Influence of the cardiac cycle on time-intensity curves using multislice dynamic magnetic resonance perfusion

Flow and pressure variations cause potential changes in magnetic resonance imaging (MRI) signal intensity across the cardiac cycle. Nevertheless, cardiac dynamic contrast-enhanced (perfusion) MRI is performed and analyzed regardless of the cardiac phase. We investigate whether the cardiac phase impacts myocardial and left ventricle (LV) cavity time intensity curves (TICs) at rest and during vasodilatation. Fifteen healthy volunteers (seven females, eight males; mean age: 32.5 ± 9.3 years; age range: 19-49 years) were included in this prospective study. They underwent four separate short-axis multislice (apical, mid and basal) LV perfusion MRI, with different electrocardiogram-triggering during normal vasotone and adenosine-stress. TIC parameters were extracted from the myocardium and the LV cavity. General linear mixed model analyses were used to evaluate their variability according to vasotone, cardiac phase and slice-position. Maximal enhancement and normalized Steepest slopes were higher at stress than at rest (p values <0.001). A similar trend towards higher inflow was shown on systole versus diastole in the LV cavity and diastole versus systole in the myocardium (p < 0.05).These TIC parameters were slice-position dependent, as the inflow decreased from the base to the apex in the LV, and peaked on the mid-slice for the myocardium. There are significant variability of both the LV and the myocardial TICs, with respect to the cardiac cycle phase and the slice position where imaging actually takes place. These appeal to measurement standardization for a better intra- and inter-study reproducibility.