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Ye Tian¹, Sophia X. Cui², Parveen Garg³, and Krishna S. Nayak^1
1Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, United States, ²Siemens Medical Solutions, Los Angeles, CA, United States, ³Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

Keywords: Myocardium, Perfusion

Myocardial first-pass perfusion (FPP) MRI is used in the clinic to diagnose coronary artery disease but has limited spatial resolution and coverage. Contemporary low-field scanners have the potential to provide FPP imaging with improved resolution and coverage by leveraging different acquisitions, such as spiral bSSFP. In this study, we demonstrate a time-efficient spiral bSSFP FPP pulse sequence at 0.55T and compare it with the standard Cartesian FPP in 4 healthy volunteers. Measured SNR, CNR, and myocardial boundary sharpness scores are all higher in the spiral images than in Cartesian images.

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Maryam Afzali^1,2,3, Lars Mueller^1,3, Sam Coveney¹, Fabrizio Fasano^4,5, John Evans², Maria Engel², Filip Szczepankiewicz⁶, Irvin Teh¹, Erica Dall'Armellina¹, Derek K Jones², and Jürgen E Schneider^1
1Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom, ²Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom, ³These authors contributed equally to this work, Leeds, United Kingdom, ⁴Siemens Healthcare Ltd, Camberly, United Kingdom, ⁵Siemens Healthcare GmbH, Erlangen, Germany, ⁶Medical Radiation Physics, Clinical Sciences Lund, Lund University, Lund, Sweden

Keywords: Heart, Diffusion Tensor Imaging, Strong gradients

Cardiac diffusion Magnetic Resonance Imaging (cardiac dMRI) allows to non-invasively assess the  microstructure of the heart. Cardiac motion typically necessitates the use of motion-compensated diffusion gradients. Here we report for the first time on the application of cardiac dMRI on a Connectom MR scanner with a gradient strength of 300 mT/m using a spin echo (SE) sequence with EPI readout and up to third order (M₃) motion-compensated diffusion gradients. The results show the benefits of applying dMRI with higher order motion compensation in the human heart using a Connectom scanner.

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Stefan Wampl¹, Ladislav Valkovic², Ferenc Mozes², Martin Meyerspeer¹, and Albrecht Ingo Schmid^1
1High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, ²Oxford Centre for Clinical MR Research, RDM Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom

Keywords: Heart, Spectroscopy, 31P MRS

To demonstrate reproducibility of cardiac 31P MR spectroscopy at 7T, three subjects were scanned on two sites in two different countries. The two sites are equipped with similar MR scanners but scanner platform versions, RF coil hardware and operators differed. The 16-channel receive array at site A provided 50% higher SNR than the 14cm single loop coil at site B, while site B achieved better linewidths, resulting in similar quality of spectral fitting. Two scan protocols were compared between the sites, both provided good reproducibility of cardiac PCr/ATP. This demonstrates the feasibility of larger multi-centre trials of cardiac MR spectroscopy.

Dounia El Hamrani¹, Emma Le Nezet¹, Marilyne Campagnac², Céline Ayez¹, Benjamin Pere², Christelle Guibert², David Benoist¹, and Bruno Quesson^3
1IHU Liryc, Bordeaux, France, ²CRCTB U1045, Bordeaux, France, ³CRMSB UMR 5536, Bordeaux, France

Keywords: Cardiomyopathy, Hypertension

Transgenic rats with Bmpr2 mutation is a model of heritable pulmonary arterial hypertension. This study aims to evaluate structural alterations of Bmpr2-mutants associated with a risk factor (chronic hypoxia) by high-resolution diffusion tensor imaging (DTI).

Chronic increases of pressure-loading conditions appears to be poorly tolerated by the right ventricle (RV). Indeed, chronic hypoxia groups showed a hypertrophy in RV. Moreover, DTI analysis showed disturbances in RV (myofibers and sheetlets) and this more prominently at basal level in transgenic rats. Consequently, hypoxic pulmonary hypertension can induce microstructural changes and electrophysiological remodeling, which are potentiated by Bmpr2 mutation.

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Ariel J Hannum^1,2,3, Tyler E Cork^1,2,3, Kawin Setsompop^1,4, and Daniel B Ennis^1,2
1Department of Radiology, Stanford University, Stanford, CA, United States, ²Division of Radiology, Veterans Administration Health Care System, Palo Alto, CA, United States, ³Department of Bioengineering, Stanford University, Stanford, CA, United States, ⁴Department of Electrical Engineering, Stanford University, Stanford, CA, United States

Keywords: Heart, Diffusion Tensor Imaging

The purpose of this work is to characterize how SNR varies with slice thickness for a given in-plane resolution for cDTI. We observed that noise in cDTI is largely physiological dominated such that increasing voxel volume yields smaller gains in SNR than what is observed in a phantom. More specifically, increased slice thickness did not significantly improve cDTI metric maps for a given in-plane resolution. However, higher in-plane resolution improved MD and FA maps. Therefore, future work will evaluate the optimal in-plane resolution and slice thickness. 
 

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Nahla M H Elsaid¹, Dana C Peters¹, Gigi Galiana¹, and Albert J Sinusas^2
1Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States, ²Medicine (Cardiology), Yale University, New Haven, CT, United States

Keywords: Heart, Diffusion/other diffusion imaging techniques

Myocardial infarction (MI) remains a leading cause of morbidity and death in the Western world.  MI causes regional dysfunction, which places remote areas of the heart at a mechanical disadvantage resulting in long-term adverse left ventricular (LV) remodeling and congestive heart failure (CHF). While the cardiac fiber structure has been the topic of study for decades, to this day, it has not been fully understood. There is a need for a deeper understanding of the normal and pathological myocardial structure. Standard techniques using diffusion tensor imaging (DTI) which typically needs one b-value (single shell) set of data, yield poor quality data, as DTI is incapable of delineating fibers that form torsions and complex interdigitation. However, multi-shell diffusion magnetic resonance imaging (dMRI) can delineate these complex fibers. This research investigates the difference between multi-shell versus single shell on the quality of the resulting cardiac tractography applied to an ex vivo normal porcine heart.

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Justino Rafael Rodríguez-Galván¹, Susana Merino-Caviedes¹, David Filgueiras-Rama², Javier Sánchez-González³, Antonio Tristán-Vega¹, and Carlos Alberola-López^1
1Laboratorio de Procesado de Imagen (LPI) Universidad de Valladolid, Valladolid, Spain, ²Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain, ³Philips Ibérica, Madrid, Spain

Keywords: Myocardium, Diffusion/other diffusion imaging techniques

Diffusion MRI in the brain has undergone tremendous advances in the last two decades while cardiac and general diffusion in the body show a lower speed. As for modelling, either isotropic or diffusion tensor imaging (DTI) are, by far, the methods used outside the brain.  In this abstract we intend to quantify the better modeling capabilities of higher order (HO) methods than DTI, i.e., than Gaussian distributions. We show, by means of ex-vivo diffusion in pig hearts, that non-Gaussianity is observable and that diffusion weighted images (DWI) generated out of a HO model show more closeness to reality than  DTI.  

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Rui Chen¹, Wei Luo¹, Zhigang Wu², Yongzhou Xu², Hui Liu¹, and Zaiyi Liu^1
1Radiology, Guangdong Provincial People’s Hospital, Guangzhou, China, ²Philips Healthcare China, Shenzhen, China

Keywords: Heart, Diffusion/other diffusion imaging techniques

Cardiac diffusion weighted imaging (DWI) is a novel tool that could provide non-invasive in-vivo microstructural assessment. However, cardiac DWI remains a challenging task due to low signal-to-noise-ratio (SNR) and motion artifacts. The second-order motion compensated (M2C) could be used to decrease the motion artifacts, and Compressed SENSE could improve the SNR of the echo planar imaging (EPI) based sequences. Hence, the combination of M2C DWI and Compressed SENSE was firstly proposed in the present study. We found that M2C DWI using Compressed SENSE showed better overall image quality and higher SNR.

Wei Luo¹, Rui Chen¹, Zhigang Wu², Hui Liu¹, and Zaiyi Liu^1
1Department of Radiology, Guangdong Provincial People’s Hospital, Guangzhou, China, ²Philips Healthcare, Shenzhen, Ltd., Shenzhen, China

Keywords: Heart, Diffusion/other diffusion imaging techniques, Computed DWI

Diagnosis of myocardial infarction (MI) remains challenge since it’s still difficult to quantify the infarction area, and to assess prognosis. Cardiac DWI could provide essential information for diagnosis of MI without exogenous contrast agents. Higher b-value DWI could improve the detection rate of myocardial infarction, but it is challenging for image acquisition in cardiac DWI due to low SNR and motion. The present study aimed to combine the 2nd order motion compensated diffusion with computed DWI to overcome these challenges. Results of this study indicates the combination is potentially a promising and valuable non-invasive method in detection of MI.

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Sam Coveney¹, Chris Kelly¹, Irvin Teh¹, Maryam Afzali^1,2, Lars Mueller¹, Arka Das³, Filip Szczepankiewicz⁴, Derek K Jones², Erica Dall’Armellina¹, and Jurgen E Schneider ^1
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom, ²Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom, ³Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom, ⁴Medical Radiation Physics, Clinical Sciences Lund, Lund University, Lund, Sweden

Keywords: Heart, Diffusion Tensor Imaging

Cardiac Diffusion Tensor Imaging (cDTI) is prone to imaging artefacts including distortion, signal dropout, and misregistration even after post-processing. We developed a method for image rejection based on a comparison between the observed images and the corresponding set of predicted images generated by tensor models fit to the observed data. A rejection threshold to exclude images from subsequent refitting of the tensor model can be chosen by the user with a simple graphical method.

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Pauline Gut^1,2, Hubert Cochet^1,3, Frederic Sacher^1,4, Pierre Jaïs^1,4, Matthias Stuber^1,2,5, and Aurélien Bustin^1,2,3
1IHU LIRYC, Electrophysiology and Heart Modeling Institute, Université de Bordeaux – INSERM U1045, Pessac, France, ²Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France, ⁴Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France, ⁵CIBM Center for Biomedical Imaging, Lausanne, Switzerland

Keywords: Myocardium, Tissue Characterization, Metallic device

Conventional LGE PSIR provides very good contrast between healthy and scar tissue, but scar patterns may be confused with blood signal. Joint LGE bright- and black-blood imaging allows for improved scar contrast and detailed cardiac anatomy. However, many patients with cardiac implantable electronic device (CIED) do not undergo cardiac imaging due to severe hyperintensity artefacts. Here we propose a technology to image myocardial scars with unprecedent scar contrast in patients with CIED by combining bright- and black-blood SPOT imaging with wideband MRI. We showed that wideband SPOT can suppress CIED-related hyperintensity artefacts, while maintaining improved scar contrast and localization.

Bo He^1
1Radiological department, Sichuan Academy of Medical Sciences – Sichuan Provincial People's Hospital(SAMSPH), Chengdu, China

Keywords: Heart, Perfusion

This study investigated the cardiovascular effects of altitude exposure, and determined the feasibility of stress first-pass perfusion CMR to objectively and noninvasively diagnose chronic HAH-induced microvascular changes. The results showed a significant decreased in LVEF as compared with NC animals at two time points. Our study has shown rest_RU and stress_RU were significantly lower and rest_MPI, stress_MPI and MPR were significantly higher. The pilot testing demonstrated that the feasibility of stress first-pass perfusion CMR to objectively and noninvasively diagnose chronic HAH-induced microvascular changes. 

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Andrew Tyler¹, Li Huang¹, Radhouene Neji^1,2, Ronald Mooiweer^1,2, Pier-Giorgio Masci¹, and Sébastien Roujol^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom

Keywords: Heart, Susceptibility

Cardiac Quantitative Susceptibility Mapping (QSM) is a promising technique for the evaluation of iron levels in the myocardium, particularly after a hemorrhagic infarction. In this abstract, we validate the accuracy of our QSM acquisition and reconstruction procedure in phantom experiments, and characterize its precision and repeatability in the myocardium in a healthy volunteer cohort. We found a strong linear relationship between the gadolinium concentration and measured susceptibility in the phantom. In vivo QSM precision and repeatability in the myocardium were 0.11±0.05 ppm and 0.02±0.02 ppm, respectively.

Tian-yi Zhang¹, Peng Wu², Lian-Ming Wu³, and Shan Mou^1
1Nephrology, Shanghai Jiaotong University School of Medicine Affiliated Renji Hospital, Shanghai, China, ²Philips Healthcare, Shanghai, China, Shanghai, China, ³Radiology, Shanghai Jiaotong University School of Medicine Affiliated Renji Hospital, Shanghai, China

Keywords: Myocardium, Tissue Characterization, End-stage renal disease

Left ventricular vertical run-length non-uniformity (VRLN) represents heterogeneity within native T1 images and reflects the extent of cardiac fibrosis. In uremic cardiomyopathy, interstitial fibrosis was found to be the major histological alteration. The aim of this study was to evaluate the prognostic value of VRLN in patients with ESRD. The primary endpoint was major adverse cardiac events (MACE). Survival analysis was calculated by Kaplan-Meier curves with log-rank test. VRLN remained associated with MACE in the multivariable model. Adding VRLN to a model containing clinical and CMR parameters significantly improved the accuracy and reclassification of the predictive model. 

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Xuelin Fang^1,2, Longwei Sun¹, Yizhen Luo¹, Guohua Liang¹, Liqi Yang¹, Kan Deng³, and Zhiyong Li^1
1Shenzhen Children’s Hospital, shenzhen, China, ²Shantou University Medical College, shantou, China, ³Philips Healthcare, guangzhou, China

Keywords: Myocardium, Tissue Characterization

To provide more imaging basis for early identification and prognosis evaluation of DMD-associated cardiomyopathy（DMD-CM）, we analyzed the distribution characteristics of LGE in global and regional left ventricle and the correlation between myocardial fibrosis index and cardiac function indexes in 29 boys with DMD. The range of LGE and the distribution pattern of interventricular septal involvement are related to the decrease of cardiac function. LGE is a reliable tool to identify subclinical DMD-CM and evaluate the severity of the disease.

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Naledi Lenah Adam¹, Kowalik Tomasz Grzegorz ¹, Andrew Tyler¹, Ronald Mooiweer^1,2, Alexander Paul Neofytou¹, Sarah McElroy¹, Karl Kunze^1,2, Peter Speier³, Daniel Stäb⁴, Radhouene Neji^1,2, Muhummad Sohaib Nazir¹, Reza Razavi¹, Amedeo Chiribiri¹, 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, Camberley, United Kingdom, ³Cardiovascular Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁴MR Research Collaborations, Siemens Healthcare Limited, Melbourne, Australia

Keywords: Heart, Perfusion

Simultaneous multi-slice (SMS) imaging enables high spatial coverage and resolution for myocardial perfusion imaging. We developed and evaluated a fast, noise-removing and signal-preserving SMS reconstruction approach combining parallel imaging and deep-learning and evaluated its benefit for myocardial perfusion imaging. In comparison to conventional parallel imaging reconstruction, the proposed SMS reconstruction provides improved perceived SNR and image quality (p<0.008), preserved sharpness and signal fidelity (p>0.05) in a short computation time (+20s for an entire dataset).

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Tyler E. Cork^1,2,3, Ariel J. Hannum^1,2,3, Matthew J. Middione^1,2, and Daniel B. Ennis^1,2
1Radiological Sciences Laboratory, Stanford University, Stanford, CA, United States, ²Division of Radiology, Veterans Administration Health Care System, Palo Alto, CA, United States, ³Bioengineering, Stanford University, Stanford, CA, United States

Keywords: Myocardium, Microstructure

The objective of this work was to control the total number of collected diffusion weighted images (DWI) across several different acquisition schemes to evaluate which combination of directions and averages provides the highest quality data.  In vivo cDTI data was collected in volunteers (N=5) using a series of fixed duration protocols that span a range of diffusion directions and signal averages. We found that balancing the number of diffusion directions (12-20) and averages (5-3) allows for robust quantification of mean diffusivity, fractional anisotropy, and helix measurements in a fixed scan time.

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Mingyue Zhao^1,2, Daming Shen^1,2, Lexiaozi Fan^1,2, Kyungpyo Hong², Li Feng³, Bradley D Allen², Daniel C Lee⁴, and Daniel Kim^1,2
1Biomedical Engineering, Northwestern University, Evanston, IL, United States, ²Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ³BioMedical Engineering and Imaging Institute(BMEII), Icahn School of Medicine at Mount Sinai, New York, NY, United States, ⁴Division of Cardiology, Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States

Keywords: Myocardium, Tissue Characterization

Late gadolinium enhancement (LGE) is the clinical standard for assessment of myocardial scarring. Current limitations of standard LGE are lengthy scan time, sensitivity to arrhythmia and/or dyspnea, and reliance of optimal inversion time (TI), which may be difficult to identify for patients with subendocardial scarring. We propose a free-breathing, single-short, multi-TI LGE approach to address the aforementioned challenges. Our results show that GRASP-Pro reconstruction with view-sharing (VS) and k-space weighted image contrast (KWIC) filtering produces multi-TI LGE images (i.e., no need for TI scout) with relatively high spatial resolution.

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Xiaowei Ruan¹, yanbing yang¹, yishi wang², and Xiuzheng yue^2
1Peoples hospital of ningxia hui autonomous region, Yinchuan, China, ²Philips Healthcare, Beijing, China

Keywords: Heart, Cardiovascular, Heart; magnetic resonance imaging; myocardial diffusion imaging; myocardial infarction

Cardiac magnetic resonance imaging can non-invasively evaluate the anatomy and function of the heart, and has been widely used in various fields of cardiovascular diseases. This study explores the diagnostic value of DWI in the evaluation of acute myocardial infarction. The preliminary results of 17 patients showed that the ADC value of infarcted myocardium was significantly reduced, and DWI had the ability to diagnose acute myocardial infarction. 

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Lucy Elizabeth Kershaw¹, Rachel Jago², Jenny Reed², and John Keen^2
1Edinburgh Imaging, University of Edinburgh, Edinburgh, United Kingdom, ²The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom

Keywords: Myocardium, Ex-Vivo Applications

We aim to develop a protocol suitable for ex-vivo DTI of the equine heart. DTI on a large sample is challenging because this is already a low SNR technique.  The main requirement for good-quality data in a formalin-fixed heart is to reduce TE as much as possible.  The protocol recommendations presented here are largely common sense, but the long acquisitions required make troubleshooting extremely time consuming.  We thought it important to share these findings for the benefit of other investigators