Abstract
BackgroundTo investigate the feasibility of accelerated electrocardiogram (ECG)-triggered contrast enhanced pulmonary vein magnetic resonance angiography (CE-PV MRA) with isotropic spatial resolution using compressed sensing (CS).MethodsNineteen patients (59 ± 13 y, 11 M) referred for MR were scanned using the proposed accelerated free breathing ECG-triggered 3D CE-PV MRA sequence (FOV = 340 × 340 × 110 mm3, spatial resolution = 1.5 × 1.5 × 1.5 mm3, acquisition window = 140 ms at mid diastole and CS acceleration factor = 5) and a conventional first-pass breath-hold non ECG-triggered 3D CE-PV MRA sequence. CS data were reconstructed offline using low-dimensional-structure self-learning and thresholding reconstruction (LOST) CS reconstruction. Quantitative analysis of PV sharpness and subjective qualitative analysis of overall image quality were performed using a 4-point scale (1: poor; 4: excellent).ResultsQuantitative PV sharpness was increased using the proposed approach (0.73 ± 0.09 vs. 0.51 ± 0.07 for the conventional CE-PV MRA protocol, p < 0.001). There were no significant differences in the subjective image quality scores between the techniques (3.32 ± 0.94 vs. 3.53 ± 0.77 using the proposed technique).ConclusionsCS-accelerated free-breathing ECG-triggered CE-PV MRA allows evaluation of PV anatomy with improved sharpness compared to conventional non-ECG gated first-pass CE-PV MRA. This technique may be a valuable alternative for patients in which the first pass CE-PV MRA fails due to inaccurate first pass timing or inability of the patient to perform a 20–25 seconds breath-hold.
Highlights
To investigate the feasibility of accelerated electrocardiogram (ECG)-triggered contrast enhanced pulmonary vein magnetic resonance angiography (CE-Pulmonary vein (PV) MR angiography (MRA)) with isotropic spatial resolution using compressed sensing (CS)
Images acquired with the conventional CE-PV MRA protocol (Figure 4a) and the proposed free breathing ECGtriggered CE-PV MRA protocol (Figure 4b) are shown in the axial orientation as well as in two coronal views crossing the left PVs, and the right PVs, respectively
Due to inaccurate acquisition timing, image acquired with the conventional CE-PV MRA protocol provided low contrast and poor image quality
Summary
To investigate the feasibility of accelerated electrocardiogram (ECG)-triggered contrast enhanced pulmonary vein magnetic resonance angiography (CE-PV MRA) with isotropic spatial resolution using compressed sensing (CS). Pulmonary vein (PV) isolation (PVI) using catheter ablation [2] is considered as an accepted treatment of paroxysmal AF [3]. During this procedure, circumferential ablation regions are created at the PV ostia to electrically isolate the PVs. PV anatomies such as the PV ostia size and the number of PVs is generally assessed prior to the PVI procedure using imaging techniques such as multidetector computed tomography (MDCT) or cardiovascular magnetic resonance (CMR) [4,5]. Post PVI imaging is performed for the detection of rare postprocedural complications such as PV stenosis or damage to the esophagus [6,7,8]
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