Julius Traber1, Lennart Wurche2, Matthias A Dieringer3, Wolfgang Utz4, Florian von Knobelsdorff-Brenkenhoff5, Andreas Greiser6, Ning Jin7, Jeanette Schulz-Menger8. 1. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. julius.traber@charite.de. 2. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. lennart.wurche@charite.de. 3. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. matthias.dieringer@charite.de. 4. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. wolfgang.utz@charite.de. 5. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. Florian.Von-Knobelsdorff@charite.de. 6. Siemens AG Healthcare Sector, Erlangen, Germany. andreas.greiser@siemens.com. 7. Siemens Medical Solutions USA, Inc., Columbus, OH, USA. ning.jin@siemens.com. 8. Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. jeanette.schulz-menger@charite.de.
Abstract
OBJECTIVES: Assessment of haemodynamics is crucial in many cardiac diseases. Phase contrast MRI (PC-MRI) can accurately access it. Arrhythmia is a major limitation in conventional segmented PC-MRI (SEG). A real-time PC-MRI sequence (RT) could overcome this. We validated RT by comparing to SEG. METHODS: A prototype RT using shared velocity encoding was tested against SEG at 1.5 T in a flow phantom and consecutively included patients with (n = 55) or without (n = 59) aortic valve disease. In patients with atrial fibrillation (Afib, n = 15), only RT was applied. Phantom: PC images were acquired in front of and behind an interchangeable aortic-stenosis-like inlay. Mean velocity and flow were quantified. PATIENTS: PC images were acquired in the ascending aorta, pulmonary trunk and superior caval vein. Peak velocity, stroke volume and regurgitant fraction were quantified. RESULTS: Phantom: Mean velocities (11 ± 1 to 207 ± 10 cm/s) and flow correlated closely between SEG and RT (r ≥ 0.99, ICC ≥ 0.98, p < 0.0005). Patients without AVD or with aortic regurgitation: Concordance of SEG and RT was excellent regarding peak velocities, stroke volumes (r ≥ 0.91, ICC ≥ 0.94, p < 0.0005) and regurgitant fractions (r = 0.95, ICC = 0.95, p < 0.0005). RT was feasible in all patients with Afib. CONCLUSIONS: The real-time sequence is accurate compared to conventional segmented PC-MRI. Its applicability in Afib was shown. Real-time PC-MRI might become a valuable tool in arrhythmia. KEY POINTS: • Assessment of haemodynamics is crucial in many cardiac diseases. • Arrhythmias are a major limitation of conventional techniques in cardiac magnetic resonance. • A real-time technique, which allows application in arrhythmia, was validated. • This real-time technique might become a valuable tool in arrhythmic patients.
OBJECTIVES: Assessment of haemodynamics is crucial in many cardiac diseases. Phase contrast MRI (PC-MRI) can accurately access it. Arrhythmia is a major limitation in conventional segmented PC-MRI (SEG). A real-time PC-MRI sequence (RT) could overcome this. We validated RT by comparing to SEG. METHODS: A prototype RT using shared velocity encoding was tested against SEG at 1.5 T in a flow phantom and consecutively included patients with (n = 55) or without (n = 59) aortic valve disease. In patients with atrial fibrillation (Afib, n = 15), only RT was applied. Phantom: PC images were acquired in front of and behind an interchangeable aortic-stenosis-like inlay. Mean velocity and flow were quantified. PATIENTS: PC images were acquired in the ascending aorta, pulmonary trunk and superior caval vein. Peak velocity, stroke volume and regurgitant fraction were quantified. RESULTS: Phantom: Mean velocities (11 ± 1 to 207 ± 10 cm/s) and flow correlated closely between SEG and RT (r ≥ 0.99, ICC ≥ 0.98, p < 0.0005). Patients without AVD or with aortic regurgitation: Concordance of SEG and RT was excellent regarding peak velocities, stroke volumes (r ≥ 0.91, ICC ≥ 0.94, p < 0.0005) and regurgitant fractions (r = 0.95, ICC = 0.95, p < 0.0005). RT was feasible in all patients with Afib. CONCLUSIONS: The real-time sequence is accurate compared to conventional segmented PC-MRI. Its applicability in Afib was shown. Real-time PC-MRI might become a valuable tool in arrhythmia. KEY POINTS: • Assessment of haemodynamics is crucial in many cardiac diseases. • Arrhythmias are a major limitation of conventional techniques in cardiac magnetic resonance. • A real-time technique, which allows application in arrhythmia, was validated. • This real-time technique might become a valuable tool in arrhythmicpatients.
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