Rapid functional cardiac imaging after gadolinium injection: Evaluation of a highly accelerated sequence with sparse data sampling and iterative reconstruction

To generate a patient-friendly, time-efficient cardiac MRI examination protocol, a highly accelerated real-time CINE MR sequence (SSIR) was acquired in the idle time in between contrast injection and late gadolinium enhancement phase. 20 consecutive patients underwent a cardiac MRI examination including a multi-breath-hold sequence as gold standard (Ref) as well as SSIR sequences with (SSIR-BH) and without breath-hold (SSIR-nonBH). SSIR sequences were acquired 4 minutes after gadolinium injection. Right- (RV) and left-ventricular (LV) volumetric functional parameters were evaluated and compared between Ref and SSIR sequences. Despite reduced contrast between myocardium and intra-ventricular blood, volumetric as well as regional wall movement assessment revealed high agreement between both SSIR sequences and Ref. Excellent correlation and narrow limits of agreements were found for both SSIR-BH and SSIR-nonBH when compared to Ref for both LV (mean LV ejection fraction [EF] Ref: 52.8 ± 12.6%, SSIR-BH 52.3 ± 12.9%, SSIR-nonBH 52.5 ± 12.6%) and RV (mean RV EF Ref: 52.7 ± 9.4%, SSIR-BH 52.0 ± 8.1%, SSIR-nonBH 52.2 ± 9.3%) analyses. Even when acquired in the idle time in between gadolinium injection and LGE acquisition, the highly accelerated SSIR sequence delivers accurate volumetric and regional wall movement information. It thus seems ideal for very time-efficient and robust cardiac MR imaging protocols.