Myocardial first pass perfusion: steady-state free precession versus spoiled gradient echo and segmented echo planar...

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Radiology

Background:

• Current first pass (FP) myocardial perfusion imaging techniques face limitations in contrast-to-noise ratio (CNR), resolution, and coverage.
• Variability in imaging performance necessitates direct comparison of sequences within subjects to establish optimal strategies.
• Existing methods like spoiled GRE and segmented EPI have known drawbacks impacting diagnostic accuracy.

Purpose of the Study:

• To directly compare the saturation recovery steady-state free precession (SSFP) technique against commonly used myocardial FP perfusion methods.
• To evaluate differences in signal-to-noise ratio (SNR), CNR, relative maximal upslope (RMU), and artifacts across sequences.
• To assess performance at comparable temporal and spatial resolutions.

Main Methods:

• Computer simulations were performed.
• Contrast agent-doped phantoms were utilized for testing.
• 16 healthy volunteers underwent imaging using SSFP, spoiled GRE, and segmented EPI sequences.

Main Results:

• SSFP demonstrated a ~77% increase in SNR and 23% in CNR compared to spoiled GRE.
• SSFP showed an ~85% increase in SNR and 50% in CNR compared to segmented EPI.
• Mean RMU was comparable between SSFP and spoiled GRE, but SSFP exhibited a 58% RMU increase over segmented EPI.

Conclusions:

• Saturation recovery SSFP offers superior SNR and CNR for first pass myocardial perfusion imaging.
• SSFP presents a significant improvement over spoiled GRE and segmented EPI, particularly in image quality metrics.
• The findings support SSFP as a promising technique for enhancing myocardial perfusion assessment.