Erdem Sukran, Erdem Orhan, Stebbings Samantha, Greil Gerald, Hussain Tarique, Zou Qing
Division of Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, 1935 Medical District Drive, Dallas, TX, 75235, USA.
University of North Texas, Denton, TX, USA.
Pediatr Radiol. 2025 May 29. doi: 10.1007/s00247-025-06266-7.
Cardiovascular magnetic resonance (CMR) cine imaging is the gold standard for assessing ventricular volumes and function. It typically requires two-dimensional (2D) bSSFP sequences and multiple breath-holds, which can be challenging for patients with limited breath-holding capacity. Three-dimensional (3D) cardiovascular magnetic resonance angiography (MRA) usually suffers from lengthy acquisition. Free-running 3D cine imaging with deep learning (DL) reconstruction offers a potential solution by acquiring both cine and angiography simultaneously.
To evaluate the efficiency and accuracy of a ferumoxytol-enhanced 3D cine imaging MR sequence combined with DL reconstruction and Heart-NAV technology in patients with congenital heart disease.
This Institutional Review Board approved this prospective study that compared (i) functional and volumetric measurements between 3 and 2D cine images; (ii) contrast-to-noise ratio (CNR) between deep-learning (DL) and compressed sensing (CS)-reconstructed 3D cine images; and (iii) cross-sectional area (CSA) measurements between DL-reconstructed 3D cine images and the clinical 3D MRA images acquired using the bSSFP sequence. Paired t-tests were used to compare group measurements, and Bland-Altman analysis assessed agreement in CSA and volumetric data.
Sixteen patients (seven males; median age 6 years) were recruited. 3D cine imaging showed slightly larger right ventricular (RV) volumes and lower RV ejection fraction (EF) compared to 2D cine, with a significant difference only in RV end-systolic volume (P = 0.02). Left ventricular (LV) volumes and EF were slightly higher, and LV mass was lower, without significant differences (P ≥ 0.05). DL-reconstructed 3D cine images showed significantly higher CNR in all pulmonary veins than CS-reconstructed 3D cine images (all P < 0.05).
Highly accelerated free-running 3D cine imaging with DL reconstruction shortens acquisition times and provides comparable volumetric measurements to 2D cine, and comparable CSA to clinical 3D MRA.
心血管磁共振（CMR）电影成像术是评估心室容积和功能的金标准。它通常需要二维（2D）平衡稳态自由进动（bSSFP）序列和多次屏气，这对于屏气能力有限的患者可能具有挑战性。三维（3D）心血管磁共振血管造影（MRA）通常采集时间较长。采用深度学习（DL）重建的自由运行3D电影成像通过同时采集电影和血管造影提供了一种潜在的解决方案。
评估结合DL重建和心脏导航（Heart-NAV）技术的 ferumoxytol增强3D电影成像MR序列在先天性心脏病患者中的效率和准确性。
本前瞻性研究经机构审查委员会批准，比较了（i）3D和2D电影图像之间的功能和容积测量；（ii）深度学习（DL）和压缩感知（CS）重建的3D电影图像之间的对比噪声比（CNR）；以及（iii）DL重建的3D电影图像与使用bSSFP序列采集的临床3D MRA图像之间的横截面积（CSA）测量。采用配对t检验比较组间测量值，Bland-Altman分析评估CSA和容积数据的一致性。
招募了16例患者（7例男性；中位年龄6岁）。与2D电影成像相比，3D电影成像显示右心室（RV）容积略大，右心室射血分数（EF）略低，仅右心室收缩末期容积有显著差异（P = 0.02）。左心室（LV）容积和EF略高，左心室质量略低，但无显著差异（P≥0.05）。DL重建的3D电影图像在所有肺静脉中的CNR均显著高于CS重建的3D电影图像（所有P < 0.05）。
采用DL重建的高度加速自由运行3D电影成像缩短了采集时间，提供了与2D电影成像相当的容积测量值，以及与临床3D MRA相当的CSA。
