title: Assessment of left ventricular function by breath-hold cine MR imaging: Comparison of different steady-state free precession sequences.
abstract: OBJECTIVE
  To compare steady-state free precession (SSFP) sequence protocols with different acquisition times (TA) and temporal resolutions (tRes) due to the implementation of a view sharing technique called shared phases for the assessment of left ventricular (LV) function by breath-hold cine magnetic resonance (MR) imaging.
  
  
  METHODS
  End-diastolic and end-systolic volumes (EDV, ESV) were measured in contiguous short-axis slices with a thickness of 8 mm acquired in 10 healthy male volunteers. The following true fast imaging with steady-state precession (TrueFISP) sequence protocols were compared: protocol A) internal standard of reference, segmented: tRes 34.5 msec, TA 18 beats per slice; protocol B) segmented, shared phases: tRes 34.1 msec, TA 10 beats per slice; and protocol C) real-time, shared phases, parallel acquisition technique: tRes 47.3 msec, TA 24 beats for 12 slices covering the entire left ventricle.
  
  
  RESULTS
  Phase sharing leads to a significant decrease in EDV, stroke volume (SV), and ejection fraction (EF) (median difference -7.0 mL [*], -9.6 mL, and -3.4%, respectively, for protocol B; -15.3 mL, -13.3 mL, and -2.4% for protocol C; P = 0.002, *P = 0.021). The observed median difference of real-time EDV and SV estimates is of clinical relevance. Real-time cine MR imaging shows a greater variability of EDV and SV. No relevant differences in ESV were observed.
  
  
  CONCLUSIONS
  The true cine frame duration of both shared phases sequence protocols exceeds the period of isovolumetric contraction (IVCT) of the left ventricle resulting in a systematic and significant underestimation of EDV and consequently SV and EF. SSFP sequence protocol parameters, particularly tRes and use of view sharing techniques, should therefore be known at follow-up examinations in order to be able to assess LV remodeling in patients with heart failure.
authors.affiliation: Department of Radiology, Johannes Gutenberg-University, Mainz, Germany. kunzp@mail.uni-mainz.de
authors.forename: R Peter
authors.initials: RP
authors.lastname: Kunz
authors.forename: Florian
authors.initials: F
authors.lastname: Oellig
authors.forename: Frank
authors.initials: F
authors.lastname: Krummenauer
authors.forename: Katja
authors.initials: K
authors.lastname: Oberholzer
authors.forename: Bernd
authors.initials: B
authors.lastname: Romaneehsen
authors.forename: Toni W
authors.initials: TW
authors.lastname: Vomweg
authors.forename: Georg
authors.initials: G
authors.lastname: Horstick
authors.forename: Carmel
authors.initials: C
authors.lastname: Hayes
authors.forename: Manfred
authors.initials: M
authors.lastname: Thelen
authors.forename: Karl-Friedrich
authors.initials: KF
authors.lastname: Kreitner
mesh_terms: D000328:Adult; D002306:Cardiac Volume / Q000502:physiology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012119:Respiration; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*