First-pass Myocardial Perfusion Magnetic Resonance Research Articles

Perceived Dark Rim Artifact in First-Pass Myocardial Perfusion Magnetic Resonance Imaging Due to Visual Illusion.

To demonstrate that human visual illusion can contribute to sub-endocardial dark rim artifact in contrast-enhanced myocardial perfusion magnetic resonance images. Numerical phantoms were generated to simulate the first-passage of contrast agent in the heart, and rendered in conventional gray scale as well as in color scale with reduced luminance variation. Cardiac perfusion images were acquired from two healthy volunteers, and were displayed by the same gray and color scales used in the numerical study. Before and after k-space windowing, the left ventricle (LV)-myocardium boarders were analyzed visually and quantitatively through intensity profiles perpendicular the boarders. k-space windowing yielded monotonically decreasing signal intensity near the LV-myocardium boarder in the phantom images, as confirmed by negative finite difference values near the board ranging -1.07 to -0.14. However, the dark band still appears, which is perceived by visual illusion. Dark rim is perceived in the in-vivo images after k-space windowing that removed the quantitative signal dip, suggesting that the perceived dark rim is a visual illusion. The perceived dark rim is stronger at peak LV enhancement than the peak myocardial enhancement, due to the larger intensity difference between LV and myocardium. In both numerical phantom and in-vivo images, the illusory dark band is not visible in the color map due to reduced luminance variation. Visual illusion is another potential cause of dark rim artifact in contrast-enhanced myocardial perfusion MRI as demonstrated by illusory rim perceived in the absence of quantitative intensity undershoot.

Intermodel agreement of myocardial blood flow estimation from stress-rest myocardial perfusion magnetic resonance imaging in patients with coronary artery disease.

The aim of this study was to assess the intermodel agreement of different magnetic resonance myocardial perfusion models and evaluate their correspondence to stenosis diameter. In total, 260 myocardial segments were analyzed from rest and adenosine stress first-pass myocardial perfusion magnetic resonance images (1.5 T, 0.050 ± 0.005 mmol/kg body weight gadolinium; 122 segments in rest, 138 in stress) in 10 patients with suspected or known coronary artery disease. Signal intensity curves were calculated per myocardial segment, of which the contours were traced with QMASS MR V.7.6 (Medis, Leiden, the Netherlands), and exported to Matlab. Myocardial blood flow quantification was performed with distributed parameter, extended Toft, Patlak, and Fermi parametric models (in-house programs; Matlab R2013a; Mathworks Inc, Natick, MA). Modeling was applied after the signal intensity curves were corrected for spatial magnetic field inhomogeneity and contrast saturation. Overall and grouped perfusion values based on presence of coronary stenosis (>50% diameter reduction) at coronary computed tomography angiography at second generation dual-source computed tomography were compared between the perfusion models. Rest and stress myocardial perfusion estimates for all models were significantly related to each other (P < 0.001). The highest correlation coefficients were found between the extended Toft and Fermi models (R = 0.89-0.91) and low correlation coefficients between the distributed parameter and Patlak models (R = 0.66-0.68). The models resulted in significantly different perfusion estimates in stress (P = 0.03), but not in rest (P = 0.74). The differences in perfusion estimates in stress were caused by differences between the distributed parameter and Patlak models and between the Patlak and Fermi models (both P < 0.001). Significantly lower perfusion estimates were found for myocardial segments subtended by coronary arteries with versus without significant stenosis, but only for estimations produced by the extended Toft model (P = 0.04) and Fermi model (P = 0.01). There were no significant differences in rest perfusion values between models. Quantitative myocardial perfusion values in stress depend on the modeling method used to calculate the perfusion estimate. The difference in myocardial perfusion estimate with or without stenosis in the subtending coronary artery is most pronounced when the extended Toft or Fermi model is used.

Fully Automatic Registration and Segmentation of First-Pass Myocardial Perfusion MR Image Sequences

Derivation of diagnostically relevant parameters from first-pass myocardial perfusion magnetic resonance images involves the tedious and time-consuming manual segmentation of the myocardium in a large number of images. To reduce the manual interaction and expedite the perfusion analysis, we propose an automatic registration and segmentation method for the derivation of perfusion linked parameters. A complete automation was accomplished by first registering misaligned images using a method based on independent component analysis, and then using the registered data to automatically segment the myocardium with active appearance models. We used 18 perfusion studies (100 images per study) for validation in which the automatically obtained (AO) contours were compared with expert drawn contours on the basis of point-to-curve error, Dice index, and relative perfusion upslope in the myocardium. Visual inspection revealed successful segmentation in 15 out of 18 studies. Comparison of the AO contours with expert drawn contours yielded 2.23 ± 0.53 mm and 0.91 ± 0.02 as point-to-curve error and Dice index, respectively. The average difference between manually and automatically obtained relative upslope parameters was found to be statistically insignificant (P = .37). Moreover, the analysis time per slice was reduced from 20 minutes (manual) to 1.5 minutes (automatic). We proposed an automatic method that significantly reduced the time required for analysis of first-pass cardiac magnetic resonance perfusion images. The robustness and accuracy of the proposed method were demonstrated by the high spatial correspondence and statistically insignificant difference in perfusion parameters, when AO contours were compared with expert drawn contours.

Contrast-Enhanced First-Pass Myocardial Perfusion Magnetic Resonance Imaging With Parallel Acquisition at 3.0 Tesla

Magnetic resonance imaging (MRI) at 3 T is significantly different than 1.5 T and needs to be optimized due to increased signal-to-noise ratio (SNR) and specific absorption ratio (SAR). This study tests the hypothesis that first-pass myocardial perfusion MRI using saturation recovery (SR)-TrueFISP with parallel imaging is superior to SR-TurboFLASH and a more achievable technique for clinical application at 3 T. Myocardial perfusion imaging was performed on 12 subjects using SR-TurboFLASH and SR-TrueFISP sequences combined with parallel imaging. Four myocardial slices were acquired and evaluated by image segmentation. Quality of the measurements was determined from SNR, contrast-to-noise ratio (CNR), enhancement-to-noise ratio (ENR), and myocardial perfusion upslope. Data were analyzed using a 2-way ANOVA with imaging method and segment number as the independent variables. SNR, CNR, ENR, and upslope were significantly higher for SR-TrueFISP versus SR-TurboFLASH (P < 0.001). Significant differences in SNR, CNR, ENR, and upslope were found among the myocardial segments (P < 0.005). Optimized SR-TrueFISP first-pass myocardial perfusion MRI at 3 T has superior image quality compared with SR-TurboFLASH, independent of the myocardial segment analyzed. However, coil sensitivity nonuniformities and dielectric resonance effects cause signal intensity differences between myocardial segments that must be accounted for when interpreting 3 T perfusion studies.

Comparative diagnostic value of dipyridamole and adenosine-triphosphate stress first-pass myocardial perfusion magnetic resonance imaging for detection of coronary artery disease

Comparative diagnostic value of dipyridamole and adenosine-triphosphate stress first-pass myocardial perfusion magnetic resonance imaging for detection of coronary artery disease

First-pass myocardial perfusion MR imaging with interleaved notched saturation: feasibility study.

The authors evaluated a magnetization preparation scheme with a "notched" section profile for T1-weighted first-pass myocardial perfusion magnetic resonance (MR) imaging at 1.5 T. The pulse sequence consisted of a preparation sequence followed by an interleaved gradient-echo echo-planar sequence. Image contrast was evaluated in a feasibility study in 12 adult patients. The notched saturation pulse allowed long magnetization recovery times without sacrificing section coverage. Image contrast between normal and ischemic myocardium was excellent.