Objectives
To determine the accuracy of three-dimensional k-t broad-use linear acquisition speed-up technique (k-t BLAST) accelerated magnetic resonance imaging (MRI) for the assessment of left ventricular (LV) parameters compared to segmented multiple breath-hold cine imaging.
Methods
A multislice cine (steady state free precession [SSFP]) sequence was performed with complete ventricular coverage during multiple breath-holds (temporal resolution 47 ms, voxel size 1.25 × 1.25 × 8 mm 3 ). In addition, two k-t BLAST sequences with complete coverage were acquired, KT1 (temporal resolution 57 ms, voxel size 1.25 × 1.25 × 4 mm 3 ) and k-t2 (temporal resolution 57 ms, voxel size 1.25 × 1.25 × 8 mm 3 ), during a single breath-hold. For comparison of SSFP and k-t BLAST, LV parameters were determined: ejection fraction (EF), end-diastolic volume, end-systolic volume, and LV mass.
Results
EF was underestimated by KT1 (47%) and KT2 (48%) compared to the SSFP sequence (53%). All parameters showed high correlation with the k-t BLAST sequences and the SSFP sequence ( r = 0.88–0.98, P < .001). The mean relative difference for KT1/KT2 compared to the SSFP sequence was −0.11/−0.09 for the EF, −0.073/−0.086 for the EDV, 0.044/0.051 for the ESV, and 0.085/0.12 for the LV mass.
Conclusions
The use of three-dimensional k-t BLAST enabled a determination of the LV parameters with high correlation compared to the SSFP sequence. EF was slightly underestimated, and LV mass was slightly overestimated.
Cardiovascular magnetic resonance imaging (MRI) is known as the standard of reference for the assessment of global left ventricular (LV) parameters, which allows the accurate and reproducible acquisition of LV volumes and mass . Imaging the beating heart with the use of MRI is challenging as both cardiac and respiratory motions have to be compensated. However, for the examination of LV function including the assessment of global LV functional parameters as well as for the assessment of regional wall motion abnormalities, MRI is considered the gold standard for a long time . Some requirements have to be fulfilled to provide the high diagnostic accuracy of MRI in the assessment of LV function. A spatial resolution of at least 2.5 mm in in-plane orientation, a temporal resolution of about 50 ms per frame, and a slice thickness of 8 mm or less should be used . The high-resolution segmented cine steady state free precession (SSFP) technique, which is the most widely used and investigated technique, can be considered as the reference technique. However, this technique consists of a time-consuming acquisition of multiple short-axis slices for coverage of the entire ventricle, so patients are required to perform multiple breath-holds .
Thus, several techniques based on parallel imaging (generalized autocalibrating partially parallel acquisition [GRAPPA], sensitivity encoding [SENSE]) were introduced for shortening the acquisition time. These techniques enable the acquisition of a reduced data set by undersampling in k-space taking into account the spatial encoding effect of coil sensitivity, if multiple receiver coils are used for signal reception . In contrast to the segmented cine SSFP technique, which traditionally requires one breath-hold per slice, the accelerated techniques can acquire the cine data with coverage of the entire left ventricle during one, two, or three breath-holds. However, these techniques involve tradeoffs in spatiotemporal resolution. If the accelerated techniques are carried out with sufficient temporal and spatial resolution, they usually cause a loss of signal-to-noise ratio (SNR) and carrier-to-noise ratio (CNR) compared to the segmented SSFP sequence .
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Material and methods
Subjects
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MRI
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Image Analysis
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Statistical Methods
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Results
SNR and CNR
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Global LV Functional Parameters
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Table 1
Mean Values of Global Left Ventricular Functional Parameters, Determined with the Different Cine Techniques and Mean Relative Differences of the Values, Determined with the k-t BLAST Techniques Compared to the Reference Technique
Mean Value Segmented SSFP Mean Value KT1 Mean Value KT2 Mean Relative Difference KT1 Mean Relative Difference KT2 EDV 168 ± 46 mL 158 ± 50 mL 155 ± 38 mL −7.3% −8.6% ESV 81 ± 43 mL 84 ± 48 mL 78 ± 34 mL +5.1% +4.4% EF 54.1 ± 12.4% 49.2 ± 12.0% 50.9 ± 9.9% −11% −9.0% LV mass 99 ± 36 g/m 2 108 ± 36 g/m 2 111 ± 32 g/m 2 +8.5% +12%
BLAST, broad-use linear acquisition speed-up technique; SSFP, steady state free precession; KT1, first three-dimensional sequence; KT2, second three-dimensional sequence; EDV, end-diastolic volume; ESV, end-systolic volume; EF, ejection fraction; LV mass, left ventricular myocardium mass.
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Table 2
Mean Values of Image Quality Scores
Segmented SSFP Aliasing Artefacts Segmented SSFP Overall KT1 Aliasing Artefacts KT1 Overall KT2 Aliasing Artefacts KT2 Overall Observer 1 3.8 3.9 3.0 3.1 3.4 3.2 Observer 2 3.9 3.7 3.1 3.2 3.4 3.5
SSFP, steady state free precession; KT1, first three-dimensional sequence; KT2, second three-dimensional sequence.
SSFP, evaluation of the presence of aliasing artefacts and overall image quality by two observers using a 4-point scale (overall image quality: 4 = excellent, 3 = good, 2 = moderate, 1 = fair; aliasing artefacts: 4 = not visible, 3 = visible, 2 = visible with relevant influence on overall image, 1 = strong artefacts).
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Discussion
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Study Limitations
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