Aziz-Safaie Taraneh, Bischoff Leon M, Katemann Christoph, Peeters Johannes M, Kravchenko Dmitrij, Mesropyan Narine, Beissel Lucia D, Dell Tatjana, Weber Oliver M, Pieper Claus C, Kütting Daniel, Luetkens Julian A, Isaak Alexander
From the Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany (T.A.-S., L.M.B., D.Kr., N.M., L.D.B., T.D., C.C.P., D.Kü., J.A.L., A.I.); Quantitative Imaging Laboratory Bonn, Bonn, Germany (T.A.-S., L.M.B., D.Kr., N.M., L.D.B., D.Kü., J.A.L., A.I.); Philips GmbH Market DACH, Hamburg, Germany (C.K., O.M.W.); and Philips MR Clinical Science, Best, the Netherlands (J.M.P.).
Invest Radiol. 2025 Apr 7. doi: 10.1097/RLI.0000000000001186.
The aim of the study was to compare the diagnostic quality of deep learning (DL) reconstructed balanced steady-state free precession (bSSFP) single-shot (SSH) cine images with standard, multishot (also: segmented) bSSFP cine (standard cine) in cardiac MRI.
This prospective study was performed in a cohort of participants with clinical indication for cardiac MRI. SSH compressed-sensing bSSFP cine and standard multishot cine were acquired with breath-holding and electrocardiogram-gating in short-axis view at 1.5 Tesla. SSH cine images were reconstructed using an industry-developed DL super-resolution algorithm (DL-SSH cine). Two readers evaluated diagnostic quality (endocardial edge definition, blood pool to myocardium contrast and artifact burden) from 1 (nondiagnostic) to 5 (excellent). Functional left ventricular (LV) parameters were assessed in both sequences. Edge rise distance, apparent signal-to-noise ratio (aSNR) and contrast-to-noise ratio were calculated. Statistical analysis for the comparison of DL-SSH cine and standard cine included the Student's t-test, Wilcoxon signed-rank test, Bland-Altman analysis, and Pearson correlation.
Forty-five participants (mean age: 50 years ±18; 30 men) were included. Mean total scan time was 65% lower for DL-SSH cine compared to standard cine (92 ± 8 s vs 265 ± 33 s; P < 0.0001). DL-SSH cine showed high ratings for subjective image quality (eg, contrast: 5 [interquartile range {IQR}, 5-5] vs 5 [IQR, 5-5], P = 0.01; artifacts: 4.5 [IQR, 4-5] vs 5 [IQR, 4-5], P = 0.26), with superior values for sharpness parameters (endocardial edge definition: 5 [IQR, 5-5] vs 5 [IQR, 4-5], P < 0.0001; edge rise distance: 1.9 [IQR, 1.8-2.3] vs 2.5 [IQR, 2.3-2.6], P < 0.0001) compared to standard cine. No significant differences were found in the comparison of objective metrics between DL-SSH and standard cine (eg, aSNR: 49 [IQR, 38.5-70] vs 52 [IQR, 38-66.5], P = 0.74). Strong correlation was found between DL-SSH cine and standard cine for the assessment of functional LV parameters (eg, ejection fraction: r = 0.95). Subgroup analysis of participants with arrhythmia or unreliable breath-holding (n = 14/45, 31%) showed better image quality ratings for DL-SSH cine compared to standard cine (eg, artifacts: 4 [IQR, 4-5] vs 4 [IQR, 3-5], P = 0.04).
DL reconstruction of SSH cine sequence in cardiac MRI enabled accelerated acquisition times and noninferior diagnostic quality compared to standard cine imaging, with even superior diagnostic quality in participants with arrhythmia or unreliable breath-holding.
本研究旨在比较深度学习（DL）重建的平衡稳态自由进动（bSSFP）单次激发（SSH）电影图像与标准的多次激发（也称为分段）bSSFP电影图像（标准电影图像）在心脏磁共振成像中的诊断质量。
本前瞻性研究在一组有心脏磁共振成像临床指征的参与者中进行。在1.5特斯拉磁场下，通过屏气和心电图门控在短轴视图中采集SSH压缩感知bSSFP电影图像和标准多次激发电影图像。使用行业开发的DL超分辨率算法重建SSH电影图像（DL-SSH电影图像）。两名阅片者对诊断质量（心内膜边缘清晰度、血池与心肌对比度和伪影负担）进行从1（非诊断性）到5（优秀）的评估。在两个序列中评估左心室（LV）功能参数。计算边缘上升距离、表观信噪比（aSNR）和对比度噪声比。DL-SSH电影图像与标准电影图像比较的统计分析包括学生t检验、Wilcoxon符号秩检验、Bland-Altman分析和Pearson相关性分析。
纳入45名参与者（平均年龄：50岁±18；30名男性）。与标准电影图像相比，DL-SSH电影图像的平均总扫描时间缩短了65%（92±8秒对265±33秒；P<0.0001）。DL-SSH电影图像在主观图像质量方面评分较高（例如，对比度：5[四分位数间距{IQR}，5 - 5]对5[IQR，5 - 5]，P = 0.01；伪影：4.5[IQR，4 - 5]对5[IQR，4 - 5]，P = 0.26），与标准电影图像相比，清晰度参数值更高（心内膜边缘清晰度：5[IQR，5 - 5]对5[IQR，4 - 5]，P<0.0001；边缘上升距离：1.9[IQR，1.8 - 2.3]对2.5[IQR，2.3 - 2.6]，P<0.0001）。DL-SSH与标准电影图像在客观指标比较中未发现显著差异（例如，aSNR：49[IQR，38.5 - 70]对52[IQR，38 - 66.5]，P = 0.74）。在评估LV功能参数方面，DL-SSH电影图像与标准电影图像之间发现强相关性（例如，射血分数：r = 0.95）。对心律失常或屏气不可靠的参与者（n = 14/45，31%）进行亚组分析显示，与标准电影图像相比，DL-SSH电影图像的图像质量评分更高（例如，伪影：4[IQR，4 - 5]对4[IQR，3 - 5]，P = 0.04）。
心脏磁共振成像中SSH电影序列的DL重建能够加快采集时间，与标准电影成像相比诊断质量不劣，在心律失常或屏气不可靠的参与者中诊断质量甚至更优。
