Accelerated real-time cardiac MRI using iterative sparse SENSE reconstruction: comparing performance in patients with sinus rhythm and atrial fibrillation

• Published in: European radiology Vol. 28; no. 7; pp. 3088 - 3096
• Main Authors: Allen, Bradley D., Carr, Maria L., Markl, Michael, Zenge, Michael O., Schmidt, Michaela, Nadar, Mariappan S., Spottiswoode, Bruce, Collins, Jeremy D., Carr, James C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018; Springer Nature B.V
• Subjects: Acceleration; Adult; Aged; Arrhythmia; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - physiopathology; Cardiac; Cardiac arrhythmia; Cardiac Imaging Techniques - methods; Diagnostic Radiology; Electrocardiography; Female; Fibrillation; Functional analysis; Heart; Heart diseases; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Image Interpretation, Computer-Assisted - methods; Image quality; Image reconstruction; Imaging; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging, Cine - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Radiology; Real time; Reproducibility of Results; Rhythm; Sinuses; Spatial discrimination; Spatial resolution; Subgroups; Time Factors; Ultrasound; Ventricle; Ventricular Function, Left - physiology; Cine MRI; Acceleration; Atrial fibrillation; Cardiac imaging techniques; Left ventricular function
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-017-5283-0

Objectives To compare accelerated real-time cardiac MRI (CMR) using sparse spatial and temporal undersampling and non-linear iterative SENSE reconstruction (RT IS SENSE) with real-time CMR (RT) and segmented CMR (SEG) in a cohort that included atrial fibrillation (AF) patients. Methods We evaluated 27 subjects, including 11 AF patients, by acquiring steady-state free precession cine images covering the left ventricle (LV) at 1.5 T with SEG (acceleration factor 2, TR 42 ms, 1.8 × 1.8 × 6 mm 3 ), RT (acceleration factor 3, TR 62 ms, 3.0 × 3.0 × 7 mm 3 ), and RT IS SENSE (acceleration factor 9.9-12, TR 42 ms, 2.0 × 2.0 × 7 mm 3 ). We performed quantitative LV functional analysis in sinus rhythm (SR) patients and qualitatively scored image quality, noise and artefact using a 5-point Likert scale in the complete cohort and AF and SR subgroups. Results There was no difference between LV functional parameters between acquisitions in SR patients. RT IS SENSE short-axis image quality was superior to SEG (4.5 ± 0.6 vs. 3.9 ± 1.1, p = 0.007) and RT (3.8 ± 0.4, p = 0.003). There was reduced artefact in RT IS SENSE compared to SEG (4.4 ± 0.6 vs. 3.8 ± 1.2, p = 0.04), driven by arrhythmia performance. RT IS SENSE short-axis image quality was superior to SEG (4.6 ± 0.5 vs. 3.1 ± 1.0, p < 0.001) in the AF subgroup. Conclusion Accelerated real-time CMR with iterative sparse SENSE provides excellent clinical performance, especially in patients with AF. Key Points • Iterative sparse SENSE significantly accelerates real-time cardiovascular MRI acquisitions. • It provides excellent qualitative and quantitative performance in sinus rhythm patients. • It outperforms standard segmented acquisitions in patients with atrial fibrillation. • It improves the trade-off between temporal and spatial resolution in real-time imaging.