Quantification of myocardial perfusion with self-gated cardiovascular magnetic resonance

Abstract

BackgroundCurrent myocardial perfusion measurements make use of an ECG-gated pulse sequence to track the uptake and washout of a gadolinium-based contrast agent. The use of a gated acquisition is a problem in situations with a poor ECG signal. Recently, an ungated perfusion acquisition was proposed but it is not known how accurately quantitative perfusion estimates can be made from such datasets that are acquired without any triggering signal.MethodsAn undersampled saturation recovery radial turboFLASH pulse sequence was used in 7 subjects to acquire dynamic contrast-enhanced images during free-breathing. A single saturation pulse was followed by acquisition of 4–5 slices after a delay of ~40 msec. This was repeated without pause and without any type of gating. The same pulse sequence, with ECG-gating, was used to acquire gated data as a ground truth. An iterative spatio-temporal constrained reconstruction was used to reconstruct the undersampled images. After reconstruction, the ungated images were retrospectively binned (“self-gated”) into two cardiac phases using a region of interest based technique and deformably registered into near-systole and near-diastole. The gated and the self-gated datasets were then quantified with standard methods.ResultsRegional myocardial blood flow estimates (MBFs) obtained using self-gated systole (0.64 ± 0.26 ml/min/g), self-gated diastole (0.64 ± 0.26 ml/min/g), and ECG-gated scans (0.65 ± 0.28 ml/min/g) were similar. Based on the criteria for interchangeable methods listed in the statistical analysis section, the MBF values estimated from self-gated and gated methods were not significantly different.ConclusionThe self-gated technique for quantification of regional myocardial perfusion matched ECG-gated perfusion measurements well in normal subjects at rest. Self-gated systolic perfusion values matched ECG-gated perfusion values better than did diastolic values.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-015-0109-1) contains supplementary material, which is available to authorized users.

Rapid rest/stress regadenoson ungated perfusion CMR for detection of coronary artery disease in patients with atrial fibrillation

“…This approach provides a “real-time” like set of images of a beating heart during gadolinium uptake and washout. We have described this type of ungated sequence in detail in previous works [13, 19]. …”

Split Bregman multicoil accelerated reconstruction technique: A new framework for rapid reconstruction of cardiac perfusion MRI

“…More details of the ungated DCE cardiac MR acquisition technique are given in Ref. 23. Though the SMART formulation has been tested on ten human ungated DCE cardiac perfusion datasets and high quality images have been reconstructed, the acquisition of ungated DCE cardiac perfusion images is relatively new and the SMART reconstruction method for ungated DCE data can likely be improved by including motion or using temporally varying weights.…”

“…23,26 Challenges with good gating signals at 3 T has led to the development of ungated 23,26 acquisition methods that do not use the cardiac gating signal but instead use self-gating 23 to bin the data into F. 6.…”

“…The data are then binned into near-systolic and near-diastolic frames using the self-gating method described in Ref. 23 using the initial set of reconstructions. The steps for this binning operation are shown in Fig.…”

Review of Journal of Cardiovascular Magnetic Resonance 2015

“…The authors tested a newly developed ungated perfusion sequence made from continuously acquired datasets which were retrospectively binned ("self-gated") into the systole and diastole using an iterative spatio-temporal reconstruction model [99]. The ungated acquisition was compared against the same sequence with ECG-gating as a ground truth in 7 controls.…”