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The assessment of the right ventricle (RV) is a challenge in today's cardiology, but of growing clinical impact regarding patient prognosis in different cardiac diseases. The detection and differentiation of small wall motion abnormalities may help to enhance the differentiation of cardiomyopathies including Arrhythmogenic Rightventricular Cardiomyopathy. Cardiovascular magnetic resonance (CMR) at 1.5T is the accepted gold standard for RV quantification. The higher spatial resolution achievable at ultrahigh field strength (UHF) offers the potential to gain new insights into the structure and function of the RV. To approach this goal accurate RV chamber quantification at 7T has to be proven. Consequently this study examines the feasibility of assessment of RV dimensions and function at 7T using improved spatial resolution enabled by the intrinsic sensitivity gain of UHF CMR. For this purpose, a dedicated 16 channel TX/RX RF coil array is used together with 2D CINE fast gradient echo (FGRE) imaging. For comparison RV chamber quantification is conducted at 1.5T using a SSFP based state of the art clinical protocol.
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) 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.
With its need for high SNR and short acquisition times, Cardiac MRI (CMR) is an intriguing target application for ultrahigh field MRI. Due to the sheer size of the upper torso, however, the known RF issues of 7T MRI are also most prominent in CMR. Recent years brought substantial progress but the full potential of the ultrahigh field for CMR is yet to be exploited. Parallel transmission (pTx) is a promising approach in this context and several groups have already reported B1 shimming for 7T CMR. In such a static pTx application amplitudes and phases of all Tx channels are adjusted individually but otherwise imaging techniques established in current clinical practice 1.5 T and 3 T are applied. More advanced forms of pTx as spatially selective excitation (SSE) using Transmit SENSE promise additional benefits like faster imaging with reduced fields of view or improved SAR control. SSE requires the full dynamic capabilities of pTx, however, and for the majority of today's implemented pTx hardware the internal synchronization of the Tx array does not easily permit external triggering as needed for CMR. Here we report a software solution to this problem and demonstrate the feasibility of CINE CMR at 7 T using a Tx array.
We have developed a double-tuned ¹H/¹⁹F birdcage resonator dedicated for hand and wrist imaging at 7 T to locally image non-steroidal anti-inflammatory drugs (NSAID) such as 2-{[3-(Trifluoromethyl) phenyl]amino}benzoic acid. The preliminary in vivo images acquired by the double-tuned ¹H/¹⁹F birdcage resonator demonstrate the feasibility for ¹H/¹⁹F hand- and wrist-imaging at 7 T. While the diagnostic quality of the coil needs to be assessed in patients with inflammatory rheumatoid disease, first ¹⁹F images of the NSAID are encouraging, and point towards the prospect of applying ¹⁹F-MRI to visualize and quantify the concentration of therapeutically-active compound at the sites of inflammation.
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.
The simultaneous assessment of glottal dynamics and larynx position can be beneficial for the diagnosis of disordered voice or speech production and swallowing. Up to now, methods either concentrate on assessment of the glottis opening using optical, acoustical or electrical (electroglottography, EGG) methods, or on visualisation of the larynx position using ultrasound, computer tomography or magnetic resonance imaging techniques.
The method presented here makes use of a time-multiplex measurement approach of space-resolved transfer impedances through the larynx. The fast sequence of measurements allows a quasi simultaneous assessment of both larynx position and EGG signal using up to 32 transmit–receive signal paths. The system assesses the dynamic opening status of the glottis as well as the vertical and back/forward motion of the larynx.
Two electrode-arrays are used for the measurement of the electrical transfer impedance through the neck in different directions. From the acquired data the global and individual conductivity is calculated as well as a 2D point spatial representation of the minimum impedance.
The position information is shown together with classical EGG signals allowing a synchronous visual assessment of glottal area and larynx position. A first application to singing voice analysis is presented that indicate a high potential of the method for use as a non-invasive tool in the diagnosis of voice, speech, and swallowing disorders.
Objectives
Interest in cardiovascular magnetic resonance (CMR) at 7 T is motivated by the expected increase in spatial and temporal resolution, but the method is technically challenging. We examined the feasibility of cardiac chamber quantification at 7 T.
Methods
A stack of short axes covering the left ventricle was obtained in nine healthy male volunteers. At 1.5 T, steady-state free precession (SSFP) and fast gradient echo (FGRE) cine imaging with 7 mm slice thickness (STH) were used. At 7 T, FGRE with 7 mm and 4 mm STH were applied. End-diastolic volume, end-systolic volume, ejection fraction and mass were calculated.
Results
All 7 T examinations provided excellent blood/myocardium contrast for all slice directions. No significant difference was found regarding ejection fraction and cardiac volumes between SSFP at 1.5 T and FGRE at 7 T, while volumes obtained from FGRE at 1.5 T were underestimated. Cardiac mass derived from FGRE at 1.5 and 7 T was larger than obtained from SSFP at 1.5 T. Agreement of volumes and mass between SSFP at 1.5 T and FGRE improved for FGRE at 7 T when combined with an STH reduction to 4 mm.
Conclusions
This pilot study demonstrates that cardiac chamber quantification at 7 T using FGRE is feasible and agrees closely with SSFP at 1.5 T.
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.