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Song Luo¹, Jun Zhang¹, and Wei Qiang Dou^2
1Jinling Hospital, Medical School of Nanjing University, Nanjing, China, ²GE Healthcare, Bei Jing, China

Keywords: Inflammation, Cardiovascular

To explore the clinical potential of multiparametric cardiac magnetic resonance (CMR) in evaluating myocardial injury in patients with exertional heat illness (EHI).This prospective study enrolled 28 male with EHI and 18 age-matched male healthy controls. All subjects underwent CMR, and 9 patients had follow-up CMR measurements 3 months after recovery from EHI. As shown in this study, EHI patients have left ventricular dysfunction, myocardial edema and fibrosis, and persistent myocardial injury at 3-month follow-up after the EHI episode. This knowledge has an important role in guiding patients recovering from EHI back to a return to work, play or duty, respectively. 

Lei Zhao¹, Weibo Chen², Yongyi Wang¹, Song Xue¹, and Lianming Wu^1
1Renji Hospital, Shanghai, China, ²Philips Healthcare, Shanghai, China

Keywords: Vessels, Cardiovascular, T2*-mapping

This study used T2*BOLD and QFR to evaluate coronary arteries with hemodynamic changes in coronary artery disease. Fifty patients with at least 1 significant coronary artery stenosis (diameter stenosis >50%) and 21 healthy control subjects underwent coronary angiography combined with QFR measurements and CMR. The CMR protocol consisted of T2* mapping and resting perfusion, contrasted with QFR. QFR≤0.80 was considered to indicate the presence of hemodynamic obstruction. Our study revealed that T2* BOLD and QFR have good agreement in detecting hemodynamic changes of stenotic coronary arteries. T2* BOLD is superior to semiquantitative perfusion imaging in analyzing myocardial perfusion without stress.

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Hazar Benan Unal¹, Shahriar Zeynali¹, Fei Han², Gregory J. Anthony³, Subha Raman⁴, Balaji Tamarappoo⁵, Rohan Dharmakumar¹, and Behzad Sharif^1
1Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, IN, United States, ²Siemens Medical Solutions, Inc., Los Angeles, CA, United States, ³Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, United States, ⁴Cardiovascular Medicine, IU Health/IU School of Medicine, Indianapolis, IN, United States, ⁵Indiana University Health, Indianapolis, IN, United States

Keywords: Myocardium, Ischemia, dobutamine

Myocardial T1 reactivity, defined as the relative T1 change from rest to stress, has been proposed as a marker for detection of ischemic heart disease. SASHA-based T1 mapping provides higher accuracy than MOLLI, but the scan time can be prohibitive under stress. In this work, we investigated the feasibility of accelerated SASHA T1 mapping for ferumoxytol-enhanced dobutamine-stress T1 reactivity studies at 3T in a preclinical setting. We showed that a 2-fold accelerated SASHA T1 mapping can provide sufficiently accurate results compared to conventional SASHA.

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Ivan Kokhanovskyi^1,2,3, Michael G Crabb², Karl P Kunze^2,4, Radhouene Neji^2,4, Carl Ganter¹, Donovan P Tripp², Carlos Castillo-Passi^2,5, Dimitrios C Karampinos¹, Claudia Prieto^2,5,6,7, and Rene M Botnar^2,3,5,6,7
1Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, ²School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ³Institute for Advanced Study, Technische Universität München, Garching, Germany, ⁴MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom, ⁵Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile, ⁶Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile, ⁷Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de Chile, Santiago, Chile

Keywords: Heart, Data Acquisition

Accurate diagnosis of cardiac disease requires imaging with high spatial resolution and whole-heart coverage. Current clinical protocols acquire contrasts sequentially, in different 2D orientations during several breath-holds leading to long examination times and misregistration artifacts. To address these limitations, we present a novel free-breathing four-heartbeat sequence for simultaneous 3D whole-heart Assessment of Cardiovascular anaTomy via bright- and black-blood Imaging and T1/T2 myocardial tissue quantificatiON (ACTION). Sequence parameters are optimized with Bloch simulations to enhance the mapping sensitivity and to improve the quality of anatomical images. Primarily results in a standardized phantom and in-vivo show potential for comprehensive heart disease detection.

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Alexander Isaak¹, Isabel Pomareda¹, Narine Mesropyan¹, Dmitrij Kravchenko¹, Leon Bischoff¹, Daniel Kuetting¹, Ulrike Attenberger¹, Sebastian Zimmer², Jens-Christian Schewe³, Stefan Kreyer³, and Julian Luetkens^1
1Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany, ²Clinic for Internal Medicine II, Heart Center, University Hospital Bonn, Bonn, Germany, ³Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany

Keywords: Cardiomyopathy, Quantitative Imaging, T1 and T2 Mapping

In this prospective study, cardiac magnetic resonance (CMR) was performed in 48 intensive care unit (ICU) survivors of acute critical illness without prior known cardiac disease. CMR revealed previously unrecognized functional abnormalities, including reduced left ventricular ejection fraction and impaired strain values, as well as evidence of focal and diffuse myocardial fibrosis represented by positive late gadolinium enhancement lesions and elevated myocardial T1 mapping and ECV. Findings were more pronounced in ICU survivors who had experienced acute kidney injury. Unrecognized fibrotic and functional myocardial alterations may be a correlate of physical impairment in post-intensive care syndrome.

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Pauline Calarnou¹, Augustin C. Ogier¹, Roger Hullin², Philippe Meyer³, Jérôme Yerly^1,4, and Ruud B. Van Heeswijk^1
1Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ²Cardiology Service, Cardiovascular Department, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, Lausanne, Switzerland, ³Cardiology Service, Department of Medicine, Geneva University Hospital and University of Geneva, Switzerland, Geneva, Switzerland, ⁴CIBM, Lausanne, Switzerland

Keywords: Myocardium, Relaxometry

We implemented and characterized a free-breathing 2D cardiac joint T₁-T₂ MR fingerprinting technique at 3T named PARMA that includes a lung-liver navigator to minimize through-plane motion. We assessed the effect of rejected navigators on the relaxation times. Joint T₁-T₂ maps with four different navigator acceptance window widths (NAWWs from ±4mm to ±32mm) were acquired in 6 healthy volunteers and compared to clinical routine techniques. The accuracy and precision of the maps resulting from the different NAWWs did not significantly differ, suggesting that the NAWW can be chosen as a balance between navigator inefficiency and through-plane motion.

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Caroline D. Jordan^1,2, Kavya Sinha², Deborah C. Vela³, L. Maximillian Buja^3,4, Christof Karmonik^2,5, and Trisha L. Roy^2,5
1School of Engineering Medicine, Texas A&M University, Houston, TX, United States, ²Houston Methodist Research Institute, Houston Methodist Hopsital, Houston, TX, United States, ³Department of Cardiovascular Pathology, Texas Heart Institute, Houston, TX, United States, ⁴Department of Pathology and Laboratory Medicine, University of Texas, Houston, Houston, TX, United States, ⁵Weill Cornell Medical College, Houston, TX, United States

Keywords: Vessels, Tissue Characterization, DVT, clot

Deep venous thrombosis (DVT) is common. Mechanical thrombectomy may offer advantages compared to medical therapy alone, but it can be challenging to determine the optimal treatment. Six patients underwent thrombectomy, and the ex vivo clot was scanned at 9.4T. We acquired T₁, T₂, and T₂* maps, and histologic content of red blood cells, fibrin, and collagen. R² between RBC content and each relaxation time was R² = 0.58 for T₁, R² = 0.82 for T₂, and R² = 0.69 for T₂*. T₁, T₂, and T₂* mapping of ex vivo DVT clots at 9.4T may be feasible for determining clot components.

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Kazuo Kodaira¹, Masami Yoneyama², Michinobu Nagao³, Mana Kato¹, Takumi Ogawa¹, Yutaka Hamatani¹, Isao Shiina¹, Yasuhiro Goto¹, and Shuji Sakai^3
1Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ²Philips Japan, Tokyo, Japan, ³Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan

Keywords: Myocardium, Quantitative Susceptibility mapping

T2mapping is generally obtained only in diastole. However, because myocardial edema can affect both diastole and systole, acquisition of T2mapping of different cardiac phases is desirable. In addition, CMRA is also necessary in post-MI. However, scanning all these sequences prolongs exam time and increases patient stress. To overcome this limitation, we report a new T2mapping technique that enables quantitative systolic and diastolic T2mapping and CMRA acquisition in one scan by using dynamic trigger delay. In this study, we demonstrate the feasibility of this approach in healthy volunteer examination.

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Jiaojiao Hu¹, Jiantai Zhou¹, Wei Cui¹, Yang Ji², Benedictor Alexander Nguchu¹, Yanming Wang¹, Yong Zhang³, and Bensheng Qiu^1
1Center for Biomedical Imaging, University of Science and Technology of China, Hefei, China, ²Wellcome Centre for Integrative Neuroimaging, FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, ³GE Healthcare, Shanghai, China

Keywords: Myocardium, Heart

Cardiac diseases are characterized by complex 3D pathological structures, 3D cardiac T₂ mapping can be used as a promising tool to describe different pathologies. However, 3D T₂ mapping requires a long acquisition time, which makes scanning more sensitive to motion, especially for high spatial resolution imaging. In our study, we aim to develop an accelerated and robust 3D cardiac T₂ mapping technique by combining bSSFP-based hybrid radial-cartesian sampling with tiny Golden angle RAdial Sparse Parallel (tyGRASP) MRI at 3 T. The results showed that our method can generate precise T₂ values with an average scan time of 6.1±1.0 min.

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Haikun Qi^1,2, Zhenfeng Lv^1,2, Jian Xu³, and Peng Hu^1,2
1School of Biomedical Engineering, ShanghaiTech University, Shanghai, China, ²Shanghai Clinical Research and Trial Center, Shanghai, China, ³UIH America, Inc., Houston, TX, United States

Keywords: Myocardium, Tissue Characterization

Cardiac T1ρ mapping is a promising technique for assessment of myocardial fibrosis without exogenous contrast agent. However, its wide application is hindered by the sensitivity of T1ρ preparation to B1 and B0 inhomogeneities. In this study, the state-of-the-art constant spin-lock methods including the composite and adiabatic excitation continuous-wave spin-lock methods were investigated using numerical simulations to assess their robustness to field inhomogeneities, and validated in phantoms and a preliminary subject. Two T1ρ preparation modules were found to generate superior T1ρ mapping quality in the presences of B0 and B1 inhomogeneities, indicating the potential of clinical application of cardiac T1ρ MRI.

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Johnathan Le^1,2, Jason Mendes², Konstantinos Sideris³, Josef Stehlik³, Brent Wilson³, Edward DiBella^1,2, and Ganesh Adluru^1,2
1Biomedical Engineering, University of Utah, Salt Lake City, UT, United States, ²Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, United States, ³Cardiology, University of Utah, Salt Lake City, UT, United States

Keywords: Myocardium, Relaxometry

Cardiac T1 mapping has been shown to be a promising method for assessing different cardiomyopathies. Most cardiac T1 mapping methods require ECG gating with long breath holds to capture specific desired cardiac phases and to minimize breathing motion. However, certain cardiomyopathies can make it difficult for patients to maintain a breath hold for the duration of a cardiac T1 mapping sequence. Furthermore, some of these diseases, for example atrial fibrillation with changing R-R intervals can make capturing a specific cardiac phase difficult. Here we propose a radial simultaneous multi-slice (SMS) cardiac T1 mapping sequence without ECG gating or breath holding.

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Mana Kato¹, Masami Yoneyama², Michinobu Nagao³, Kazuo Kodaira¹, Takumi Ogawa¹, Yutaka Hamatani¹, Isao Shiina¹, Yasuhiro Goto¹, and Shuji Sakai^3
1Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ²Philips Japan, Tokyo, Japan, ³Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan

Keywords: Heart, Heart

T2-mapping is generally obtained only in diastole. However, because myocardial edema can affect both diastole and systole, acquisition of T2-mapping of different cardiac phases is desirable, but it prolongs examination time and increases patient stress. To overcome this limitation, we report a new T2-mapping technique using dynamic trigger delay which enables quantitative mapping at multiple cardiac phases in one scan. In this study, we demonstrate the feasibility of this approach in healthy volunteer examination.

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Haikun Qi^1,2, Junpu Hu³, Jian Xu⁴, Jiayu Zhu³, René Rene Botnar⁵, Claudia Prieto⁵, and Peng Hu^1,2
1ShanghaiTech University, Shanghai, China, ²Shanghai Clinical Research and Trial Center, Shanghai, China, ³United Imaging Healthcare, Shanghai, China, ⁴UIH America, Inc., Houston, TX, United States, ⁵School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

Keywords: Myocardium, Tissue Characterization

Relaxation parameters T1 and T1ρ have shown promising results for endogenous assessment of myocardial tissue. However, mapping of the whole moving heart is challenging. This study proposes a novel free-breathing joint T1 and T1ρ mapping technique with near-isotropic spatial resolution, whole left ventricle coverage and short acquisition time of 5-6min. A diaphragmatic navigator was leveraged for prospective motion correction and retrospective motion mitigation. The T1ρ preparation module was optimized to be robust to field inhomogeneities and applicable to 3T. Phantom results indicated good accuracy of the proposed technique, and in vivo feasibility was demonstrated in healthy subjects.

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Michael G Crabb¹, Karl P Kunze^1,2, Carlos Castillo-Passi^1,3, Camila Munoz¹, Carlos Velasco¹, Radhouene Neji^1,2, Claudia Prieto^1,3, and Rene M Botnar^1,3,4
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom, ³Institute for Biological and Medical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile, ⁴School of Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile

Keywords: Myocardium, Low-Field MRI

Native T1 and T1ρ mapping has shown promising results for the detection of focal and diffuse myocardial fibrosis without requiring contrast agents. However, conventional myocardial maps are acquired sequentially in 2D at 1.5T/3T fields. 3D joint T1/T1ρ mapping has recently been proposed at 1.5T, but not demonstrated at lower field, which could potentially make cardiac MRI more accessible and affordable. Furthermore, lower T1 relaxation times, reduced SAR and fewer B0/B1 inhomogeneities make low-field MRI an attractive alternative for joint T1/T1ρ mapping. Here, we investigate the feasibility of novel 3D whole-heart joint T1/T1ρ mapping on the latest 0.55T MR scanner generation.

Jiali Wang¹, Kai Xu¹, Chunfeng Hu¹, Yankai Meng¹, Shuguang Han¹, Peng Wu², Lu Han², and Yongzhou Xu^3
1The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China, ²Philips Healthcare, Shanghai, China, ³Philips Healthcare, Guangzhou, China

Keywords: Myocardium, Ischemia, T1 mapping

To assess the potential of texture analysis (TA) of area-at-risk (AAR) based on native T1 mapping in predicting the severity of injury in ST-segment elevation myocardial infarction (STEMI) patients. Cine, T1 mapping, and late gadolinium enhancement (LGE) images were analyzed to evaluate cardiac function, and scar characteristics. The predictive value of TA for adverse LV remodeling (ALVR) and large final infarct size was evaluated. Entropy and uniformity (parameters of TA) in AAR of T1 mapping were highly correlated with convalescent infarct size, uniformity independently predicted large final infarct size, however, TA of AAR was not associated with convalescent ALVR.

Jinyang Wen¹, Lu Huang¹, Xiaoyue Zhou², and Liming Xia^1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology., Wuhan, Hubei, China, China, ²MR Collaboration, Siemens Healthineers Ltd., Shanghai, China, China

Keywords: Myocardium, Myocardium, Susceptibility-weighted Imaging

Diagnosis of intramyocardial hemorrhage (IMH) in ST-segment elevation myocardial infarction (STEMI) patients following reperfusion treatment is critical for determining prognosis. This study investigated the feasibility of susceptibility-weighted imaging (SWI) to detect IMH in STEMI patients that underwent reperfusion therapy by comparing the diagnostic performance and image quality with T1/T2 mapping. SWI showed excellent diagnostic performance in detecting IMH among STEMI patients that underwent reperfusion treatment and was comparable with T1/T2 mapping. SWI is a sensitive technique to accurately diagnose IMH in STEMI patients following reperfusion treatment.

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Yuta Endo¹, Sanae Takahashi¹, Haruna Shibo¹, Kuninori Kobayashi¹, Makoto Amanuma¹, and Shigehide Kuhara^1
1Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan

Keywords: Myocardium, Relaxometry, Myocardial T1 mapping, PCTIP

Myocardial T1 mapping by polarity-corrected inversion time preparation (PCTIP) is expected to reduce measurement underestimation compared to the MOLLI method. However, measurement precision is reportedly reduced, especially for heart-rate variability. We devised an analysis to overcome this problem in PCTIP and showed that it improved measurement accuracy at high heart rates. Conventional analysis has difficulty fitting to this complex T1 relaxation, resulting in less accurate and precise measurement of longer T1. T1 analysis of PCTIP using the proposed analysis showed the potential to achieve accurate and precise T1 measurements, even for irregular heart rate variability.

Zilong Ren¹, Didi Wen², Jianxiu Lian³, Jiantao Liu³, Zhe Huang³, and Minwen Zheng^4
1Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China, ²Department of Radiology, Xijing Hospital, Forth Military Medical University, Xi'an, China, ³Philips Healthcare China, Xi'an, China, ⁴Xijing Hospital, Fourth Military Medical University, Xi'an, China

Keywords: Cardiomyopathy, Animals

To investigate whether T1 mapping and extracellular volume (ECV) can be used as predictors of myocardial fibrosis for ischemia with non-obstructive coronary artery disease (INOCA). Results showed pigs models with INOCA had higher native T1 mapping and ECV (mean native T1 mappingnormal = 1068.3 ± 111.5 ms, mean native T1 mappingINOCA = 1291.7 ± 109.2 ms, P = 0.018; mean ECVnormal = 23.0 ± 1.7 %, mean ECVINOCA = 46.6 ± 10.4 5, P = 0.006). T1 mapping technology could be a noninvasive way for assessing the myocardial fibrosis for INOCA models.

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Fang Wang¹, Lili Yang¹, Yanbin Yang¹, Xiaowei Ruan¹, Rui Wang¹, and Xiuzheng Yue^2
1Peoples hospital of ningxia hui autonomous region, Yinchuan, China, ²Philips Healthcare, Beijing, China, Beijing, China

Keywords: Cardiomyopathy, Cardiomyopathy, CMR, light chain amyloidosis, hypertension cardiomyopathy

The value of cardiac magnetic resonance imaging in diagnosing light chain amyloidosis has been confirmed, and its characteristic LGE manifestations are an important means to identify myocardial amyloidosis. However, early-stage light-chain amyloidosis patients always have the same symptoms as hypertensive cardiomyopathy in clinical practices. This study aimed to investigate the combined diagnostic efficacy of T1mapping, ECV, and myocardial strain techniques in early myocardial amyloidosis by comparing with healthy controls and patients with hypertensive cardiomyopathy that also caused uniform myocardial thickening.

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Dmitrij Kravchenko^1,2, Alexander Isaak^1,2, Narine Mesropyan^1,2, Claus Christian Pieper¹, Daniel Kuetting^1,2, Leon M. Bischoff¹, Ulrike Attenberger¹, and Julian Luetkens^1,2
1Diagnostic and interventional radiology, University Hospital Bonn, Bonn, Germany, ²Quantitative Imaging Laboratory Bonn, Bonn, Germany

Keywords: Myocardium, Cardiomyopathy

Cardiac amyloidosis can be visualized on CMR, but to date no reliable imaging parameters exist to distinguish the two most common forms of cardiac amyloidosis, AL and ATTR. Retrospective analysis of 37 cardiac amyloidosis patients shows that T2 times are markedly elevated in AL compared to ATTR, and in both compared to a control group of patients with other reasons for cardiac hypertrophy. Myocardial T2 mapping may be a useful CMR parameter for the differentiation of AL and ATTR cardiac amyloidosis.
Keywords: amyloidosis, cardiac, MRI, CMR