Application value of cardiac cine with compressed sensing real-time imaging and retrospective fully automated non-rigid motion correction for assessment of right ventricular function and strain in patients with pulmonary arterial hypertension

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• Clinical Articles •

LI Yanyu LIN Lu WANG Jian CAO Likun LIU Yajing PANG Jianing AN Jing JIN Zhengyu WANG Yining

Cite this article as: Li YY, Lin L, Wang J, et al. Application value of cardiac cine with compressed sensing real-time imaging and retrospective fully automated non-rigid motion correction for assessment of right ventricular function and strain in patients with pulmonary arterial hypertension[J]. Chin J Magn Reson Imaging, 2022, 13(10): 114-120. DOI:10.12015/issn.1674-8034.2022.10.017.

Abstract

[Abstract] Objective To evaluate the feasibility and accuracy of free-breathing cardiac cine MR imaging (cine-MoCo) combined with compressed sensing, highly accelerated real-time acquisition, and retrospective fully automated non-rigid motion correction for right ventricular (RV) function and strain analysis in patients with pulmonary arterial hypertension (PAH).Materials and Methods Suspected or confirmed PAH patients clinically scheduled for CMR assessment were enrolled in Department of Radiology of Peking Union Medical College Hospital of Chinese Academy of Medical Sciences from January 2020 to April 2021. All enrolled patients received the standard cine imaging with 2D segmented acquisition and retrospective ECG gating (cine-SegBH) and cine-MoCo. Image quality (IQ) was evaluated using a qualitative 5-point Likert scale and the European CMR registry standardized criteria, and edge sharpness was measured. RV function and strain were measured and compared.Results Forty patients were enrolled in this study. The mean scan times of cine-SegBH and cine-MoCo were (143±42) s and (115±24) s, respectively (P＜0.05). The general subjective IQ scores of cine-MoCo and cine-SegBH were (4.4±0.7) and (4.1±0.8), respectively (P＜0.05), and the standardized criteria IQ scores of cine-MoCo and cine-SegBH based on the European CMR registry standardized criteria were (0.125±0.404) and (0.425±0.844), respectively (P＜0.05). There was no significant difference by edge sharpness measurement between cine-SegBH and cine-MoCo [(0.064±0.133) vs. (0.065±0.139), P＞0.05]. There were no significant differences in the assessment of RV functional parameters between cine-SegBH and cine-MoCo, including RV ejection fraction (RVEF), RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volumes (RVSV), and RV mass (RVM), additionally, all RV functional parameters showed strong correlations (r=0.966-0.992) between the two cine techniques. RV myocardial strain including global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) derived from cine-MoCo were significantly lower than those by cine-SegBH (all P＜0.05). GCS and GRS showed strong correlations (r=0.895 for GCS; r=0.908 for GRS), but GLS showed a weak correlation (r=0.564) between the two cine techniques. Subgroup analysis showed that GLS, GCS, and GRS measured with cine-MoCo were significantly underestimated in patients with mild PAH (WHO function class Ⅰ-Ⅱ, Group 1) but no significant differences in patients with severe PAH (WHO function class Ⅲ-Ⅳ, Group 2) when compared with those measured with cine-SegBH. All parameters for both techniques showed good intra-observer and inter-observer agreement.Conclusions Compared with cine-SegBH, cine-MoCo can shorten image acquisition time, obtain equivalent or even better IQ, and achieve precise quantitative analytic results for RV function in patients with PAH, and obtain accurate strain evaluation in patients with severe PAH.

[Keywords] pulmonary arterial hypertension；myocardial strain；cardiac functional analysis；motion correction；magnetic resonance imaging；cardiac magnetic resonance cine imaging；compressed sensing

Contributor Information

LI Yanyu¹ LIN Lu¹ WANG Jian¹ CAO Likun¹ LIU Yajing¹ PANG Jianing² AN Jing³ JIN Zhengyu¹ WANG Yining^1*

¹ Department of Radiology, Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, Beijing 100730, China

² Siemens Medical Solutions USA Inc., Chicago, IL USA

³ Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen 518057, China

Wang YN, E-mail: wangyining@pumch.cn

Conflicts of interest None.

Publication Information

ACKNOWLEDGMENTS Major International (Regional) Joint Research Project of National Natural Science Foundation of China (No. 82020108018); Natural Science Foundation of Beijing (No. Z210013); CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2020-I2M-C & T-B-034).

Received 2022-07-08

Accepted 2022-10-08

DOI: 10.12015/issn.1674-8034.2022.10.017

Text

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