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

Combined Educational & Scientific Session

Cardiovascular Tissue Characterization

SKILL LEVEL: Intermediate

ORGANIZERS: Daniel B. Ennis, Ph.D. & Martin J. Graves, Ph.D.

Wednesday 3 June 2015

Cardiovascular tissue characterization is an emerging clinical technique with tremendous potential. This session will provide invited clinical perspectives on both myocardial tissue characterization and vessel wall characterization, interleaved with scientific presentations on advanced research topics.

Target Audience
Attendees possessing familiarity with the basic principles of tissue characterization will benefit from the talks presented in this session as it provides fresh clinical perspectives and the latest innovations.

Educational Objectives
As a result of attending this course, participants should be able to:
Differentiate the role of various myocardial tissue characterization techniques and their application in the clinic;
Evaluate the role of vessel wall characterization and emerging methods in the clinic; and
Integrate their augmented understanding of the principles of tissue characterization into their clinical and research work flows.

Moderators: Neville D. Gai, Ph.D., Richard B. Thompson, Ph.D.
13:30   What is the Clinical Value of Quantitative Myocardial Tissue Characterization?
Jeanette Schulz-Menger, M.D.
14:00 0661.   
Application of native myocardial T1 mapping in subjects with coronary microvascular dysfunction and no obstructive coronary artery disease
Jaime L. Shaw1,2, Janet Wei3, Puja K. Mehta3, David Chen1, Michael Nelson1,3, Louise E.J. Thomson3, Daniel S. Berman3, C. Noel Bairey Merz3, Debiao Li1,2, and Behzad Sharif1
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 2Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, 3Cedars-Sinai Heart Institute, Los Angeles, CA, United States

Abnormally elevated myocardial native T1 values are known to suggest diffuse myocardial fibrosis. In this study, we hypothesized that native myocardial T1 would be abnormally elevated in subjects with signs and symptoms of ischemia, no obstructive coronary artery disease (CAD), and suspected coronary microvascular dysfunction (CMD). We measured myocardial native T1 in symptomatic women with no obstructed CAD enrolled in a single-site cohort of the NHLBI-sponsored WISE-Coronary Vascular Dysfunction study. Relative to published normal native T1 values, native T1 values in women with signs and symptoms of ischemia and no obstructive CAD were significantly elevated.

14:12 0662.   Black-Blood Contrast-Enhanced MRI: Validation of a Novel Technique for the Diagnosis of Myocardial Infarction
Han W Kim1, Wolfgang G Rehwald2, David C Wendell1, Elizabeth R Jenista1, Lowie Van Assche1, Christoph Jensen1, Peter Filev1, Enn-Ling Chen1, Michele A Parker1, and Raymond J Kim1
1Cardiology/Medicine, Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center, Durham, NC, United States, 2Siemens Healthcare, NC, United States

PURPOSE. Flow-Independent Dark-blood DeLayed-Enhancement (FIDDLE) allows visualization of tissue contrast-enhancement with blood-pool suppression. METHODS. We validated FIDDLE in a canine model of myocardial infarction (MI) and demonstrated feasibility in patients. FIDDLE and standard delayed-enhancement-MRI (DE-MRI) were compared to histopathology (animals) and the infarct-related-artery by cath (patients). RESULTS. FIDDLE black-blood images were successfully obtained in all animals and patients, and provided improved accuracy for the diagnosis of MI compared with DE-MRI. CONCLUSIONS. We have developed a novel technique that provides tissue contrast-enhancement simultaneous with blood-suppression. Validation and feasibility is demonstrated for diagnosis of MI; additional applications are expected beyond cardiac imaging.

14:24 0663.   Cardiovascular Susceptibility Weighted Imaging Computed Using Water-Fat Separation Improves Intramyocardial Hemorraghe Detection Specificity
James Goldfarb1,2
1Department of Research and Education, Saint Francis Hospital, Roslyn, NY, United States, 2Biomedical Engineering, Stony Brook University, Stony Brook, New York, United States

A new susceptibility weighted imaging (SWI) method is implemented and evaluated for the detection of intramyocardial hemorrhage in myocardial infarction. Intramyocardial fat and hemorrhage are features of chronic and acute myocardial infarction, respectively. Use of fat-water separation processing before conventional SWI image construction removes susceptibility contributions from intramyocardial fat and improves the specificity of IMH detection. Results are presented from 20 patients with acute and chronic myocardial infarction.

14:54   What is the Clinical Value of Vessel Wall Characterization?
Tobias Saam, M.D.
15:06 0664.   Intracranial Vessel Wall MR Registry
Qi Yang1,2, Haiqing Song2, Hongqi Zhang2, Feng Ling2, Yiu-Cho Chung3, Lei Zhang3, Zhaoyang Fan1, Xin Liu3, Kuncheng Li2, and Debiao Li1
1Biomedical Imaging Research Institute, Cedars Sinai Medical Center, LA, CA, United States, 2Xuanwu Hospital, Beijing, Beijing, China, 3Shenzhen Institutes of Advanced Technology, Chinese Academic of Sciences, Shenzhen, Guangdong, China

The Intracranial Vessel Wall MR Registry sought to evaluate indications, image quality, safety and impact on patient management of clinical routine intracranial vessel wall MR in a large number of cases (n=325). Based on our data intracranial vessel wall MR is frequently performed in daily clinical routine. The most important indications were workup of atherosclerotic disease (32%), risk stratification in suspected dissection(25%), as well as assessment of venous sinus thrombosis (20%).

15:18 0665.   Evaluation of Distribution of Femoral Artery Atherosclerotic Disease in Asymptomatic Old Adults Using 3D MR Vessel Wall Imaging - permission withheld
Maobin Guan1, Huijun Chen2, Zhu Zhu1, Le He2, Qiang Zhang2, Niranjan Balu3, Chun Yuan2,3, and Xihai Zhao2
1Department of Radiology, Yangzhou First People's Hospital, Yangzhou, China, 2Center for Biomedical Imaging research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China, 3Department of Radiology, University of Washington, Seattle, WA, United States

This study investigated the atherosclerotic plaque distribution in different femoral artery segments of asymptomatic old adults by 3D MR vessel wall imaging. We found that femoral artery plaque was prevalent in old adults, particularly in the segment of popliteal artery segment of femoral artery. After normalized the natural vessel size along femoral artery longitudinally, we found that popliteal artery segment showed the largest plaque burden as measured by NWI among all femoral artery segments. Our findings suggest that more attention needs to be paid to the popliteal artery segment of femoral artery in old adults for atherosclerotic disease care.

15:30   Adjournment & Meet the Teachers