Multidisciplinary Cardiovascular Research Centre & The Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK.
Philips, Guildford, England, UK.
Int J Cardiovasc Imaging. 2021 Feb;37(2):685-698. doi: 10.1007/s10554-020-02044-8. Epub 2020 Oct 4.
Exercise cardiovascular magnetic resonance (Ex-CMR) typically requires complex post-processing or transient exercise cessation, decreasing clinical utility. We aimed to demonstrate the feasibility of assessing biventricular volumes and great vessel flow during continuous in-scanner Ex-CMR, using vendor provided Compressed SENSE (C-SENSE) sequences and commercial analysis software (Cvi42).
12 healthy volunteers (8-male, age: 35 ± 9 years) underwent continuous supine cycle ergometer (Lode-BV) Ex-CMR (1.5T Philips, Ingenia). Free-breathing, respiratory navigated C-SENSE short-axis cines and aortic/pulmonary phase contrast magnetic resonance (PCMR) sequences were validated against clinical sequences at rest and used during low and moderate intensity Ex-CMR. Optimal PCMR C-SENSE acceleration, C-SENSE-3 (CS3) vs C-SENSE-6 (CS6), was further investigated by image quality scoring. Intra-and inter-operator reproducibility of biventricular and flow indices was performed.
All CS3 PCMR image quality scores were superior (p < 0.05) to CS6 sequences, except pulmonary PCMR at moderate exercise. Resting stroke volumes from clinical PCMR sequences correlated stronger with CS3 than CS6 sequences. Resting biventricular volumes from CS3 and clinical sequences correlated very strongly (r > 0.93). During Ex-CMR, biventricular end-diastolic volumes (EDV) remained unchanged, except right-ventricular EDV decreasing at moderate exercise. Biventricular ejection-fractions increased at each stage. Exercise biventricular cine and PCMR stroke volumes correlated very strongly (r ≥ 0.9), demonstrating internal validity. Intra-observer reproducibility was excellent, co-efficient of variance (COV) < 10%. Inter-observer reproducibility was excellent, except for resting right-ventricular, and exercise bi-ventricular end-systolic volumes which were good (COV 10-20%).
Biventricular function, aortic and pulmonary flow assessment during continuous Ex-CMR using CS3 sequences is feasible, reproducible and analysable using commercially available software.
运动心脏磁共振（Ex-CMR）通常需要复杂的后处理或短暂的运动停止，从而降低了临床实用性。我们旨在证明使用供应商提供的压缩感应（C-SENSE）序列和商业分析软件（Cvi42）在连续扫描的 Ex-CMR 期间评估双心室容积和大血管流量的可行性。
12 名健康志愿者（8 名男性，年龄：35±9 岁）接受了仰卧位脚踏车（Lode-BV）连续 Ex-CMR（1.5T 飞利浦 Ingenia）。自由呼吸、呼吸导航的 C-SENSE 短轴电影和主动脉/肺动脉相位对比磁共振（PCMR）序列在静息和低强度及中等强度 Ex-CMR 期间与临床序列进行了验证。进一步通过图像质量评分研究了最佳 PCMR C-SENSE 加速，C-SENSE-3（CS3）与 C-SENSE-6（CS6）。还进行了双心室和流量指数的内-间操作员可重复性。
所有 CS3 PCMR 图像质量评分均优于 CS6 序列（p<0.05），除了中等运动时的肺动脉 PCMR。临床 PCMR 序列的静息心搏量与 CS3 比 CS6 序列相关性更强。CS3 和临床序列的静息双心室容积相关性非常强（r>0.93）。在 Ex-CMR 期间，除了中度运动时右心室舒张末期容积（EDV）减少外，双心室舒张末期容积保持不变。双心室射血分数在每个阶段均增加。运动时双心室电影和 PCMR 心搏量相关性非常强（r≥0.9），证明了内部有效性。观察者内重复性极好，变异系数（COV）<10%。观察者间重复性极好，除了静息时的右心室和运动时的双心室收缩末期容积外，重复性良好（COV 为 10-20%）。
使用 CS3 序列在连续 Ex-CMR 期间评估双心室功能、主动脉和肺动脉流量是可行的，使用商业上可用的软件可进行重复性和分析。
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