Assessment of Left Ventricular Function with Single Breath-Hold Magnetic Resonance Cine Imaging in Patients with Arrhythmia

So Hyeon Bak; Sung Mok Kim; Sung-Ji Park; Min-Ji Kim; Yeon Hyeon Choe

doi:10.13104/imri.2017.21.1.20

Journal List > Investig Magn Reson Imaging > v.21(1) > 1070316

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Bak, Kim, Park, Kim, and Choe: Assessment of Left Ventricular Function with Single Breath-Hold Magnetic Resonance Cine Imaging in Patients with Arrhythmia

Original Article

iMRI 2017;21(1):20-27.

Published online: 5 January 2017

DOI: https://doi.org/10.13104/imri.2017.21.1.20

Assessment of Left Ventricular Function with Single Breath-Hold Magnetic Resonance Cine Imaging in Patients with Arrhythmia

So Hyeon Bak^1,², Sung Mok Kim^1,³, Sung-Ji Park^3,⁴, Min-Ji Kim⁵, Yeon Hyeon Choe^1,³

¹Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

²Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea

³Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

⁴Department of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

⁵Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea

Correspondence to: Sung Mok Kim, M.D., Ph.D. Department of Radiology and Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel. +82-2-3410-2519 Fax. +82-2-3410-2559 E-mail: sungmok_kim@hanmail.net

Received 5 January 201716 March 2017 Accepted 16 March 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

To evaluate quantification results of single breath-hold (SBH) magnetic resonance (MR) cine imaging compared to results of conventional multiple breath-hold (MBH) technique for left ventricular (LV) function in patients with cardiac arrhythmia.

Materials and Methods

MR images of patients with arrhythmia who underwent MBH and SBH cine imaging at the same time on a 1.5T MR scanner were retrospectively reviewed. Both SBH and MBH cine imaging were performed with balanced steady state free precession. SBH scans were acquired using temporal parallel acquisition technique (TPAT). Fifty patients (65.4 ± 12.3 years, 72% men) were included. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass, and LV regional wall motion were evaluated.

Results

EF, myocardial mass, and regional wall motion were not significantly different between SBH and MBH acquisition techniques (all P-values > 0.05). EDV, ESV, and SV were significant difference between the two techniques. These parameters for SBH cine imaging with TPAT tended to lower than those in MBH. EF and myocardial mass of SBH cine imaging with TPAT showed good correlation with values of MBH cine imaging in Passing-Bablok regression charts and Bland-Altman plots. However, SBH imaging required significantly shorter acquisition time than MBH cine imaging (15 ± 7 sec vs. 293 ± 104 sec, P < 0.001).

Conclusion

SBH cine imaging with TPAT permits shorter acquisition time with assessment results of global and regional LV function comparable to those with MBH cine imaging in patients with arrhythmia.

Keywords: Temporal parallel acquisition technique, Single breath-hold cine magnetic resonance, TGRAPPA, Arrhythmia, Left ventricular function

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Fig. 1.

Passing-Bablok regression chart (a) and Bland-Altman plot (b) of EF obtained from SBH and MBH hold cine imaging. EF values in SBH cine imaging with TPAT showed good correlation with those in MBH cine imaging. EF = ejection fraction; MBH = multiple breath-hold; SBH = single breath-hold; TPAT = temporal parallel acquisition technique

Fig. 2.

Passing-Bablok regression chart (a) and Bland-Altman plot (b) of myocardial mass obtained from SBH and MBH cine imaging. Myocardial mass in SBH cine imaging with TPAT was correlated with that in MBH cine imaging. SBH cine imaging with TPAT revealed a tendency to overestimate myocardial mass compared to MBH cine imaging. MBH = multiple breath-hold; SBH = single breath-hold; TPAT = temporal parallel acquisition technique

Fig. 3.

Distribution of regional wall motion abnormality evaluated by two acquisition techniques (n = 800 segments in each technique). Regional wall motion abnormality was not significantly different between the two acquisition techniques (P = 0.552).

Fig. 4.

Mid-ventricular short-axis images of a 78-year-old female with atrial fibrillation obtained with MBH cine imaging (a) or SBH cine imaging with TPAT (b). MBH cine imaging resulted in blurring of the myocardium.

Table 1.

Global LV Functional Parameters and Myocardial Mass Meeasured by SBH Cine Imaging with TPAT and MBH Cine Imaging

	SBH cine imaging	MBH cine imaging	P-value
	Mean ± SD	Mean ± SD	P-value
EDV^∗	195.6 ± 120.0	207.8 ± 125.8	< 0.000
ESV	115.3 ± 107.4	119.7 ± 108.7	0.001
SV^∗	78.9 ± 31.6	85.6 ± 35.1	0.000
EF	48.9 ± 18.4	48.8 ± 17.8	0.942
MM	152.8 ± 56.9	151.8 ± 56.6	0.625

Global LV function parameters and MM were compared between the two techniques using paired t-test or Wilcoxon signed rank test.

^∗ Data were analyzed using Wilcoxon signed rank test.

EDV = end-diastolic volume; EF = ejection fraction; ESV = end-systolic volume; LV = left ventricular; MBH = multiple breath-hold; MM = myocardial mass; SBH = single breath-hold; SD = standard deviation; SV = Stroke volume.

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