Three-dimensional Whole-Heart Cardiac MRI Sequence for Measuring Trabeculation in Left Ventricular Noncompaction

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Physics

Background:

• Left ventricular noncompaction (LVNC) is a congenital heart defect characterized by a bilayered myocardium.
• Accurate measurement of compacted (CM) and noncompacted myocardium (NCM) is crucial for LVNC diagnosis and management.
• Standard two-dimensional (2D) cine MRI has limitations in fully characterizing the complex myocardial structure in LVNC.

Purpose of the Study:

• To compare the efficacy of three-dimensional (3D) whole-heart MRI with isotropic submillimeter resolution against standard 2D cine MRI for measuring the bilayered myocardium in LVNC.
• To evaluate image quality and interobserver agreement between the two MRI techniques for LVNC assessment.

Main Methods:

• Retrospective analysis of 24 patients with LVNC who underwent both 3D whole-heart and 2D cine MRI.
• Measurement of CM and NCM using Petersen (long axis) and Jacquier (short axis) approaches for both MRI sequences.
• Image quality assessment and statistical analysis using Pearson, Spearman, and intraclass correlation coefficients (ICC).

Main Results:

• 3D whole-heart MRI demonstrated strong to very strong correlations with 2D cine MRI for both CM and NCM measurements in both long and short axes.
• Higher ICC values were observed for 3D whole-heart MRI compared to 2D cine MRI for both CM and NCM, indicating better interobserver agreement.
• 3D whole-heart MRI exhibited significantly higher image quality (P < .001) with better discrimination between myocardial layers and adjacent tissues.

Conclusions:

• 3D whole-heart MRI with isotropic submillimeter resolution provides superior image quality and interobserver agreement for measuring myocardial layers in LVNC compared to standard 2D cine MRI.
• The findings suggest that 3D whole-heart MRI is a more robust technique for the detailed assessment of LVNC.
• This advanced MRI technique can improve diagnostic accuracy and patient management for LVNC.