Print
Email
Cardiac Function Evaluation with Cine MRI of the Heart
Publication Name:
Current Protocols in Magnetic Resonance Imaging
Unit Number:
Unit A11.4
DOI:
10.1002/0471142719.mia1104s015
Online Posting Date:
June, 2008 Abstract
This unit describes how to determine hemodynamic parameters of cardiac function such as ejection fraction (EF), end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), and cardiac mass, based on experience using a Siemens 1.5 T Sonata scanner. Briefly, cine loops are acquired over several heartbeats, synchronized with the heart cycle by gating of the encoding steps with the patients electrocardiogram (ECG). Recently, it has become feasible to acquire cine loops in real time, although the temporal resolution is not optimal. Options discussed in this unit include breath hold versus free breathing, prospective triggering versus retrospective gating, and volumetric data sets versus biplanar approaches. Patient parameters such as heart rate or rhythm, degree of functional impairment, the presence of valvular disease, and the need to assess for jets from shunts or valve dysfunction are also treated.
Keywords: cardiac function; cine loop; hemodynamic parameters
Figures
-
Figure A11.4.1Coronal (A) and transverse (B) scout images acquired with single-shot steady-state free precession imaging technique while the patient holds his or her breath. The transverse scout image is used to position the slice for the pseudo-long-axis localizer. The slice position and orientation are shown in the image on B as a dark gray bar. -
Figure A11.4.2The image in A shows a pseudo-long vertical long-axis view of the heart. Use this scout image to position the slices for a series of short-axis views near the base of the heart. The resulting short-axis views are shown in images B and C. The slice orientation for cine acquisition in a four-chamber, long-axis view should pass through the center of the left ventricle, and intersect with the antero-lateral tip of the right ventricle, as shown by the dark bar in image C. -
Figure A11.4.3Two frames from a cine acquisition with steady state free precession sequence for a four-chamber long-axis view of the heart with the long-axis slice orientation prescribed as shown in Figure -
Figure A11.4.4Regurgitant jet (highlighted by the arrow) in a patient with myocardial infarction and acute mitral valve regurgitation that developed with severe ventricular failure. The cine images were acquired with a steady-state free precession (SSFP) sequence. With SSFP sequences, turbulent flow causes pronounced signal loss and is well visualized. -
Figure A11.4.5Panel A shows an image of the signal phase (after background correction) in a patient at the level of bifurcation of the pulmonary trunk. Flow was encoded in a direction perpendicular to the slice plane. The slice plane was oriented to intersect the ascending aorta at a right angle. The phase of the signal is encoded on a gray scale, and the phase is directly proportional to the flow velocity. Panel B shows a graph of aortic flow versus the delay time after the R-wave. The flow is calculated from the phase images by integrating the flow velocity over the aortic cross-section to obtain flow in units of ml/sec, in this case. Flow analysis software is available as an option on most MRI scanners. -
Figure A11.4.6Example of variation of left ventricular volume over the cardiac cycle for (A) a healthy volunteer, and (B) a patient with congestive heart failure (CHF). The CHF patient had an enlarged ventricle (i.e., large volume), and a very low ejection fraction (EF). Because of the low EF, the curve in (B) is relatively flat. Ventricular volumes were calculated by Simpson's rule from a set of short-axis images. The endocardial border had been traced on each cine frame to obtain a complete LV volume versus time curve. -
Figure A11.4.7Comparison of cine acquisition with steady-steady free precession (SSFP) technique (A, B); with “conventional” gradient-echo sequence (C, D). The SSFP technique affords better contrast between blood pool and myocardium. Poorer contrast in the cases of (C) and (D) can lead to an underestimate of ventricular volume and an overestimate of myocardial mass.
Literature Cited
| Literature Cited | |
| Barkhausen, J., Ruehm, S.G., Goyen, M., Buck, T., Laub, G., and Debatin, J.F. 2001. MR evaluation of ventricular function: True fast imaging with steady-state precession versus fast low-angle shot cine MR imaging: Feasibility study. Radiology 219:264-269. | |
| Bloomgarden, D.C., Fayad, Z.A., Ferrari, V.A., Chin, B., Sutton, M.G., and Axel, L. 1997. Global cardiac function using fast breath-hold MRI: Validation of new acquisition and analysis techniques. Magn. Reson. Med. 37:683-692. | |
| Bundy, J., Simonetti, O., Laub, G., and Finn, J.P. 1999. Segmented trueFISP cine imaging of the heart. Seventh Meeting of the International Society for Magnetic Resonance in Medicine. Philadelphia. | |
| Chatzimavroudis, G.P., Walker, P.G., Oshinski, J.N., Franch, R.H., Pettigrew, R.I., and Yoganathan, A.P. 1997. The importance of slice location on the accuracy of aortic regurgitation measurements with magnetic resonance phase velocity mapping. Ann. Biomed. Eng. 25:644-652. | |
| Cranney, G.B., Lotan, C.S., Dean, L., Baxley, W., Bouchard, A., and Pohost, G.M. 1990. Left ventricular volume measurement using cardiac axis nuclear magnetic resonance imaging. Validation by calibrated ventricular angiography. Circulation. 82:154-163. | |
| Czegledy, F.P. and Katz, J. 1993. A new geometric description of the right ventricle. J. Biomed. Eng. 15:387-391. | |
| Duerk, J.L., Lewin, J.S., Wendt, M., and Petersilge, C. 1998. Remember true FISP A high SNR, near 1-second imaging method for T | |
| Dulce, M.C., Mostbeck, G.H., Friese, K.K., Caputo, G.R., and Higgins, C.B. 1993. Quantification of the left ventricular volumes and function with cine MR imaging: Comparison of geometric models with three-dimensional data. Radiology 188:371-376. | |
| Lorenz, C.H., Walker, E.S., Morgan, V.L., Klein, S.S., and Graham, T.P. Jr. 1999. Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J. Cardiovasc. Magn. Reson. 1:7-21. | |
| Matheijssen, N.A., Baur, L.H., Reiber, J.H., van der Velde, E.A., van Dijkman, P.R., van der Geest, R.J., de Roos, A., and van der Wall, E.E. 1996. Assessment of left ventricular volume and mass by cine magnetic resonance imaging in patients with anterior myocardial infarction intra-observer and inter-observer variability on contour detection. Int. J. Card. Imaging 12:11-19. | |
| Nagel, E., Lehmkuhl, H.B., Bocksch, W., Klein, C., Vogel, U., Frantz, E., Ellmer, A., Dreysse, S., and Fleck, E. 1999. Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: Comparison with dobutamine stress echocardiography. Circulation 99:763-770. | |
| Pennell, D.J., Underwood, S.R., and Longmore, D.B. 1993. Improved cine MR imaging of left ventricular wall motion with gadopentetate dimeglumine. J. Magn. Reson. Imaging 3:13-19. | |
| Pereles, F.S., Kapoor, V., Carr, J.C., Simonetti, O.P., Krupinski, E.A., Baskaran, V., and Finn, JP. 2001. Usefulness of segmented trueFISP cardiac pulse sequence in evaluation of congenital and acquired adult cardiac abnormalities. Am. J. Roentgenol. 177:1155-1160. | |
| Plein, S., Bloomer, T.N., Ridgway, J.P., Jones, T.R., Bainbridge, G.J., and Sivananthan, M.U. 2001. Steady-state free precession magnetic resonance imaging of the heart: Comparison with segmented k-space gradient-echo imaging. J. Magn. Reson Imaging 14:230-236. | |
| Schulen, V., Schick, F., Loichat, J., Helber, U., Huppert, P.E., Laub, G., and Claussen, C.D. 1996. Evaluation of k-space segmented cine sequences for fast functional cardiac imaging. Invest. Radiol. 31:512-522. | |
| Setser, R.M., Fischer, S.E., and Lorenz, C.H. 2000. Quantification of left ventricular function with magnetic resonance images acquired in real time. J. Magn. Reson. Imaging. 12:430-438. | |
| Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott-Raven, Philadelphia. | |
| Stillman, A.E., Wilke, N., and Jerosch-Herold, M. 1997. Use of an intravascular T | |
| Thiele, H., Nagel, E., Paetsch, I., Schnackenburg, B., Bornstedt, A., Kouwenhoven, M., Wahl, A., Schuler, G., and Fleck, E. 2001. Functional cardiac MR imaging with steady-state free precession (SSFP) significantly improves endocardial border delineation without contrast agents. J. Magn. Reson. Imaging 14:362-367. | |
| Internet Resources | |
| http://www.medis.nl | |
| The software package MASS (Magnetic Resonance Analytical Software System) has been developed for the quantitative analysis of multi-slice/multi-cardiac phase left and right ventricular function. | |
| http://www.siemensmedical.com | |
| Leonardo is an analysis software package from Siemens Medical Systems for evaluating cardiac magnetic resonance cine images and assessment of ventricular functions. | |
Editorial announcements
Troubleshooting Tips
|
TOOLS & CALCULATORS |
Join the Conversation
Post new comment