Abstract
BackgroundQuantitative blood flow and aspects of regional myocardial function such as myocardial displacement and strain can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR). Since a gadolinium-based contrast agent is often used to measure myocardial infarct size, we sought to determine whether the contrast agent affects measurements of aortic flow and myocardial displacement and strain. Phase-contrast data pre and post contrast agent was acquired during free breathing using 1.5T PC-CMR.ResultsFor aortic flow and regional myocardial function 12 and 17 patients were analysed, respectively. The difference pre and post contrast agent was 0.03 ± 0.16 l/min for cardiac output, and 0.1 ± 0.5 mm for myocardial displacement. Linear regression for myocardial displacement (MD) after and before contrast agent (CA) showed MDpostCA = 0.95MDpreCA+0.05 (r = 0.95, p < 0.001). For regional myocardial function, the contrast-to-noise ratios for left ventricular myocardial wall versus left ventricular lumen were pre and post contrast agent administration 7.4 ± 3.3 and 4.4 ± 8.9, respectively (p < 0.001). The contrast-to-noise ratios for left ventricular myocardial wall versus surrounding tissue were pre and post contrast agent administration -16.9 ± 22 and -0.2 ± 6.3, respectively (p < 0.0001).ConclusionsQuantitative measurements of aortic flow yield equal results both in the absence and presence of gadolinium contrast agent. The total examination time may thereby be reduced when assessing both viability and quantitative flow using PC-CMR, by assessing aortic flow post contrast agent administration. Phase-contrast information for myocardial displacement is also assessable both in the absence and presence of contrast agent. However, delineation of the myocardium may be difficult or impossible post contrast agent due to the lower image contrast. Acquisition of myocardial displacement should therefore be performed pre contrast agent using current PC-CMR sequences.
Highlights
Quantitative blood flow and aspects of regional myocardial function such as myocardial displacement and strain can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR)
It is of importance to know whether presence of contrast agent has impact on flow quantification using PC-CMR data, by for instance altered signal-to-noise (SNR) ratio and/or additional phase effects owing to the contrast agent administration
To compare the measurements of flow in the aorta and left ventricular regional function pre and post contrast agent administration, cardiac output and myocardial displacement was derived from the phase-contrast data, respectively
Summary
Quantitative blood flow and aspects of regional myocardial function such as myocardial displacement and strain can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR). Aspects of regional function such as motion and myocardial displacement can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR). A gadolinium-based contrast agent is often administered during the CMR session for acquisition of myocardial infarct size. Delineating and evaluating myocardium and differentiating it from the blood pool and surrounding tissue may be more difficult. This can be expected since the gadolinium-based contrast agent affects magnitude images both regarding intensity and contrast, and by increased sensitivity to flow artefacts. An in vivo investigation of PC-CMR accuracy of quantification after contrast agent administration has not been previously performed
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