Klemenz Ann-Christin, Watzke Lena-Maria, Deyerberg Karolin K, Böttcher Benjamin, Gorodezky Margarita, Manzke Mathias, Dalmer Antonia, Lorbeer Roberto, Weber Marc-André, Meinel Felix G
Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany.
GE HealthCare, Munich, Germany.
Eur Radiol. 2025 Aug 23. doi: 10.1007/s00330-025-11941-2.
To evaluate deep-learning (DL) based real-time cardiac cine sequences acquired in free breathing (FB) vs breath hold (BH).
In this prospective single-centre cohort study, 56 healthy adult volunteers were investigated on a 1.5-T MRI scanner. A set of real-time cine sequences, including a short-axis stack, 2-, 3-, and 4-chamber views, was acquired in FB and with BH. A validated DL-based cine sequence acquired over three cardiac cycles served as the reference standard for volumetric results. Subjective image quality (sIQ) was rated by two blinded readers. Volumetric analysis of both ventricles was performed.
sIQ was rated as good to excellent for FB real-time cine images, slightly inferior to BH real-time cine images (p < 0.0001). Overall acquisition time for one set of cine sequences was 50% shorter with FB (median 90 vs 180 s, p < 0.0001). There were significant differences between the real-time sequences and the reference in left ventricular (LV) end-diastolic volume, LV end-systolic volume, LV stroke volume and LV mass. Nevertheless, BH cine imaging showed excellent correlation with the reference standard, with an intra-class correlation coefficient (ICC) > 0.90 for all parameters except right ventricular ejection fraction (RV EF, ICC = 0.887). With FB cine imaging, correlation with the reference standard was good for LV ejection fraction (LV EF, ICC = 0.825) and RV EF (ICC = 0.824) and excellent (ICC > 0.90) for all other parameters.
DL-based real-time cine imaging is feasible even in FB with good to excellent image quality and acceptable volumetric results in healthy volunteers.
Question Conventional cardiac MR (CMR) cine imaging is challenged by arrhythmias and patients unable to hold their breath, since data is acquired over several heartbeats. Findings DL-based real-time cine imaging is feasible in FB with acceptable volumetric results and reduced acquisition time by 50% compared to real-time breath-hold sequences. Clinical relevance This study fits into the wider goal of increasing the availability of CMR by reducing the complexity, duration of the examination and improving patient comfort and making CMR available even for patients who are unable to hold their breath.
评估基于深度学习（DL）的自由呼吸（FB）与屏气（BH）状态下采集的实时心脏电影序列。
在这项前瞻性单中心队列研究中，对56名健康成年志愿者进行了1.5-T磁共振成像扫描仪检查。在自由呼吸和屏气状态下采集了一组实时电影序列，包括短轴堆栈、二腔、三腔和四腔视图。以经过三个心动周期采集的经过验证的基于深度学习的电影序列作为容积结果的参考标准。由两名不知情的阅片者对主观图像质量（sIQ）进行评分。对两个心室进行容积分析。
自由呼吸实时电影图像的sIQ评分为良好至优秀，略逊于屏气实时电影图像（p < 0.0001）。一组电影序列的总体采集时间在自由呼吸时缩短了50%（中位数90秒对180秒，p < 0.0001）。实时序列与参考标准在左心室（LV）舒张末期容积、LV收缩末期容积、LV搏出量和LV质量方面存在显著差异。然而，屏气电影成像与参考标准显示出极好的相关性，除右心室射血分数（RV EF，组内相关系数[ICC]=0.887）外，所有参数的ICC均>0.90。对于自由呼吸电影成像，与参考标准的相关性在LV射血分数（LV EF，ICC = 0.825）和RV EF（ICC = 0.824）方面良好，在所有其他参数方面极好（ICC > 0.90）。
基于深度学习的实时电影成像即使在自由呼吸状态下也是可行的，在健康志愿者中具有良好至优秀的图像质量和可接受的容积结果。
问题 传统心脏磁共振（CMR）电影成像受到心律失常和无法屏气患者的挑战，因为数据是在多个心跳期间采集的。研究结果 基于深度学习的实时电影成像在自由呼吸状态下是可行的，具有可接受的容积结果，与实时屏气序列相比采集时间减少了50%。临床意义 本研究符合通过降低检查复杂性、缩短检查持续时间、提高患者舒适度以及使CMR甚至适用于无法屏气的患者来提高CMR可用性这一更广泛的目标。
