在 1.5T 和 3.0T 磁共振成像中应用心音图和心电图触发二维稳态自由进动电影成像评估左心室功能的比较。
Comparison of left ventricular function assessment using phonocardiogram- and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T.
机构信息
Department of Diagnostic Radiology, University Hospital, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
出版信息
Eur Radiol. 2010 Jun;20(6):1344-55. doi: 10.1007/s00330-009-1676-z. Epub 2009 Dec 16.
OBJECTIVE
As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to interference from electromagnetic fields (EMF) and to magneto-hydrodynamic (MHD) effects increases and with it the motivation for a CMR triggering alternative. This study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects (n = 14).
METHODS
Quantitative analysis of 2D CINE steady-state free precession (SSFP) images was conducted to compare ACT's performance with vector ECG (VCG). Endocardial border sharpness (EBS) was examined paralleled by quantitative LV function assessment.
RESULTS
Unlike VCG, ACT provided signal traces free of interference from EMF or MHD effects. In the case of correct R-wave recognition, VCG-triggered 2D CINE SSFP was immune to cardiac motion effects-even at 3.0 T. However, VCG-triggered 2D SSFP CINE imaging was prone to cardiac motion and EBS degradation if R-wave misregistration occurred. ACT-triggered acquisitions yielded LV parameters (end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular mass (LVM)) comparable with those derived from VCG-triggered acquisitions (1.5 T: ESV(VCG) = (56 +/- 17) ml, EDV(VCG) = (151 +/- 32) ml, LVM(VCG) = (97 +/- 27) g, SV(VCG) = (94 +/- 19) ml, EF(VCG) = (63 +/- 5)% cf. ESV(ACT) = (56 +/- 18) ml, EDV(ACT) = (147 +/- 36) ml, LVM(ACT) = (102 +/- 29) g, SV(ACT) = (91 +/- 22) ml, EF(ACT) = (62 +/- 6)%; 3.0 T: ESV(VCG) = (55 +/- 21) ml, EDV(VCG) = (151 +/- 32) ml, LVM(VCG) = (101 +/- 27) g, SV(VCG) = (96 +/- 15) ml, EF(VCG) = (65 +/- 7)% cf. ESV(ACT) = (54 +/- 20) ml, EDV(ACT) = (146 +/- 35) ml, LVM(ACT) = (101 +/- 30) g, SV(ACT) = (92 +/- 17) ml, EF(ACT) = (64 +/- 6)%).
CONCLUSIONS
ACT's intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical CMR.
目的
随着高磁场心脏磁共振（CMR）的应用越来越广泛，心电图受到电磁场（EMF）和磁流体动力（MHD）效应干扰的倾向以及因此需要替代触发的动机也越来越大。本研究旨在探讨声学心脏触发（ACT）在健康受试者（n=14）左心室（LV）功能评估中的适用性。
方法
对二维电影稳态自由进动（SSFP）图像进行定量分析，比较 ACT 与向量心电图（VCG）的性能。同时检查心内膜边界清晰度（EBS）并进行 LV 功能定量评估。
结果
与 VCG 不同，ACT 提供的信号迹线不受 EMF 或 MHD 效应的干扰。在正确识别 R 波的情况下，即使在 3.0 T 下，VCG 触发的二维 SSFP CINE 成像也不受心脏运动的影响。然而，如果 R 波配准错误，VCG 触发的二维 SSFP CINE 成像容易受到心脏运动和 EBS 恶化的影响。ACT 触发的采集产生的 LV 参数（舒张末期容积（EDV）、收缩末期容积（ESV）、心搏量（SV）、射血分数（EF）和左心室质量（LVM））与 VCG 触发的采集相似（1.5 T：ESV（VCG）=（56 ± 17）ml，EDV（VCG）=（151 ± 32）ml，LVM（VCG）=（97 ± 27）g，SV（VCG）=（94 ± 19）ml，EF（VCG）=（63 ± 5）%，对比 ESV（ACT）=（56 ± 18）ml，EDV（ACT）=（147 ± 36）ml，LVM（ACT）=（102 ± 29）g，SV（ACT）=（91 ± 22）ml，EF（ACT）=（62 ± 6）%；3.0 T：ESV（VCG）=（55 ± 21）ml，EDV（VCG）=（151 ± 32）ml，LVM（VCG）=（101 ± 27）g，SV（VCG）=（96 ± 15）ml，EF（VCG）=（65 ± 7）%，对比 ESV（ACT）=（54 ± 20）ml，EDV（ACT）=（146 ± 35）ml，LVM（ACT）=（101 ± 30）g，SV（ACT）=（92 ± 17）ml，EF（ACT）=（64 ± 6）%）。
结论
ACT 对电磁场干扰的固有不敏感性使其适合临床 CMR。
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