Gunasekaran Suvai, Haji-Valizadeh Hassan, Lee Daniel C, Avery Ryan J, Wilson Brent D, Ibrahim Mark, Markl Michael, Passman Rod S, Kholmovski Eugene G, Kim Daniel
Department of Radiology (S.G., D.C.L., R.J.A., M.M., D.K.) and Department of Internal Medicine, Division of Cardiology (D.C.L., R.S.P.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Biomedical Engineering, Northwestern University, Evanston, Ill (S.G., M.M., D.K.); Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass (H.H.V.); and Department of Internal Medicine, Division of Cardiovascular Medicine (B.D.W., M.I.), and Department of Radiology and Imaging Sciences (E.G.K.), University of Utah, Salt Lake City, Utah.
Radiol Cardiothorac Imaging. 2020 Oct 15;2(5):e200134. doi: 10.1148/ryct.2020200134.
To develop an accelerated three-dimensional (3D) late gadolinium enhancement (LGE) pulse sequence using balanced steady-state free precession readout with stack-of-stars k-space sampling and extra motion-state golden-angle radial sparse parallel (XD-GRASP) reconstruction and test the performance for detecting atrial scar and fibrosis in patients with atrial fibrillation (AF).
Twenty-five patients with AF (20 paroxysmal and five persistent; 65 years ± 7 [standard deviation]; 18 men) were imaged at 1.5 T using the proposed LGE sequence with 1.3 mm × 1.3 mm × 2-mm spatial resolution and predictable imaging time. The resulting images were compared with historic images of 25 patients with AF (18 paroxysmal and seven persistent; 67 years ± 10; 14 men) obtained using a reference 3D left atrial (LA) LGE sequence with 1.3 mm × 1.3 mm × 2.5-mm spatial resolution. Two readers visually graded the 3D LGE images (conspicuity, artifact, noise) on a five-point Likert scale (1 = worst, 3 = acceptable, 5 = best), in which the summed visual score (SVS) of 9 or greater was defined as clinically acceptable. Appropriate statistical analyses (Cohen κ coefficient, Mann-Whitney test, tests, and intraclass correlation) were performed, where a value < .05 was considered significant.
Mean imaging time was significantly shorter ( < .01) for the proposed pulse sequence (5.9 minutes ± 1.3) than for the reference pulse sequence (10.6 minutes ± 2). Median SVS was significantly higher ( < .01) for the proposed (SVS = 11) than reference (SVS = 9.5) 3D LA LGE images. Interrater reproducibility in visual scores was higher for the proposed (κ = 0.78-1) than reference 3D LA LGE (κ = 0.44-0.75). Intrareader repeatability in fibrosis quantification was higher for the reference cohort (intraclass correlation coefficient [ICC] = 0.94) than the prospective cohort (ICC = 0.79).
The proposed 3D LA LGE method produced clinically acceptable image quality with 1.5 mm × 1.5 mm × 2-mm nominal spatial resolution and 6-minute predictable imaging time for quantification of LA scar and fibrosis in patients with AF. © RSNA, 2020.
利用星状堆叠式k空间采样的平衡稳态自由进动读出和额外运动状态黄金角径向稀疏并行（XD-GRASP）重建技术，开发一种加速三维（3D）延迟钆增强（LGE）脉冲序列，并测试其在检测心房颤动（AF）患者心房瘢痕和纤维化方面的性能。
25例AF患者（20例阵发性和5例持续性；65岁±7岁[标准差]；18例男性）在1.5T磁共振成像系统上采用所提出的LGE序列进行成像，空间分辨率为1.3mm×1.3mm×2mm，成像时间可预测。将所得图像与25例AF患者（18例阵发性和7例持续性；67岁±10岁；14例男性）的历史图像进行比较，后者使用参考三维左心房（LA）LGE序列获得，空间分辨率为1.3mm×1.3mm×2.5mm。两名阅片者对3D LGE图像的清晰度、伪影、噪声进行五分制李克特量表评分（1=最差，3=可接受，5=最佳），其中总视觉评分（SVS）≥9定义为临床可接受。进行适当的统计分析（Cohen κ系数、Mann-Whitney检验、检验和组内相关分析），P值<0.05被认为具有统计学意义。
所提出的脉冲序列平均成像时间（5.9分钟±1.3）明显短于参考脉冲序列（10.6分钟±2）（P<0.01）。所提出的3D LA LGE图像的SVS中位数（SVS=11）明显高于参考图像（SVS=9.5）（P<0.01）。所提出的3D LA LGE图像视觉评分的阅片者间重复性（κ=0.78-1）高于参考图像（κ=0.44-0.75）。参考队列中纤维化定量的阅片者内重复性（组内相关系数[ICC]=0.94）高于前瞻性队列（ICC=0.79）。
所提出的3D LA LGE方法在AF患者中产生了临床可接受的图像质量，名义空间分辨率为1.5mm×1.5mm×2mm，成像时间可预测为6分钟，用于量化LA瘢痕和纤维化。©RSNA，2020。
