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• Technical Article •
Application value of 4-shot compressed sensing cardiac cine imaging in risk stratification of patients with pulmonary hypertension
ZHANG Junsheng  HE Jian  LIU Wangyan  SUN Xiaoxuan  WANG Qiang  ZHU Xiaomei  XU Yi 

DOI:10.12015/issn.1674-8034.2026.05.016.


[Abstract] Objective To compare the acquisition efficiency, image quality, consistency of cardiac function quantification, and risk stratification discriminatory ability of 4-shot compressed sensing cardiac cine (4-shot CS cine) versus traditional segmented cine in patients with pulmonary hypertension (PAH).Materials and Methods This retrospective study included 84 PAH patients who underwent cardiac magnetic resonance imaging between October 2022 and September 2024 and completed both cine sequences in the same examination. Scanning time, subjective image quality scores, and objective metrics were compared. Biventricular volume and functional parameters were measured, and differences and correlations were analyzed. According to the simplified risk stratification scale recommended in the Chinese Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension (2021 Edition), patients were divided into a low-risk group (n = 41 cases) and an intermedium-to-high-risk group (n = 43 cases). Univariate logistic models based on right ventricular end systolic volume (RVESV) were built for each sequence, and the Area Under the Curve (AUC) was calculated and compared using the DeLong test.Results 4-shot CS cine had a shorter scanning time than traditional segmented cine [(86.78 ± 18.17) s vs. (109.54 ± 29.46) s, P < 0.001], and the number of breath holds was reduced [(3.80 ± 0.53) times vs. (5.19 ± 0.42) times, P < 0.001]. Both sequences achieved subjective scores of ≥ 3. Blood-pool-to myocardial signal ratio, signal-to-noise ratio, and contrast-to-noise ratio were higher with traditional segmented cine than with 4-shot CS cine (all P < 0.001). Biventricular parameters showed good overall consistency with strong correlations (all r > 0.80). For RVESV-based model, AUCs did not differ significantly between the two sequences for discriminating PAH risk stratification (DeLong test, P > 0.05).Conclusions 4-shot CS cine reduces acquisition burden in PAH patients while providing comparable performance to traditional segmented cine for cardiac function quantification and risk stratification discrimination. Its characteristics of shortening scanning time and reducing breath-holding times can also improve the success rate of the examination, making it potentially valuable as a clinical alternative or supplement.
[Keywords] pulmonary hypertension；4-shot；compressed sensing；magnetic resonance imaging；cine imaging

ZHANG Junsheng1, 2   HE Jian1   LIU Wangyan1   SUN Xiaoxuan3   WANG Qiang3   ZHU Xiaomei1   XU Yi1*  

1 Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

2 Department of Imaging, Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210032, China

3 Department of Rheumatology and Immunology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Corresponding author: XU Y, E-mail: yixu@njmu.edu.cn

Conflicts of interest   None.

Received  2026-01-30
Accepted  2026-04-17
DOI: 10.12015/issn.1674-8034.2026.05.016
DOI:10.12015/issn.1674-8034.2026.05.016.

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