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Cardiac MR (CMR) is of proven clinical value but also an area of vigorous ongoing research since image quality is not always exclusively defined by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Recent developments of CMR at 7.0 T have been driven by pioneering explorations into novel multichannel transmit and receive coil array technology to tackle the challenges B1+-field inhomogeneities, to offset specific-absorption rate (SAR) constraints and to reduce banding artifacts in SSFP imaging. For this study, recognition of the benefits and performance of local surface Tx/Rx-array structures recently established at 7.0 T inspired migration to 3.0 T, where RF inhomogeneities and SAR limitations encountered in routine clinical CMR, though somewhat reduced versus the 7.0 T situation, remain significant. For all these reasons, this study was designed to build and examine the feasibility of a local four channel Tx/Rx cardiac coil array for anatomical and functional cardiac imaging at 3.0 T. For comparison, a homebuilt 4 channel Rx cardiac coil array exhibiting the same geometry as the Tx/Rx coil and a Rx surface coil array were used.
In current clinical cardiovascular MR (CMR) practice cardiac motion is commonly dealt with using ECG based synchronization. However, ECG is corrupted by magneto-hydrodynamic (MHD) effects in magnetic fields. This leads to artifacts in the ECG trace and evokes severe T-wave elevations, which might be misinterpreted as R-waves resulting in erroneous triggering. At (ultra)high field strengths, the propensity of ECG recordings to MHD effects is further pronounced. Pulse oximetry (POX) being inherently sensitive to blood oxygenation provides an alternative approach for cardiac gating. However, due to the travel time of the blood the peak of maximum oxygenation and hence the trigger is delayed by approx. 300 ms with respect to the ECG's R-wave. Also the peak of maximum oxygenation shows a jitter of up to 65 ms. Alternative triggering approaches include acoustic cardiac triggering (ACT). In current clinical practice cardiac gating / triggering commonly relies on using single physiological signals only. Realizing this limitation this study proposes a combined triggering approach which exploits multiple physiological signals including ECG, POX or ACT to track cardiac activity. The feasibility of the coupled approach is examined for LV function assessment at 7.0 T. For this purpose, breath-held 2D-CINE imaging in conjunction with cardiac synchronization was performed paralleled by real time logging of physiological waveforms to track (mis)synchronization between the cardiac cycle and data acquisition. Combinations of the ECG, POX and ACT signals were evaluated and processed in real time to facilitate reliable trigger information.
Cardiac MR (CMR) at ultrahigh (≥7.0 T) fields is regarded as one of the most challenging MRI applications. At 7.0 T image quality is not always exclusively defined by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Detrimental effects bear the potential to spoil the signal-to-noise (SNR) and contrast-to-noise (CNR) benefits of cardiac MR (CMR) at 7.0 T. B₁⁺-inhomogeneities and signal voids represent the main challenges. Various pioneering coil concepts have been proposed to tackle these issues, enabling cardiac MRI at 7.0 T. This includes a trend towards an ever larger number of transmit and receive channels. This approach affords multi-dimensional B₁⁺ modulations to improve B₁⁺ shimming performance and to enhance RF efficiency. Also, parallel imaging benefits from a high number of receive channels enabling two-dimensional acceleration. Realizing the limitations of existing coil designs tailored for UHF CMR and recognizing the opportunities of a many element TX/RX channel architecture this work proposes a modular, two dimensional 32-channel transmit and receive array using loop elements and examines its efficacy for enhanced B¹+ homogeneity and improved parallel imaging performance.
Purpose
To design and evaluate a modular transceiver coil array with 32 independent channels for cardiac MRI at 7.0T.
Methods
The modular coil array comprises eight independent building blocks, each containing four transceiver loop elements. Numerical simulations were used for B1+ field homogenization and radiofrequency (RF) safety validation. RF characteristics were examined in a phantom study. The array's suitability for accelerated high spatial resolution two-dimensional (2D) FLASH CINE imaging of the heart was examined in a volunteer study.
Results
Transmission field adjustments and RF characteristics were found to be suitable for the volunteer study. The signal-to-noise intrinsic to 7.0T together with the coil performance afforded a spatial resolution of 1.1 × 1.1 × 2.5 mm3 for 2D CINE FLASH MRI, which is by a factor of 6 superior to standardized CINE protocols used in clinical practice at 1.5T. The 32-channel transceiver array supports one-dimensional acceleration factors of up to R = 4 without impairing image quality significantly.
Conclusion
The modular 32-channel transceiver cardiac array supports accelerated and high spatial resolution cardiac MRI. The array is compatible with multichannel transmission and provides a technological basis for future clinical assessment of parallel transmission techniques at 7.0T.
Objective: As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to interference from electromagnetic fields (EMF) and to magneto-hydrodynamic (MHD) effects increases and with it the motivation for a CMR triggering alternative. This study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects (n=14). Methods: Quantitative analysis of 2D CINE steady-state free precession (SSFP) images was conducted to compare ACT’s performance with vector ECG (VCG). Endocardial border sharpness (EBS) was examined paralleled by quantitative LV function assessment. Results: Unlike VCG, ACT provided signal traces free of interference from EMF or MHD effects. In the case of correct Rwave recognition, VCG-triggered 2D CINE SSFP was immune to cardiac motion effects—even at 3.0 T. However, VCG-triggered 2D SSFP CINE imaging was prone to cardiac motion and EBS degradation if R-wave misregistration occurred. ACT-triggered acquisitions yielded LV parameters (end-diastolic volume (EDV), endsystolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular mass (LVM)) comparable with those derived fromVCG-triggered acquisitions (1.5 T: ESVVCG=(56± 17) ml, EDVVCG=(151±32)ml, LVMVCG=(97±27) g, SVVCG=(94± 19)ml, EFVCG=(63±5)% cf. ESVACT= (56±18) ml, EDVACT=(147±36) ml, LVMACT=(102±29) g, SVACT=(91± 22) ml, EFACT=(62±6)%; 3.0 T: ESVVCG=(55±21) ml, EDVVCG=(151±32) ml, LVMVCG=(101±27) g, SVVCG=(96±15) ml, EFVCG=(65±7)% cf. ESVACT=(54±20) ml, EDVACT=(146±35) ml, LVMACT= (101±30) g, SVACT=(92±17) ml, EFACT=(64±6)%). Conclusions: ACT’s intrinsic insensitivity to interference from electromagnetic fields renders
As high-field cardiac MRI (CMR) becomes more widespread the propensity of ECG to distortions and mistriggering increases and with it the motivation for a cardiac triggering alternative. Hence, this study explores the suitability of acoustic cardiac triggering (ACT) for left ventricular (LV) function assessment in healthy subjects at 1.5T and 3.0T.
Background
To demonstrate the applicability of acoustic cardiac triggering (ACT) for imaging of the heart at ultrahigh magnetic fields (7.0 T) by comparing phonocardiogram, conventional vector electrocardiogram (ECG) and traditional pulse oximetry (POX) triggered 2D CINE acquisitions together with (i) a qualitative image quality analysis, (ii) an assessment of the left ventricular function parameter and (iii) an examination of trigger reliability and trigger detection variance derived from the signal waveforms.
Results
ECG was susceptible to severe distortions at 7.0 T. POX and ACT provided waveforms free of interferences from electromagnetic fields or from magneto-hydrodynamic effects. Frequent R-wave mis-registration occurred in ECG-triggered acquisitions with a failure rate of up to 30% resulting in cardiac motion induced artifacts. ACT and POX triggering produced images free of cardiac motion artefacts. ECG showed a severe jitter in the R-wave detection. POX also showed a trigger jitter of approximately Δt = 72 ms which is equivalent to two cardiac phases. ACT showed a jitter of approximately Δt = 5 ms only. ECG waveforms revealed a standard deviation for the cardiac trigger offset larger than that observed for ACT or POX waveforms.
Image quality assessment showed that ACT substantially improved image quality as compared to ECG (image quality score at end-diastole: ECG = 1.7 ± 0.5, ACT = 2.4 ± 0.5, p = 0.04) while the comparison between ECG vs. POX gated acquisitions showed no significant differences in image quality (image quality score: ECG = 1.7 ± 0.5, POX = 2.0 ± 0.5, p = 0.34).
Conclusions
The applicability of acoustic triggering for cardiac CINE imaging at 7.0 T was demonstrated. ACT's trigger reliability and fidelity are superior to that of ECG and POX. ACT promises to be beneficial for cardiovascular magnetic resonance at ultra-high field strengths including 7.0 T.
This study demonstrates the feasibility of applying free-breathing, cardiac-gated, susceptibility-weighted fast spin-echo imaging together with black blood preparation and navigator-gated respiratory motion compensation for anatomically accurate T₂ mapping of the heart. First, T₂ maps are presented for oil phantoms without and with respiratory motion emulation (T₂ = (22.1 ± 1.7) ms at 1.5 T and T₂ = (22.65 ± 0.89) ms at 3.0 T). T₂ relaxometry of a ferrofluid revealed relaxivities of R2 = (477.9 ± 17) mM⁻¹s⁻¹ and R2 = (449.6 ± 13) mM⁻¹s⁻¹ for UFLARE and multiecho gradient-echo imaging at 1.5 T. For inferoseptal myocardial regions mean T₂ values of 29.9 ± 6.6 ms (1.5 T) and 22.3 ± 4.8 ms (3.0 T) were estimated. For posterior myocardial areas close to the vena cava T₂-values of 24.0 ± 6.4 ms (1.5 T) and 15.4 ± 1.8 ms (3.0 T) were observed. The merits and limitations of the proposed approach are discussed and its implications for cardiac and vascular T₂-mapping are considered.