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Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent

BACKGROUND: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer...

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Autores principales: Makowski, Marcus R, Wiethoff, Andrea J, Jansen, Christian HP, Uribe, Sergio, Parish, Victoria, Schuster, Andreas, Botnar, Rene M, Bell, Aaron, Kiesewetter, Christoph, Razavi, Reza, Schaeffter, Tobias, Greil, Gerald F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438073/
https://www.ncbi.nlm.nih.gov/pubmed/22849703
http://dx.doi.org/10.1186/1532-429X-14-53
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author Makowski, Marcus R
Wiethoff, Andrea J
Jansen, Christian HP
Uribe, Sergio
Parish, Victoria
Schuster, Andreas
Botnar, Rene M
Bell, Aaron
Kiesewetter, Christoph
Razavi, Reza
Schaeffter, Tobias
Greil, Gerald F
author_facet Makowski, Marcus R
Wiethoff, Andrea J
Jansen, Christian HP
Uribe, Sergio
Parish, Victoria
Schuster, Andreas
Botnar, Rene M
Bell, Aaron
Kiesewetter, Christoph
Razavi, Reza
Schaeffter, Tobias
Greil, Gerald F
author_sort Makowski, Marcus R
collection PubMed
description BACKGROUND: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). METHODS: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18–25 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. RESULTS: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, Bland–Altman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R(2) = 0.92 vs. R(2) = 0.71), compared to 3D-SSFP with GdD. CONCLUSIONS: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. TRIAL REGISTRATION: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/001–0001, EudraCTnumber 2006–007042).
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spelling pubmed-34380732012-09-12 Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent Makowski, Marcus R Wiethoff, Andrea J Jansen, Christian HP Uribe, Sergio Parish, Victoria Schuster, Andreas Botnar, Rene M Bell, Aaron Kiesewetter, Christoph Razavi, Reza Schaeffter, Tobias Greil, Gerald F J Cardiovasc Magn Reson Research BACKGROUND: Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP). METHODS: LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18–25 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days. RESULTS: All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, Bland–Altman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R(2) = 0.92 vs. R(2) = 0.71), compared to 3D-SSFP with GdD. CONCLUSIONS: A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function. TRIAL REGISTRATION: The study was approved by the local research ethics committee (Study No. 07/Q0704/2) and was registered with the Medicines and Healthcare Products Regulatory Agency (MHRA Study No. 28482/0002/001–0001, EudraCTnumber 2006–007042). BioMed Central 2012-07-31 /pmc/articles/PMC3438073/ /pubmed/22849703 http://dx.doi.org/10.1186/1532-429X-14-53 Text en Copyright ©2012 Makowski et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Makowski, Marcus R
Wiethoff, Andrea J
Jansen, Christian HP
Uribe, Sergio
Parish, Victoria
Schuster, Andreas
Botnar, Rene M
Bell, Aaron
Kiesewetter, Christoph
Razavi, Reza
Schaeffter, Tobias
Greil, Gerald F
Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title_full Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title_fullStr Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title_full_unstemmed Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title_short Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
title_sort single breath-hold assessment of cardiac function using an accelerated 3d single breath-hold acquisition technique - comparison of an intravascular and extravascular contrast agent
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438073/
https://www.ncbi.nlm.nih.gov/pubmed/22849703
http://dx.doi.org/10.1186/1532-429X-14-53
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