Li Huang¹, Radhouene Neji^1,2, Muhummad Sohaib Nazir¹, Amedeo Chiribiri¹, Reza Razavi¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom

Modified Look-Locker inversion recovery (MOLLI) as a commonly used myocardial T1 mapping approach shows high precision and reproducibility. Its limited capability in multi-slice acquisition per breathhold prolongs examination time in cases of desired full left ventricular coverage. The previously proposed fast single-breathhold 2D multi-slice myocardial T1 mapping (FAST1) technique can achieve time-efficient full left ventricular coverage at 1.5T. In this work, this capability of FAST1 at 3T is optimized and characterized. Compared to MOLLI, FAST1 can yield 4-fold increase of spatial coverage, limited penalty of T1 spatial variability, no significant difference of T1 repeatability and linearly correlated T1 values.

Jack Allen^1,2, Peter Gatehouse^1,2, Rick Wage¹, David Firmin^1,2, and Jennifer Keegan^1,2
1Cardiovascular Magnetic Resonance Unit, Royal Brompton and Harefield NHS Trust, London, United Kingdom, ²National Heart and Lung Institute, Imperial College London, London, United Kingdom

3D LGE is used to assess scar in patients with atrial fibrillation. However, the fast and variable heart rate in these patients results in poor image quality. An existing dynamic-TI method varies inversion time on a beat-by-beat basis (according to the previous cardiac cycle length) to improve myocardial nulling, but blood signal variations are incompletely corrected and cause ghosting. We have developed an improved technique which bases the beat-by-beat TI on the history of RR intervals (rather than the previous one) and reduces blood signal variations while maintaining myocardial nulling. Simulations with patient RR interval distributions show significantly improved results.

Suvai Gunasekaran¹, Mohammed S.M. Elbaz¹, Daniel Lee¹, Michael Markl¹, Rod Passman¹, and Daniel Kim^1
1Northwestern University, Chicago, IL, United States

Given the thin nature of the left atrial (LA) wall and the need to perform respiratory gating, the clinical translation of LA late gadolinium-enhanced (LGE) MRI has proven challenging, particularly at 1.5 Tesla. To address this, a recent study described development of a self-navigated, free-breathing 3D LA LGE pulse sequence using stack-of-stars k-space sampling and XD-GRASP reconstruction. Here, we aim to derive the cut point for LA fibrosis for this 3D LA LGE technique, by using image intensity ratio (LA wall/blood signal) of healthy volunteers, and evaluate LA fibrosis in patients with and without atrial fibrillation. 

Masami Yoneyama¹, Michinobu Nagao², Yasuhiro Goto³, Shuo Zhang⁴, Isao Shiina³, Kazuo Kodaira³, Yutaka Hamatani³, and Marc Van Cauteren^5
1Philips Japan, Tokyo, Japan, ²Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University, Tokyo, Japan, ³Department of Radiological Services,, Tokyo Women’s Medical University, Tokyo, Japan, ⁴Philips Healthcare, Hamburg, Germany, ⁵Philips Healthcare, Best, Netherlands

Current myocardial T2-mapping based on either segmented or single-shot readout obtains one 2D slice per breath hold. To overcome the limitations in spatial coverage and breath hold dependence, we report free-breathing 3D isotropic whole-heart T2 mapping using a T2-prepared segmented gradient echo sequence with interleaved scan, which enables quantitative mapping at multiple cardiac phases such as late diastole and systole. We demonstrate the feasibility of this approach with comparison to the conventional techniques in healthy volunteer examination.

Dominique Franson¹, Rajiv Ramasawmy², Nicole Seiberlich^1,3, and Adrienne Campbell-Washburn^2
1Case Western Reserve University, Cleveland, OH, United States, ²National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States, ³University of Michigan, Ann Arbor, MI, United States

A free-breathing late gadolinium enhancement scan may be beneficial for patients who have difficulty with breath-holds.  However, the fast data acquisition needed may be difficult to achieve at low field strengths.  Here, an undersampled spiral (R=3) acquisition with a through-time spiral GRAPPA reconstruction is used to achieve high spatial (1.25 x 1.25 mm²) and temporal (139 ms acquisition window) resolution for LGE imaging at 0.55T.  The resulting images have qualitatively good contrast-to-noise between lesions and healthy myocardium, with acceptable SNR and without motion blurring.  

Xiaomeng Wu¹, Shuai Liu², Zhangxuan Hu², Tan Gong¹, Xue Lin³, Hua Guo², Weitian Chen⁴, Fei Shang¹, and Xihai Zhao^2
1Department of Biomedical Engineering, Beijing Institute of Technology, Beijing, China, ²Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, ³Department of Cardiology, Peking Union Medical College Hospital, Beijing, China, ⁴Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China

Quantitative Cardiovascular Magnetic Resonance (CMR) imaging has been widely used in detection of    myocardial diseases. In this study, T1 rho and T1 mapping MR imaging were performed in subjects with and without alcohol consumption to assess the impact of drinking on the heart. The results suggested that compared with healthy controls, heavy alcohol consumption may lead to detectable changes in myocardial tissues, while moderate alcohol consumption showed no significant difference. In addition, T1 mapping was more sensitive to detect myocardial changes caused by alcohol than T1 rho.

Yaodan Liang¹, Yuanwei Xu², Weihao Li², Jing An³, and Yucheng Chen^2
1Department of Cardiology, Beijing Hospital, Beijing, China, ²Department of Cardiology, West China Hospital, Chengdu, China, ³Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China

This study aimed to demonstrate the dynamic changes of tissue characteristics in patients with peripartum cardiomyopathy (PPCM). Cardiovascular magnetic resonance (CMR) examination was performed using a 3.0T MR scanner, consisted of a MOLLI sequence for T1 mapping, and a T2 prep with bSSFP for T2 mapping. Ten PPCM patients with repeated CMR and 20 healthy age-matched females were analyzed. After a median 15.3-month follow-up, five patients had a recovered left ventricular ejection fraction. PPCM patients showed significantly higher native T1, extracellular volume, and T2 than normal controls. Furthermore, native T1 decreases significantly in the follow-up CMR of PPCM patients.

Bo He¹, Jie Zheng², and Fabao Gao^1
1Radiology, Medical Imaging，West China School of Medicine, Sichuan University, Chengdu， Sichuan, China, ²Mallinckrodt Institute of Radiology, Washington, WA, United States

10 healthy volunteers underwent rest and stress Free-breathing myocardial native T1 mapping CMR scanning twice in a 3.0T MR scanner in midventricular short-axis position using a custom-made MRI-compatible ergometer pedal exerciser. It was demonstrated that T1 reactivity (ΔT1 values) had a moderate reliability and an excellent repeatability. The assessment of native myocardial T1 value using the pedal exerciser CMR stress/rest T1 mapping holds promise for myocardium ischemia detection without injecting gadolinium contrast agents and pharmacologic agents, also shows an excellent repeatability to demonstrates for the first time that normal myocardium has distinctive ranges of T1 reactivity to exercise stress.

Antonella Meloni¹, Maddalena Casale^2,3, Aldo Filosa², Laura Pistoia¹, Vincenzo Positano¹, Emanuele Grassedonio⁴, Elda Chiara Resta⁵, Gennaro Restaino⁶, Riccardo Righi⁷, Lorella Pitrolo⁸, Antonella Quarta⁹, and Alessia Pepe^1
1MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli", Napoli, Italy, ³Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy, ⁴Policlinico "Paolo Giaccone", Palermo, Italy, ⁵Ospedale “SS. Annunziata”, Taranto, Italy, ⁶Fondazione di Ricerca e Cura "Giovanni Paolo II", Campobasso, Italy, ⁷Ospedale del Delta, Lagosanto (FE), Italy, ⁸Ospedale "V. Cervello", Palermo, Italy, ⁹Ospedale "A. Perrino", Brindisi, Italy

In pediatric thalassemia major patients who performed a baseline and a follow-up MRI study at 18±3 months the percentage changes in global heart T2* values per month were not influenced by initial hepatic iron levels and were not correlated to final hepatic iron. Moreover, the correlation between % changes in global heart T2* and MRI liver iron concentration values did not reach the statistical significance So, our data seem not supporting the hypothesis for which it is necessary to clean the liver before removing iron from the heart.

Alina Psenicny¹, Camila Munoz¹, Aurélien Bustin¹, Karl P Kunze², Radhouene Neji^1,2, Pier-Giorgio Masci¹, René M Botnar¹, and Claudia Prieto^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom

Simultaneous ¹⁸F-FDG PET-MR imaging has shown promise for improved diagnostic accuracy of inflammatory cardiac diseases, such as cardiac sarcoidosis. However, respiratory motion and mis-registration between free-breathing 3D PET and conventional 2D breath-held MR images remain a challenge that has hindered clinical adoption of this technique. Here we introduce a 3x-accelerated free-breathing motion-corrected 3D whole-heart T₂-mapping prototype sequence, which provides characterisation of myocardial inflammation while additionally providing non-rigid respiratory deformation fields to correct simultaneously acquired PET data. Results from phantom, healthy subjects and patients show that the method produces good-quality high-resolution 3D T₂ maps from an efficient scan of ~10 minutes.

Karolina Dorniak¹, Lorenzo Di Sopra², Agniezka Sabisz³, Anna Glinska³, Christopher W Roy², Kamil Gorczewski⁴, Davide Piccini^2,5, Jérôme Yerly^2,6, Jadwiga Fijałkowska³, Edyta Szurowska³, Matthias Stuber^2,6, and Ruud B van Heeswijk^2
1Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Gdansk, Poland, ²Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, ³2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland, ⁴Siemens Healthineers, Erlangen, Germany, ⁵Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland, ⁶Center for Biomedical Imaging (CIBM), Lausanne, Switzerland

T₂ mapping can be used to effectively detect myocardial edema and inflammation. However, the focal nature of myocardial inflammation may render 2D approaches suboptimal and make whole-heart isotropic 3D mapping desirable. Unfortunately, at 1.5T, self-navigated 3D radial bSSFP results in too noisy images for adequate T₂ mapping. In this study, we therefore used a respiratory motion-resolved reconstruction together with image registration to improve the 3D T₂ mapping precision and accuracy at 1.5T in patients with inflammatory myocardial injury. The resulting myocardial T₂ values matched those of the routine 2D T₂ maps, with no discernible bias and slightly lower precision.

Sandra Lehmann^1,2, Min-Chi Ku^1,3, Joao dos Santos Periquito¹, Han Haopeng¹, Andreas Pohlmann¹, and Thoralf Niendorf^1,3,4
1Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany, ²Technische Universität Berlin, Berlin, Germany, ³DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany, ⁴Experimental and Clinical Research Center, Charite Medical Faculty and the Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany

Hypertrophic cardiomyopathy (HCM) is the most frequent inherited monogenic heart disease and could lead to heart failure or even sudden cardiac death. Effective relaxation time T₂* is related to different physiological parameters. Dynamic CINE mapping of T₂* covering the entire cardiac cycle facilitates distinction of healthy and pathologic myocardial tissue. Here we propose, implement, evaluate and apply an effective approach of retrospective cardiac gating that affords for the first time CINE T₂*-mapping in mice at 9.4T and provides the technological basis for translational research into a deeper understanding of the mechanisms underlying hypertrophic cardiomyopathy.

Yuta Endo¹, Rei Ikegawa¹, Kuninori Kobayashi¹, Makoto Amanuma¹, and Shigehide Kuhara^1
1Kyorin University Faculty of Heaith Science, Mitaka, Japan

Fast cardiac T1 mapping including MOLLI with ECG-gating leads to poorer T1 measurement accuracy, since the recovery time of the longitudinal magnetization changes with heart rate variation. Ikekawa et al. proposed correction methods for the changes in the inversion recovery time at each sampling point and in that of longitudinal magnetization on the heartrate variation; however, the specific factor that predominantly improves T1 measurement remains unclear. Here, we investigated the dominant effect of the proposed correction method in the effect of heartrate variation on T1 measurement using BlochSolver.

Hongqin Liang¹, Liqiang Zhu², Bing Ji¹, Qing Li³, Xiaoyue Zhou⁴, and Jian Wang^1
1Southwest Hospital, Army Medical University, Chongqing, China, ²The Central Theater Command Air Force Hospital of PLA, Datong, China, ³Siemens Healthineers Ltd., Shanghai, China, ⁴Siemens Healthcare Ltd, Shanghai, China

Long-term military training leads to the remodeling of the heart and may cause exercise-induced myocardial injury (EIMI). The mechanism of heart remodeling is studied by using cardiac cine MRI to estimate left ventricular cardiac function and global stress. This study found that prolonged and intensive training lasting 4 years leads to cardiac morphological adaptations. Contrary to conventional thinking, left ventricular function changes happens earlier than the mechanical direction.

David Lohr¹, Maxim Terekhov¹, Ibrahim A. Elabyad¹, Franziska Veit², and Laura Maria Schreiber^1
1Chair of Cellular and Molecular Imaging, Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany, ²Chair Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, Würzburg, Germany

MRI measurements of ex-vivo hearts at ultrahigh field strengths (≥7T) can provide high resolution, high fidelity ground truth data that complement clinical cardiac MRI. In this study we demonstrate ex-vivo sample preparation steps and capabilities of a custom built, multiple element transceiver array dedicated to high resolution imaging of ex-vivo hearts. Measurements included whole heart data for T₂^* maps, a high resolution 3D FLASH, as well as high resolution DTI. We found that receive sensitivity of the dedicated coil was superior to a commercial head coil and that SNR was similar, even without the application of B₁­-shim.

Anna V Naumova¹, Lauren E Neidig^2,3,4, Hiroshi Tsuchida^2,3, Kenta Nakamura⁵, Charles E Murry^2,3, and Vasily L Yarnykh^1
1Radiology, University of Washington, Seattle, WA, United States, ²Pathology, University of Washington, Seattle, WA, United States, ³Institute for Stem Cells and Regenerative Medicine, University of Washington, Seattle, WA, United States, ⁴Comparative Medicine, University of Washington, Seattle, WA, United States, ⁵Cardiology, University of Washington, Seattle, WA, United States

This pilot study shows the feasibility of fast MPF mapping in cardiac applications in the clinical magnetic field using a large-animal model. The results demonstrate that MPF maps present the effective source of the quantitative soft tissue endogenous contrast in sub-acute myocardial infarction and can be obtained with high spatial and temporal resolution.

Malte Roehl^1,2, Peter Gatehouse^1,2, Pedro Ferreira^1,2, Sonia Nielles-Vallespin^1,2, Sonya Babu-Narayan^1,2, Margarita Gorodezky^1,2, Hui Xue³, Peter Kellman³, Dudley Pennell^1,2, David Firmin^1,2, and Andrew Scott^1,2
1Imperial College London, London, United Kingdom, ²Royal Brompton Hospital, London, United Kingdom, ³NIH, Bethesda, MD, United States

In regions of short T2*decay during long spiral k-space covering readouts can cause significant image blurring. In this work we introduce a novel correction for spatially varying T2* including a stimulated echo-based spiral T2* mapping sequence and compare it to an existing correction for constant T2*. Using both computational simulations and in-vivo spiral cardiac diffusion tensor data we show that the spatially varying correction improves the sharpness compared to the constant correction.

Seraina A. Dual^1,2, Nyasha G. Maforo^3,4, Patrick Magrath^1,5, Doff B. McElHinney⁶, Ashley Prosper⁵, Holden H. Wu^4,5, Nancy Halnon⁷, Shiraz Maskatia^6,8, Pierangelo Renella^3,5, and Daniel B. Ennis^1,8,9
1Department of Radiology, Stanford University, Palo Alto, CA, United States, ²Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, United States, ³Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, CA, United States, ⁴Department of Radiological Sciences, University of California, Los Angeles, CA, United States, ⁵Department of Bioengineering, University of California, Los Angeles, CA, United States, ⁶Department of Pediatrics, Stanford University, Palo Alto, CA, United States, ⁷Department of Pediatrics, University of California, Los Angeles, CA, United States, ⁸Maternal & Child Health Research Insitute, Palo Alto, CA, United States, ⁹Cardiovascular Insitute, Stanford University, Palo Alto, CA, United States

Early diagnosis of cardiac involvement in boys with Duchenne muscular dystrophy (DMD) allows for timely therapy. The aim of this study was to assess the association between native T1 in the right ventricle (RV) and cardiac involvement as marked by decreased left ventricular (LV) or RV ejection fraction (EF). Healthy boys (N=10) and boys with DMD (N=16) underwent 3T cardiac MR using motion-corrected gradient-MOLLI T1-mapping, a clinically routine protocol. RV-T1 did not correlate with LVEF or RVEF. Longer native LV-T1 was associated with lower LVEF. Based on this data, native RV-T1 does not provide insight to cardiac involvement in DMD.

Ernest Cheung¹, Hui-Chen Han¹, Emma Hornsey¹, Leonid Churilov^2,3, Kyung Pyo Hong⁴, Han Lim^1,2, Julie Smith¹, Daniel Kim⁴, and Ruth Lim^1,2
1Austin Health, Melbourne, Australia, ²The University of Melbourne, Melbourne, Australia, ³The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia, ⁴Northwestern University, Evanston, IL, United States

We compare two cardiac T1 mapping techniques, arrhythmia insensitive rapid (AIR) which is a saturation recovery technique acquired in a short breath-hold and robust to arrhythmia, and Modified Look-Locker inversion recovery (MOLLI), in 55 patients with mitral valve prolapse. There was excellent inter-reader agreement in T1 values and extracellular volume (ECV) between techniques. However, higher T1 values were observed in AIR compared to MOLLI and vice versa for ECV, consistent with previous studies reporting significantly different T1 and ECV values between inversion recovery and saturation recovery techniques. These differences are important to consider when applying T1 mapping to clinical practice. 

Yasuhiro Goto¹, Michinobu Nagao², Masami Yoneyama³, Isao Shiina¹, Kazuo Kodaira¹, Yutaka Hamatani¹, Mamoru Takeyama¹, Isao Tanaka¹, and Shuji Sakai^2
1Department of Radiological Services, Tokyo Women's Medical University Hospital, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

We compared the image quality of the motion-compensated (MoCo) and conventional (non-MoCo) cardiac TSE-DWI by visual evaluation and homogeneity evaluation. MC-TSE-DWI achieved superior image quality compared with non-MoCo-TSE-DWI in all b-values and all segments. MoCo-TSE-DWI improves the image quality and may increase the diagnostic potential.

Xingmin Guan^1,2, Yinyin Chen^1,3,4, Hsin-Jung Yang¹, and Rohan Dharmakumar^1
1Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²University of California, Los Angeles, Los Angeles, CA, United States, ³Radiology, Zhongshan Hospital, Fudan University, Shanghai, China, ⁴Medical Imaging, Shanghai Medical School, Shanghai Institute of Medical Imaging, Shanghai, China

Double inversion recovery preparation is often used in T2* cardiac MRI to acquire dark-blood images. We investigated the impact of dark-blood preparation on imaging of intramyocardial hemorrhage in patients with acute MI at 1.5T. SNR and CNR were compared between dark-blood and bright-blood T2* weighted images. Hemorrhage size, T2* were evaluated and compared between methods. Inter-observer reliability were reported as intraclass correlation coefficients. Our findings here support the notion that when choosing between bright-blood and dark-blood T2* cardiac MRI for the determination of intramyocardial hemorrhage in patients at 1.5T, bright-blood T2* cardiac MRI is likely the preferred approach.

Li Huang¹, Radhouene Neji^1,2, Filippo Bosio¹, Amedeo Chiribiri¹, Reza Razavi¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom

Extra-cellular volume (ECV) mapping using combined native and post-contrast myocardial T1 maps shows promise in assessing cardiomyopathies. However, its feasibility for full left ventricular (LV) coverage is limited using conventional myocardial T1 mapping techniques such as modified Look-Locker inversion recovery (MOLLI) with single-slice acquisition per breathhold. The previously proposed fast single-breathhold 2D multi-slice myocardial T1 mapping (FAST1) technique can provide time-efficient full LV coverage. In this work, its capability for ECV mapping with full LV coverage at 1.5T is evaluated. Compared to MOLLI, FAST1 yields 4-fold increased spatial coverage, limited penalty of ECV spatial variability and highly correlated ECV values.

Shiyu Wang¹ and Fabao Gao^1
1Department of Radiology, West China Hospital / West China School of Medicine, Chengdu, China

the aim of this study is to identify early stages of doxorubicin (DOX)-induced cardiotoxicity in rat model using 7.0 tesla cardiac magnetic resonance (CMR) combining creatine kinase isoenzymes (CKMB).Comparison of Ejection fraction (EF), Global radial (GRS), circumferential (GCS) and longitudinal strain (GLS) parameters of LV and CKMB between experimental groups and controls at 4,6, 8, 10 weeks.CKMB can detect DOX-induced cardiotoxicity at the earliest time. Decreased GLS during treatment identifies impaired LV mechanic as an early marker of DOX-induced cardiotoxicity, in the absence of EF. CKMB and CMR-TT are an effective method to evaluate DOX-induced cardiotoxicity at early stage.

Tiago Ferreira da Silva^1,2, Paula Montesinos¹, Carlos Galan-Arriola², Robert Austin Benn², Borja Ibañez^2,3, and Javier Sánchez-González^1
1Philips Healthcare Iberia, Madrid, Spain, ²Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain, ³Department of Cardiology, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain

We propose a new 3D simultaneous T1 and T2 mapping technique to acquire accurate co-registered 3D T1 and T2 maps of the entire left ventricle in a single breath-hold. The technique combines T2-prep and saturation pulses with compressed SENSE.

The proposed sequence successfully acquired co-registered 3D T1 and T2 maps in a single breath-hold of 17 s (HR=60 bpm). Phantom estimated T1 and T2 values were in agreement with gold-standard values obtained from IR-SE and GraSE, respectively. Accuracy and precision results were similar to previously published values for saturation recovery at 3T.

Haojie Li¹, Hui Zhu¹, Zhaoxia Yang¹, and Liming Xia^1
1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Fulminant myocarditis is a  rare form of acute severe myocarditis and accurate detection and monitoring of the inflammatory myocardial edema is essential for clinical decision-making. We therefore evaluated the ability of multiparametric CMR to  detect and monitor the inflammation myocardial alterations and to differentiate acute and convalescent stage of fulminant myocarditis.

Maria Teodora Antuaneta Wetscherek¹, Christian Lücke², Philipp Lurz³, and Matthias Gutberlet^2
1Radiology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom, ²Department of Diagnostic and Interventional Radiology, University Leipzig – Heart Center Leipzig, Leipzig, Germany, ³Department of Cardiology, University Leipzig – Heart Center Leipzig, Leipzig, Germany

.The purpose of our study was to evaluate T1-mapping for the comparison of chronic myocarditis, nonischemic dilated cardiomyopathy (DCM) and hypertensive heart disease using two MOLLI schemes in a clinical setting. We prospectively enrolled 81 patients investigated for suspected myocarditis that underwent a cardiac magnetic resonance protocol including consecutively acquired 3(3)3(3)5MOLLI and 5(3)3 MOLLI T1-mapping. We performed an overall and segmental analysis on a single mid ventricular short-axis slice. The results from the two MOLLI schemes are very similar. A segmental evaluation of 5(3)3MOLLI data could enable refining diagnosis in clinical practice, particularly when DCM is within the differential diagnoses.

Seonghwan Yee¹ and Seonghwan Yee^2
1CU Anschutz medical, Aurora, CO, United States, ²Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States

A novel generalized modeling method is presented here for the MOLLI signal. When compared with the conventional 3-parameter exponential modeling, this new modeling  demonstrates the better accuracy, particularly with the larger T1 values in the case of using enhanced acquisition timing scheme (e.g. 4s(1s)3s(1s)2s).  The fact that this novel modeling method does not require full recovery of longitudinal magnetization in successive inversion pulses strongly suggests the possibility of further reducing the total MOLLI scan time to the level a few seconds less than 10 s, which would be much beneficial for those patients who have difficulty in holding the breath.

Tao Wu¹, Yan Ren², Wei Cheng¹, Wei Wang², Fangli Zhou², Xiaoyue Zhou³, Yucheng Chen⁴, and Jiayu Sun^1
1Department of Radiology, West China Hospital, Chengdu, China, ²Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Chengdu, China, ³MR Collaboration, Siemens Healthineers Ltd, Shanghai, China, ⁴Department of Cardiology, West China Hospital, Chengdu, China

Primary aldosteronism (PA) increases cardiovascular morbidity. In order to elucidate the early features of heart damage of PA, we used the cardiac MRI and T1 mapping technique to evaluate and compare cardiac function and myocardium changes in PA and essential hypertension (EH) patients. Our results found that the PA patients had higher native T1 than the EH group, while other functional parameters had no significant differences between two groups. The change of myocardium was earlier in PA patients than in EH patients, suggesting that it is mainly due to myocardial fibrosis induced by inappropriate secretion of aldosterone.

Kylian Haliot^1,2,3, Andreea Hertanu⁴, Olivier Girard⁴, Lucas Soustelle⁴, Guillaume Duhamel⁴, Julie Magat^1,2,3, and Bruno Quesson^1,2,3
1IHU Liryc, Fondation Bordeaux Université, Pessac, France, ²U1045 CRCTB, Université de Bordeaux, Bordeaux, France, ³INSERM, CRCTB, U1045, Bordeaux, France, ⁴Aix-Marseille Univ, CNRS, CRMBM, Marseille, France

The Purkinje network (PN) of the heart plays a major role in cardiac electrical diseases such as in sudden cardiac death. Imaging of this fine network is of central interest to better characterize the links between electrical disorders and structural modifications of the heart. PN is composed of fibers containing cardiomyocytes surrounded by a collagen sheath (PF). In this study, we implemented inhomogeneous magnetization transfer (ihMT) sequence at 9.4T and evaluate this technique on ex vivo samples of pig heart fixed into formalin. We show that ihMT is a suitable candidate to increase the contrast between PF and cardiac muscle.

Chenao Zhan¹, Tao Ai¹, Yayuan Geng², and Liming Xia^1
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²Huiying Medical Technology Co., Ltd, Beijing, China

In clinical setting, there are three distinguishable entities presented mainly with left ventricular cardiac hypertrophy, including HCM, HHP and CA. Imaging differential diagnosis relies on LGE-CMR, and recently proposed native T1 mapping, which has high diagnostic accuracy and is potentially more sensitive for detecting disease than LGE imaging. However, both modalities are insufficient robustness for the differential diagnosis of three diseases. In this study, radiomics analysis was adopted into the differential diagnosis of cardiac hypertrophy with MR T1-mapping. And diagnostic accuracy of 0.95/0.96 can be achieved with test dataset, which is significantly improved as compared with conventional native T1 mapping.

Antonella Meloni¹, Laura Pistoia¹, Vincenzo Positano¹, Giuseppe Peritore², Paolo Preziosi³, Ada Riva⁴, Massimiliano Missere⁵, Antonino Vallone⁶, Valentina Carrai⁷, F. Mehtap Pasin³, Mauro Murgia⁸, and Alessia Pepe^1
1MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²"ARNAS" Civico, Di Cristina Benfratelli, Palermo, Italy, ³Ospedale "Sandro Pertini", Roma, Italy, ⁴Ospedale “SS. Annunziata” ASL Taranto, Taranto, Italy, ⁵Fondazione di Ricerca e Cura "Giovanni Paolo II", Campobasso, Italy, ⁶Azienda Ospedaliera "Garibaldi" Presidio Ospedaliero Nesima, Catania, Italy, ⁷Universitaria Careggi, Firenze, Italy, ⁸Ospedale San Martino di Oristano, Oristano, Italy

In patients with thalassemia intermedia (TI) pancreatic iron overload is frequent (58.1%), especially if regular transfusions are performed. Pancreatic T2* values were correlated with cardiac T2* values and a normal pancreas T2* showed negative predictive value of 100% for cardiac iron. Global pancreas T2* values were not correlated to biventricular volumes and ejection fraction or to myocardial fibrosis.

Zhengyang Ming^1,2, Hengjie Liu^1,2, Caroline Colbert^1,2, Kim-Lien Nguyen^1,2,3, and Peng Hu^1,2
1Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States, ²Physics and Biology in Medicine Inter-Departmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, United States, ³Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States

T1 relaxation time for myocardial tissue represents a biomarker for a variety of pathologies. High resolution and pixel-wise T1 mapping can be acquired with Modified Look-Locker Imaging1 (MOLLI). Besides, T1 measurements of blood can be used as a reference value to calculate function parameters like extracellular volume (ECV) fraction2,3 and myocardial blood volume4.5 (MBV). Blood flow may affect blood T1 measurements and cause further deviation in calculating function parameters 6. In our work, we proposed a MOLLI-based flow model to simulate flow effect. Substantial T1 deviation may happen when the spin replacement rate is between 0.65 and 0.70.

Giulio Ferrazzi¹, Sarah McElroy¹, Radhouene Neji^1,2, Karl Kunze^1,2, Muhummad Sohaib Nazir¹, Peter Speier³, Daniel Stäb⁴, Christoph Forman³, Reza Razavi¹, Amedeo Chiribiri¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom, ³Cardiovascular MR predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁴MR Research Collaborations, Siemens Healthcare Limited, Melbourne, Australia

The clinical need of covering multiple slices in myocardial perfusion constrains the saturation delay time to be short. However, this may be suboptimal in terms of myocardial/defect tissue contrast and blood/myocardium signal ratios. Moreover, it is not possible to acquire the same slice twice, and all slices are at different cardiac phases.

In this study, we develop a perfusion sequence which provides dual phase and dual contrast data using simultaneous multi-slice at two different saturation delay times. Simulations and in-vivo data acquired in patients demonstrated a 150% increase of myocardial/defect contrast, and decreased blood/myocardium signal ratio by 60 to 80%.

Xenios Milidonis¹, Russell Franks¹, Kajol Verma¹, Torben Schneider^1,2, Javier Sánchez-González³, Sven Plein¹, and Amedeo Chiribiri^1
1King's College London, London, United Kingdom, ²Philips Healthcare, Guilford, United Kingdom, ³Philips Healthcare, Madrid, Spain

The arterial input function (AIF) describes the contrast agent input to the myocardium and is required for blood flow quantification. However, the impact of the AIF sampling location on quantification by cardiovascular magnetic resonance and the diagnosis of coronary artery disease (CAD) has yet to be determined. In this study, perfusion imaging was performed in patients with suspected CAD and blood flow was quantified for seven different locations. It was found that the sampling location has a significant impact on blood flow measurements, while the ascending aorta led to the most accurate prediction of inducible perfusion abnormalities.

Sungtak Hong¹, Kyungpyo Hong², Li-Yueh Hsu³, Daniel C Lee⁴, and Daniel Kim^1
1Radiology, Northwestern University, Chicago, IL, United States, ²Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ³National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States, ⁴Division of Cardiology, Internal Medicine, Northwestern University, Chicago, IL, United States

We have recently developed a perfusion CMR pulse sequence using golden angle radial acquisitions and CS reconstruction. The radial k-space sampling allows retrospective manipulation of saturation-recovery time (TS) using k-space weighted image contrast (KWIC) filtering. This study was conducted to determine the importance of SNR in myocardial blood flow quantification derived from cardiac perfusion CMR. Our analysis shows that mean resting MBF values decreases with TS, where the result with the highest TS = 95 ms agrees best with literature value reported by cardiac PET studies.   

Sarah McElroy¹, Giulio Ferrazzi¹, Sohaib Nazir¹, Karl Kunze², Radhouene Neji², Peter Speier³, Daniel Staeb⁴, Christoph Forman³, Reza Razavi¹, Amedeo Chiribiri¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom, ³Cardiovascular MR Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁴MR Research Collaborations, Siemens Healthcare Pty Ltd, Melbourne, Australia

CMR perfusion imaging requires high temporal resolution, which limits the achievable spatial coverage and spatial resolution using conventional acquisition techniques. Simultaneous multi-slice (SMS) bSSFP perfusion imaging has been previously demonstrated at 1.5 T with matched spatial resolution and doubled spatial coverage compared to conventional protocols. In this work, we have implemented a pseudorandom undersampling scheme for SMS-bSSFP perfusion with compressed sensing reconstruction to increase in-plane acceleration of SMS-bSSFP imaging, enabling high spatial coverage and spatial resolution perfusion imaging at 1.5 T.

Sarah McElroy¹, Sohaib Nazir¹, Karl Kunze², Radhouene Neji², Amedeo Chiribiri¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom

Accurate quantification of myocardial blood flow using cardiac MR perfusion imaging requires a linear relationship between the arterial input function and myocardial signal intensity curves. Typically this condition is not fulfilled with standard contrast agent doses, but can be achieved using signal calibration techniques for direct contrast concentration quantification. These methods use a low flip angle (LFA) reference image for normalisation. However, normalisation based on a low SNR reference image results in poor precision of T1 estimates. In this study the use of a high flip angle reference image shows improved precision compared to a LFA technique.

Johnathan Le^1,2,3, Ye Tian^2,3,4, Jason Mendes^2,3, Mark Ibrahim⁵, Brent Wilson⁵, Edward DiBella^1,2,3, and Ganesh Adluru^1,2,3
1Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States, ²Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States, ³Utah Center for Advanced Imaging Research (UCAIR), University of Utah, Salt Lake City, UT, United States, ⁴Department of Physics, University of Utah, Salt Lake City, UT, United States, ⁵Department of Cardiology, University of Utah, Salt Lake City, UT, United States

Although dynamic contrast enhanced (DCE) MRI has been successfully applied for characterizing coronary artery diseases, an acquisition scheme limited to 2-4 short axis slices restricts coverage of the left ventricle. Radial simultaneous multi-slice (SMS) has been shown to improve DCE cardiac perfusion by providing complete coverage of the left ventricle but also requires an increase in reconstruction time. Here we propose using a 3D residual booster U-Net to improve reconstruction time of spatio-temporal constrained reconstruction methods for radial SMS datasets. Results demonstrate promising improvements with a speed up in reconstruction by a factor of ~200.

Ye Tian¹, Qi Huang¹, Jason Mendes¹, Ganesh Adluru¹, and Edward DiBella^1
1Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States

We study the flow effects in AIF estimation for myocardial perfusion MRI. Simulations were performed and radially acquired datasets were retrospectively analyzed. We reconstruct images using different number of rays and estimated AIF from each reconstruction. The results show an increase in peak AIF values with a longer acquisition window. For acquisition window of 125ms and 187ms, we found an averaged 10.6% and 22.9% increase when compared with acquisition window of 62ms. A low acquisition window is preferred to acquire an accurate AIF for quantitative myocardial perfusion MRI.

Vanessa Landes¹, Ahsan Javed², Terrence Jao³, Qin Qin^4,5, and Krishna Nayak^2
1Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, ²Electrical Engineering, University of Southern California, Los Angeles, CA, United States, ³Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ⁴Radiology, Johns Hopkins University, Baltimore, MD, United States, ⁵F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States

We present an improved velocity-selective (VS) labeling pulse for myocardial arterial spin labeling (ASL) that addresses limitations of prior pulses. The proposed pulse is designed using a Fourier Transform based Velocity-Selective (FT-VS) pulse train and optimized to label coronary blood while not labeling myocardium. Myocardial VSASL experiments were performed in healthy adult volunteers. The proposed pulse provided comparable measurements to FAIR ASL and a 2.5-fold reduction in physiological noise compared to a prior VS-ASL pulse.  

Qi Huang^1,2, Ye Tian², Jason Mendes², Ganesh Adluru^1,2, and Edward DiBella^1,2
1Biomedical Engineering, University of Utah, Salt Lake City, UT, United States, ²Utah Center for Advanced Imaging Research (UCAIR), University of Utah, salt lake city, UT, United States

Here we propose a unique perfusion acquisition that applies a 2D/3D alternating acquisition method to obtain 2D simultaneous multi-slice (SMS) and 3D stack-of-stars (SoS) data every other heartbeat. Within each heartbeat, 2D SMS and 3D acquisitions are performed following a saturation pulse. Potential advantages include different spatio-temporal resolution and artifacts, accurate AIF acquisitions and the ability to compare the sequences directly with a single injection. Preliminary quantitative results of 7 dog and 3 human studies show the promise of this approach.

Antonella Meloni¹, Antonio De Luca², Cinzia Nugara³, Chiara Cappelletto², Camilla Cavallaro⁴, Chrysanthos Grigoratos¹, Giovanni Donato Aquaro¹, Giancarlo Todiere¹, Andrea Barison¹, Gianfranco Sinagra², Giuseppina Novo³, Germano Di Sciascio⁴, and Alessia Pepe^1
1MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²University of Trieste, Trieste, Italy, ³University of Palermo, Palermo, Italy, ⁴Università Campus Bio-Medico, Roma, Italy

We assessed for the first time the prognostic value of the ΔESPVR (difference between peak and rest end-systolic pressure-volume relation) index evaluated during dipyridamole stress-CMR in 196 patients with known or suspected coronary artery disease. During a mean follow-up time of 53.17±28.21 months 50 cardiac events were recorded. In the multivariate analysis the independent predictive factors for cardiac events were diabetes, a ΔESPVR index≤0.02 mmHg/mL/m2, and myocardial fibrosis.

Antonella Meloni¹, Antonio De Luca², Cinzia Nugara³, Chiara Cappelletto², Camilla Cavallaro⁴, Giovanni Donato Aquaro¹, Chrysanthos Grigoratos¹, Giancarlo Todiere¹, Andrea Barison¹, Gianfranco Sinagra², Giuseppina Novo³, Germano Di Sciascio⁴, and Alessia Pepe^1
1MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²University of Trieste, Trieste, Italy, ³University of Palermo, Palermo, Italy, ⁴Università Campus Bio-Medico, Roma, Italy

We showed for the first time that the ΔESPVR index, an index of myocardial contractile function easily obtained during routine stress echocardiography, can be noninvasively calculated during a dipyridamole stress-CMR exam. The ΔESPVR index was independent from baseline LV dimensions and function while it was lower in patients with myocardial fibrosis and in patients with abnormal stress CMR. At receiver-operating characteristic curve analysis, a ΔESPVR<0.02 predicted the presence of future cardiac events, being useful for additional prognostic stratification.

Douglas Black¹, Sokratis Stoumpos¹, Michael Jerosch-Herold², Neil Chatterjee³, Peter Gatehouse⁴, Geeshath Jayasekera¹, Timothy Carroll⁵, David Kingsmore¹, Colin Berry¹, Patrick Mark¹, Giles Roditi¹, and Aleksandra Radjenovic^1
1University of Glasgow, Glasgow, United Kingdom, ²Harvard Medical School, Boston, MA, United States, ³University of Pennsylvania, Philadelphia, PA, United States, ⁴Imperial College, London, United Kingdom, ⁵University of Chicago, Chicago, IL, United States

Estimates of myocardial fractional blood volume (FBV), capillary level vascular-interstitial water exchange rate and permeability surface area product were obtained in a cohort of chronic kidney disease (CKD) patients and a control set of healthy volunteers using iron-enhanced MRI (Fe-MRI). FBV was elevated in females, in both CKD patients and control subjects. Fe-MRI also demonstrated reduced permeability surface area product in CKD patients compared to healthy controls, and may provide unique insights into microvascular pathophysiology, particularly in patients with contraindications to gadolinium-based contrast agents.

Rui Wang¹, Zixu Yan², Tianjing Zhang³, Xinyan Tao², Zhen Zhou⁴, Hongwei Wang⁵, Qian Qi⁶, and Lei Xu^2
1Radiology, Beijing Anzhen Hospital, Captial Medical University, Beijing, China, ²Beijing Anzhen Hospital, Capital Medical University, Beijing, China, ³Philips Healthcare, Guangzhou, China, ⁴Beijing Anzhen Hospital,Capital Medical University, Beijing, China, ⁵Beijing Anzhen Hospital, Beijing, China, ⁶Philips Healthcare, Beijing, China

Recently, we proposed a novel LGE approach that could help radiologists/technicians automatically specify TI values .We propose a PSIR-specific TI optimization that could help automatically nulls TI while maintaining the scar-to-myocardium contrast. As a TFE preparation pulse is user defined on scanner, clinical application is readily available on current MR systems without the need for extensive optimizations, software modifications, and/or additional training.

Lixian Zou^1,2, Yu Ding³, Junpu Hu⁴, Lele Zhao⁴, Jian Xu³, Hairong Zheng¹, Xin Liu¹, and Yuan Zheng^3
1Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences, Shenzhen, China, ²Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China, ³UIH America Inc., Houston, TX, United States, ⁴Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China

Auto-calibrated multiband CAIPIRINHA with through-time encoding (tSMS) has been proposed to acquire multiple slices simultaneously without extra reference scans. Reference images are estimated from the consecutive cardiac phases at a lower temporal resolution for subsequent slice separation. We implemented the tSMS method in a myocardial perfusion sequence and explored the feasibility of whole heart perfusion imaging with tSMS and CS reconstruction retrospectively. The preferable in-vivo results demonstrated the whole heart perfusion imaging is feasible using the tSMS+CS method.

Shaoyang Lei¹, Chunhui Shan¹, Jie Wu¹, Jing Wu¹, Yunfeng Bao¹, Yingmin Chen¹, and Shuqian Zhang^1
1Hebei General Hospital, Shijiazhuang, China

Black Blood Vessel Wall Imaging, a valuable tool to detect abnormalities of intracranial vessel walls, was combined with 3D-ASL, a noninvasive approach for detecting cerebral perfusion, to explore the effects of plaque vulnerability and intracranial stenosis on cerebral perfusion. Absolute and relative values of CBF were determined in regions drawn manually based on the territory of blood supply in ASL images. Multivariate regression analysis indicated plaque vulnerability had no significant impact on perfusion while different degrees of luminal narrowing had statistically differences, signifying intracranial stenosis might be a more critical factor for decreased perfusion.