yang and colleagues report on their single-center experience with high-field coronary Mra using a new Mr contrast agent. data on 30 patients were compared with conventional X-ray angiography. their new coronary Mra approach seems favourable when compared with previous Mra methods.
PURPOSE: To compare higher spatial resolution 3D late gadolinium enhancement (LGE) cardiovascular magnetic resonance (Cardiac MR) with 2D LGE in patients with prior myocardial infarction. MATERIALS AND METHODS: Fourteen patients were studied using high spatial resolution 3D LGE (1.3 x 1.3 x 5.0 mm(3)) and conventional 2D LGE (2 x 2 x 8 mm(3)) scans. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Total infarct volume, peri-infarct volume measured in a limited slab, and papillary muscle scar volume were compared using Bland-Altman analysis. Image quality was graded. RESULTS: 3D LGE had higher scar SNR (P < 0.001), higher myocardial SNR (P = 0.001), higher papillary scar-blood CNR (P = 0.01), and greater sharpness (P = 0.01). The scar volumes agreed (14.5 +/- 8.2 for 2D, vs. 13.2 +/- 8.8 for 3D), with bias +/- 2 standard deviations (SDs) of 0.5 +/- 6.8 mL, P = 0.59 R = 0.91. The peri-infarct volumes correlated but less strongly than scar (P = 0.40, R = 0.77). For patients with more heterogeneous scar, larger peri-infarct volumes were measured by 3D (1.9 +/- 1.1 mL for 2D vs. 2.4 +/- 1.6 mL for 3D, P = 0.15, in the matched region). Papillary scar, present in 6/14 (42%) patients, was more confidently identified on 3D LGE. CONCLUSION: Higher spatial resolution 3D LGE provides sharper images and higher SNR, but less myocardial nulling. Scar volumes agree well, with peri-infarct volumes correlating less well. 3D LGE may be superior in visualization of papillary muscle scar.
In this paper, we proposed novel noise reduction algorithms that can be used to enhance image quality in various medical imaging modalities such as magnetic resonance and multidetector computed tomography. The noisy captured 3-D data are first transformed by discrete complex wavelet transform. Using a nonlinear function, we model the data as the sum of the clean data plus additive Gaussian or Rayleigh noise. We use a mixture of bivariate Laplacian probability density functions for the clean data in the transformed domain. The MAP and minimum mean-squared error (MMSE) estimators allow us to efficiently reduce the noise. The employed prior distribution is mixture and bivariate, and thus accurately characterizes the heavy-tail distribution of clean images and exploits the interscale properties of wavelets coefficients. In addition, we estimate the parameters of the model using local information; as a result, the proposed denoising algorithms are spatially adaptive, i.e., the intrascale dependency of wavelets is also well exploited in the enhancement process. The proposed approach results in significant noise reduction while the introduced distortions are not noticeable as a result of accurate statistical modeling. The obtained shrinkage functions have closed form, are simple in implementation, and efficiently enhances data. Our experiments on CT images show that among our derived shrinkage functions usually BiLapGausMAP produces images with higher peak SNR. However, BiLapGausMMSE is preferred especially for CT images, which have high SNRs. Furthermore, BiLapRayMAP yields better noise reduction performance for low SNR MR datasets such as high-resolution whole heart imaging while BiLapGauMAP results in better performance in MR data with higher intrinsic SNR such as functional cine data.
PURPOSE: To compare two coronary vein imaging techniques using whole-heart balanced steady-state free precession (SSFP) and a targeted double-oblique spoiled gradient-echo (GRE) sequences in combination with magnetization transfer (MT) preparation sequence for tissue contrast improvement. MATERIALS AND METHODS: Nine healthy subjects were imaged with the proposed technique. The results are compared with optimized targeted MT prepared GRE acquisitions. Both quantitative and qualitative analyses were performed to evaluate each imaging method. RESULTS: Whole-heart images were successfully acquired with no visible image artifact in the vicinity of the coronary veins. The anatomical features and visual grading of both techniques were comparable. However, the targeted small slab acquisition of the left ventricular lateral wall was superior to whole-heart acquisition for visualization of relevant information for cardiac resynchronization therapy (CRT) lead implantation. CONCLUSION: We demonstrated the feasibility of whole-heart coronary vein MRI using a 3D MT-SSFP imaging sequence. A targeted acquisition along the lateral left ventricular wall is preferred for visualization of branches commonly used in CRT lead implantation.
OBJECTIVES: We sought to evaluate radiofrequency (RF) ablation lesions in atrial fibrillation (AF) patients using cardiac magnetic resonance (CMR), and to correlate the ablation patterns with treatment success. BACKGROUND: RF ablation procedures for treatment of AF result in localized scar that is detected by late gadolinium enhancement (LGE) CMR. We hypothesized that the extent of scar in the left atrium and pulmonary veins (PV) would correlate with moderate-term procedural success. METHODS: Thirty-five patients with AF, undergoing their first RF ablation procedure, were studied. The RF ablation procedure was performed to achieve bidirectional conduction block around each PV ostium. AF recurrence was documented using a 7-day event monitor at multiple intervals during the first year. High spatial resolution 3-dimensional LGE CMR was performed 46 +/- 28 days after RF ablation. The extent of scarring around the ostia of each PV was quantitatively (volume of scar) and qualitatively (1: minimal, 3: extensive and circumferential) assessed. RESULTS: Thirteen (37%) patients had recurrent AF during the 6.7 +/- 3.6-month observation period. Paroxysmal AF was a strong predictor of nonrecurrent AF (15% with recurrence vs. 68% without, p = 0.002). Qualitatively, patients without recurrence had more completely circumferentially scarred veins (55% vs. 35% of veins, p = NS). Patients without recurrence more frequently had scar in the inferior portion of the right inferior pulmonary vein (RIPV) (82% vs. 31%, p = 0.025, Bonferroni corrected). The volume of scar in the RIPV was quantitatively greater in patients without AF recurrence (p < or = 0.05) and was a univariate predictor of recurrence using Cox regression (p = 0.049, Bonferroni corrected). CONCLUSIONS: Among patients undergoing PV isolation, AF recurrence during the first year is associated with a lesser degree of PV and left atrial scarring on 3-dimensional LGE CMR. This finding was significant for RIPV scar and may have implications for the procedural technique used in PV isolation.
A T(2) magnetization-preparation (T(2) Prep) sequence is proposed that is insensitive to B(1) field variations and simultaneously provides fat suppression without any further increase in specific absorption rate (SAR). Increased B(1) inhomogeneity at higher magnetic field strength (B(0) > or = 3T) necessitates a preparation sequence that is less sensitive to B(1) variations. For the proposed technique, T(2) weighting in the image is achieved using a segmented B(1)-insensitive rotation (BIR-4) adiabatic pulse by inserting two equally long delays, one after the initial reverse adiabatic half passage (AHP), and the other before the final AHP segment of a BIR-4 pulse. This sequence yields T(2) weighting with both B(1) and B(0) insensitivity. To simultaneously suppress fat signal (at the cost of B(0) insensitivity), the second delay is prolonged so that fat accumulates additional phase due to its chemical shift. Numerical simulations as well as phantom and in vivo image acquisitions were performed to show the efficacy of the proposed technique.
