Healthcare, Imaging & Therapy Systems, Magnetic Resonance, Erlangen, Germany, 4Siemens SRL, Corporate Technology, Brasov, Romania, 5Siemens Corporation, Corporate Technology, Princeton, NJ, United States

MR CINE acquisitions represent the gold standard for the assessment of left ventricular function. Although recently introduced single breath-hold real-time 2-D CINE and 3-D CINE acquisitions feature a high in-plane resolution, small details could be missed by the low spatial resolution in slice direction. To address this limitation, a single breath-hold 3-D CINE acquisition is proposed in this work featuring an isotropic resolution below 2 mm. In-vivo experiments were performed on 5 healthy volunteers and cardiac function was compared to gold standard 2-D CINE.

09:48 1012.   Pericardial fat quantification using respiratory triggered 3D-Dixon pulse sequence
Rami Homsi1, Alois M. Sprinkart1,2, Julian Luetkens1, Juergen Gieseke1,3, Hans H. Schild1, Michael Meier-Schroers1, Daniel Kuetting1, Darius Dabir1, and Daniel Thomas1
1Radiology, University Hospital Bonn, Bonn, NRW, Germany, 2Institute of Medical Engineering, Ruhr-University Bochum, Bochum, Germany, 3Philips Healthcare, Best, Netherlands

MRI is increasingly used to quantify pericardial fat volume. This study introduces a new method to quantify pericardial fat with a respiratory triggered 3D-Dixon sequence in healthy subjects. Results are correlated to parameters of cardiovascular risk such as BMI, age and pulse wave velocity.