Imaging Sequences for First Pass Perfusion - A Review

Laboratory of Cardiac Energetics, Department of Health and Human Services, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892-1061, USA.
Journal of Cardiovascular Magnetic Resonance (Impact Factor: 4.56). 02/2007; 9(3):525-37. DOI: 10.1080/10976640601187604
Source: PubMed


Myocardial perfusion imaging sequences and analysis techniques continue to improve. We review the state-of-the-art in cardiovascular magnetic resonance first pass perfusion pulse sequences including the application of parallel imaging. There are a wide range of sequence designs and parameters to consider when optimizing an acquisition protocol. The interdependence of these parameters forces the user to make compromises. We describe the technical issues and provide insights into the various performance tradeoffs. We also review the basic design for T1-weighted first pass myocardial perfusion imaging and go on to discuss the tradeoffs associated with various schemes to provide multi-slice coverage. Artifact mechanisms are discussed and related to sequence design and parameters. The selection of quantitative versus qualitative analysis affects various performance requirements, such as spatial and temporal resolution and linearity of enhancement. Understanding the interaction between the pulse sequence parameters and resulting image quality is important for improving myocardial perfusion imaging.

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    • "Parallel imaging has been extensively used in first pass CMR perfusion imaging to improve spatio-temporal resolution and spatial coverage [30]. The primary side effect associated with its use is reduced SNR based on the shortened readout time and g-factor losses. "
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    ABSTRACT: : Background Myocardial arterial spin labeling (ASL) is a noninvasive MRI based technique that is capable of measuring myocardial blood flow (MBF) in humans. It suffers from poor sensitivity to MBF due to high physiological noise (PN). This study aims to determine if the sensitivity of myocardial ASL to MBF can be improved by reducing image acquisition time, via parallel imaging. Methods Myocardial ASL scans were performed in 7 healthy subjects at rest using flow-sensitive alternating inversion recovery (FAIR) tagging and balanced steady state free precession (SSFP) imaging. Sensitivity encoding (SENSE) with a reduction factor of 2 was used to shorten each image acquisition from roughly 300 ms per heartbeat to roughly 150 ms per heartbeat. A paired Student’s t-test was performed to compare measurements of myocardial blood flow (MBF) and physiological noise (PN) from the reference and accelerated methods. Results The measured PN (mean ± standard deviation) was 0.20 ± 0.08 ml/g/min for the reference method and 0.08 ± 0.05 ml/g/min for the accelerated method, corresponding to a 60% reduction. PN measured from the accelerated method was found to be significantly lower than that of the reference method (p = 0.0059). There was no significant difference between MBF measured from the accelerated and reference ASL methods (p = 0.7297). Conclusions In this study, significant PN reduction was achieved by shortening the acquisition window using parallel imaging with no significant impact on the measured MBF. This indicates an improvement in sensitivity to MBF and may also enable the imaging of subjects with higher heart rates and imaging during systole.
    Journal of Cardiovascular Magnetic Resonance 01/2014; 16(1):15. DOI:10.1186/1532-429X-16-15 · 4.56 Impact Factor
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    ABSTRACT: We have evaluated the use of deconvolution using an exponential approximation basis for the quantification of myocardial blood flow from perfusion cardiovascular magnetic resonance. Our experiments, based on simulated signal intensity curves, phantom acquisitions, and clinical image data, indicate that exponential deconvolution allows for accurate quantification of myocardial blood flow. Together with automated respiratory motion correction myocardial contour delineation, the exponential deconvolution enables efficient and reproducible quantification of myocardial blood flow in clinical routine.
    IEEE transactions on bio-medical engineering 05/2012; 59(7):2060-7. DOI:10.1109/TBME.2012.2197620 · 2.35 Impact Factor
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    • "Susceptibility artefacts originating at the interface between blood (high gadolinium concentration) and the myocardium (low gadolinium concentration) may occur more often in small hearts with thin walls, in which fewer pixels are imaged transmurally. Kellman et al. demonstrated larger artefacts at lower spatial resolution [19]. It is therefore crucial to reduce the field-of-view and thus, increase spatial resolution in paediatric studies (even allowing for wrap-around artefacts close to the LV). "
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    ABSTRACT: As coronary artery disease may also occur during childhood in some specific conditions, we sought to assess the feasibility and accuracy of perfusion cardiovascular magnetic resonance (CMR) in paediatric patients. First-pass perfusion CMR studies were performed under pharmacological stress with adenosine and by using a hybrid echo-planar pulse sequence with slice-selective saturation recovery preparation. Fifty-six perfusion CMR examinations were performed in 47 patients. The median age was 12 years (1 month-18 years), and weight 42.8 kg (2.6-82 kg). General anaesthesia was required in 18 patients. Mean examination time was 67 +/- 19 min. Diagnostic image quality was obtained in 54/56 examinations. In 23 cases the acquisition parameters were adapted to patient's size. Perfusion CMR was abnormal in 16 examinations. The perfusion defects affected the territory of the left anterior descending coronary artery in 11, of the right coronary artery in 3, and of the circumflex coronary artery in 2 cases. Compared to coronary angiography, perfusion CMR showed a sensitivity of 87% (CI 52-97%) and a specificity of 95% (CI 79-99%). In children, perfusion CMR is feasible and accurate. In very young children (less than 1 year old), diagnostic image quality may be limited.
    Journal of Cardiovascular Magnetic Resonance 11/2009; 11(1):51. DOI:10.1186/1532-429X-11-51 · 4.56 Impact Factor
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