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Inversion-recovery-prepared SSFP for cardiac-phase-resolved delayed-enhancement MRI
J S Detsky1, J A Stainsby, R Vijayaraghavan
1Department of Imaging Research, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. jay.detsky@sri.utoronto.ca
Abstract:
Delayed-enhancement magnetic resonance imaging (DE-MRI) can be used to visualize myocardial infarction (MI). DE-MRI is conventionally acquired with an inversion-recovery gradient-echo (IR-GRE) pulse sequence that yields a single bright-blood image. IR-GRE imaging requires an accurate estimate of the inversion time (TI) to null the signal from the myocardium, and a separate cine acquisition is required to visualize myocardial wall motion. Simulations were performed to examine the effects of a steady-state free precession (SSFP) readout after an inversion pulse in the setting of DE-MRI. Using these simulations, a segmented IR-SSFP sequence was optimized for infarct visualization. This sequence yields both viability and wall motion images over the cardiac cycle in a single breath-hold. Viability images at multiple effective TIs are produced, providing a range of image contrasts. In a study of 11 patients, IR-SSFP yielded infarct sizes and left ventricular ejection fractions (LVEFs) similar to those obtained by IR-GRE and standard SSFP, respectively. IR-SSFP images yielded improved visualization of the infarct-blood border because of the simultaneous nulling of healthy myocardium and blood. T(1) (*) recovery curves were extracted from IR-SSFP images and showed excellent qualitative agreement with theoretical simulations.
Insights
A new magnetic resonance imaging technique, inversion-recovery steady-state free precession (IR-SSFP), visualizes myocardial infarction (MI) and wall motion simultaneously. This method improves infarct visualization and offers multiple contrast options in a single breath-hold.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
- Medical Diagnostics
Background:
- Delayed-enhancement magnetic resonance imaging (DE-MRI) is crucial for visualizing myocardial infarction (MI).
- Conventional DE-MRI uses inversion-recovery gradient-echo (IR-GRE) sequences, requiring separate cine acquisitions for wall motion assessment.
- Accurate inversion time (TI) estimation is critical for IR-GRE to null myocardial signal.
Purpose of the Study:
- To investigate the utility of a steady-state free precession (SSFP) readout after an inversion pulse for DE-MRI.
- To optimize a segmented IR-SSFP sequence for improved infarct visualization and simultaneous wall motion assessment.
- To evaluate the performance of IR-SSFP compared to conventional IR-GRE techniques.
Main Methods:
- Simulations were conducted to analyze the effects of SSFP readout post-inversion pulse in DE-MRI.
- A segmented IR-SSFP sequence was developed and optimized based on simulation results.
- The optimized IR-SSFP sequence was tested in 11 patients, acquiring viability and wall motion images within a single breath-hold.
Main Results:
- The IR-SSFP sequence successfully generated viability images with multiple effective TIs, offering varied contrast.
- Simultaneous visualization of myocardial viability and wall motion was achieved in a single breath-hold.
- IR-SSFP demonstrated comparable infarct sizes and left ventricular ejection fractions (LVEFs) to IR-GRE and standard SSFP, respectively.
- Improved visualization of the infarct-blood border was observed due to simultaneous nulling of healthy myocardium and blood.
- Extracted T(1) (*) recovery curves from IR-SSFP images showed strong qualitative agreement with theoretical simulations.
Conclusions:
- The optimized IR-SSFP sequence provides a single-breath-hold method for simultaneous myocardial viability and wall motion assessment.
- IR-SSFP enhances the visualization of the infarct-blood border, offering diagnostic advantages.
- This novel sequence shows promise for more efficient and comprehensive cardiac MRI assessments of MI.
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