ISMRM 24th Annual Meeting & Exhibition 07-13 May 2016 Singapore

Combined Educational & Scientific Session: Regional Function & Cardiac Tissue Characterization

Skill Level: Intermediate to Advanced

Organizers: Martin Graves Ph.D. & Jeanette Schulz-Menger, M.D.

Wednesday 11 May 2016

The characterisation of cardiac tissue encompasses a number of approaches including techniques for imaging myocardial strain as well as quantitative relaxation time mapping. This session will provide invited perspectives on the latest developments in the assessment of regional cardiac function and tissue microstructure, interleaved with cutting-edge scientific developments.

Target Audience
Clinicians, scientists and engineers who wish to be appraised of the state-of-the-art in cardiac tissue function and characterisation.

Educational Objectives
Upon completion of this course, participants should be able to:

  • Critically appraise the various methods for the evaluation of cardiac tissue function and characterisation;
  • Review and integrate the latest scientific developments in the field into their own practice; and
  • Design clinical/research workflows that incorporate state-of-the-art techniques for cardiac tissue function and characterisation.

Moderators: Daniel Ennis, Bernd Wintersperger
Tissue Phase Mapping & more: new Insights into Regional Cardiac Function
Bernd Jung1
1University Hospital Bern
The purpose of this talk is the presentation of an overview of the different MRI approaches to measure regional cardiac function. Such methods go beyond the routinely used standard CINE images (providing global functional parameters such as ventricular volumes) and include myocardial  tagging, DENSE, SENC and Tissue Phase Mapping. The latter technique measures myocadial velocities and will be discussed in somewhat more detail. Some recent studies are presented also including the determination of strain values from velocity data. Finally, feature tracking based on SSFP CINE images is illustrated which can also be used to determine strain values.

Associations between Inflammatory Markers and Global Systolic Function Measured by MRI: The Multi-Ethnic Study of Atherosclerosis (MESA)
Amir Ali Rahsepar1, Mohammadali Habibi2, Cheeling Chan3, Nadine kawel2, Kiang Liu3, Joao Lima2, and James Carr1
1Radiology, Northwestern University, Chicago, IL, United States, 2Cardiology, Johns Hopkins University, Baltimore, MD, United States, 3Preventive medicine, Northwestern University, Chicago, IL, United States
In this cross-sectional study, we investigated the associations between Inflammatory markers and global systolic function measured by MRI in The Multi-Ethnic Study of Atherosclerosis (MESA).

Potential application of tissue phase mapping in early detection of heart function deficiency in Fabry disease with cardiac manifestation
Yi-Ting Wu1, Hsu-Hsia Peng2, Meng-Chu Chang2, Ming-Ting Wu3, and Hsiao-Wen Chung1
1Graduate Institute of Biomedical Electronics and Bioinformatics, Taipei, Taiwan, 2Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan, 3Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Fabry disease is an X chromosome-linked genetic disease that can lead to cardiac dysfunction later in life. For early detection of heart function deficiency, velocity information in the myocardium obtained in a cardiac cycle using MR tissue phase mapping (TPM) can potentially provide a preclinical diagnosis of Fabry cardiomyopathy. Regional MR TPM analysis was performed on 7 Fabry disease patients and 22 healthy subjects. Preliminary results demonstrated significantly delayed time course as well as decreased velocity amplitudes in myocardial contractions in the patients. MR TPM may find useful value in early detection of myocardial defects.

Innovations in Cardiac Tissue Characterization
Sonia Nielles-Vallespin1,2, Pedro Ferreira2, Ranil de Silva2, Andrew D Scott2, Philip Kilner2, Daniel Ennis3, Eric Aliotta3, Peter Kellman1, Dimitru Mazilu1, Robert S Balaban1, Dudley J Pennell2, David N Firmin2, and Andrew E Arai1
1National Institutes of Health, MD, United States, 2Imperial College of London, Royal Brompton Hospital, London, United Kingdom, 3University of California, CA, United States
This study shows that helical and laminar microstructures in the myocardium and their dynamic reorientations during cardiac contraction can be studied by in vivo cDTI non-invasively and non- destructively. Furthermore, it demonstrates in the loaded and beating heart in vivo that sheetlet reorientation is the predominant mechanism underlying myocardial LV wall thickening during systolic contraction. Further study of the microstructural dynamics of cardiac contraction and myocardial dysfunction with in vivo cDTI may produce new diagnostic and prognostic information in human cardiac disease. 

Free-breathing Diffusion Tensor Imaging of the In Vivo Human Heart - Stimulated Echo vs. Spin Echo Acquisition
Constantin von Deuster1,2, Christian T. Stoeck1,2, Martin Genet2, David Atkinson3, and Sebastian Kozerke1,2
1Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom, 2Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland, 3Centre for Medical Imaging, University College London, London, United Kingdom
In vivo cardiac Diffusion Tensor Imaging (DTI) using the Stimulated Echo Acquisition Mode (STEAM) is particularly challenging during free breathing acquisition. To address this limitation, spin echo (SE) sequences employing motion-compensated diffusion gradients may be used. In this work, scan time, SNR efficiency and diffusion tensor metrics are compared between the STEAM method and a second-order motion compensated SE approach. For SE, SNR and gating efficiency were increased by 2.65 and 29% relative to STEAM, respectively. It is concluded that the SE method is an attractive alternative to STEAM based approaches for in vivo free-breathing cardiac DTI.

Characterization of Myocardial Fiber Orientation to Assess Therapeutic Exosomes from Cardiosphere-derived Cells (CDCs) in Myocardial Infarcted Porcine with In Vivo Diffusion-Tensor CMR on a Clinical Scanner
Christopher Nguyen1, James Dawkins2, Xiaoming Bi3, Debiao Li1,4, and Eduardo Marban2
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 2Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 3Siemens Healthcare, Los Angeles, CA, United States, 4Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
Diffusion-Tensor cardiovascular magnetic resonance (DT-CMR) is capable of mapping myocardial fiber orientation. In myocardial infarction (MI) murine models, DT-CMR can identify the effects of stem cell therapy on myocardial fiber orientations. The study illustrated the powerful potential of DT-CMR in identifying adverse treatment despite successful delivery of viable stem cells. However, it remains to be seen if this recent work is translatable to large animal and clinical studies. In a MI porcine model, in vivo DT-CMR revealed that myocardial fiber orientation was preserved with CDC-derived exosome treatment and adversely changed with placebo treatment consistent with observed viability and function changes.

Resolving Microscopic Fractional Anisotropy in the Heart
Irvin Teh1, Henrik Lundell2, Hannah J Whittington1, Tim Bjrn Dyrby2, and Jrgen E Schneider1
1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom, 2Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
Diffusion tensor imaging (DTI) is widely used for structural characterization of the heart. However, the measured fractional anisotropy (FA) is influenced by diffusion anisotropy as well as orientation dispersion. In the heart, orientation dispersion is ubiquitous and stems from the transmural variation in cardiomyocyte orientation and regions where multiple cell populations intersect. We propose microscopic FA (FA) as a more robust measure of intrinsic diffusion anisotropy that is insensitive to orientation dispersion, and demonstrate this with simulations and ex vivo MRI.

Adjournment & Meet the Teachers

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