title: Rapid assessment of left ventricular segmental wall motion, ejection fraction, and volumes with single breath-hold, multi-slice TrueFISP MR imaging.
abstract: OBJECTIVE
  To reduce imaging time and complexity, we sought to determine whether single breath-hold, multi-slice TrueFISP (SB-MST) magnetic resonance imaging (MRI) method is comparable to standard multi-breath-hold, multi-slice TrueFISP (MB-MST) for assessment of left ventricular (LV) wall motion abnormality (WMA), volumes, and ejection fraction (EF).
  
  
  RESULTS
  We studied 62 patients having cardiac MRI at 1.5-Tesla. After acquiring standard MB-MST (one slice per breath-hold), SB-MST was performed, acquiring 3 short- and 2 long-axis views over only 20 heartbeats. Using both techniques, wall motion was scored using a 6-point, 17-segment LV model for all scans (62 patients x 2 techniques/patient = 124 scans) on two separate occasions. Separately, EF and ventricular volumes were evaluated using both MB-MST and SB-MST. For all analyses, MB-MST was considered the standard against which SB-MST was compared. Twenty-six of 62 patients exhibited at least one segmental WMA by MB-MST. Exact agreement for wall motion was found in 965/1054 segments (92%, kappa = 0.74, p < 0.001), and agreement was within 1 score point in 1010/1054 segments (96%). Considering a score >1 abnormal, exact agreement for presence of WMA was found in 131/193 segments (68%) abnormal by MB-MST and for absence of WMA in 838/861 segments (97%) normal by MB-MST. Agreement within 1 score point occurred in 167/193 abnormal (87%) and in 843/861 normal segments (98%). There were no significant differences in agreement between first and second read of the data. Variability of SB-MST on read one versus read two was small (5%, 996/1054 segments read identically, p = ns) and statistically identical to variability of MB-MST on read one versus read two (4%, 1007/1054 segments read identically, p = ns). For end-diastolic volumes, end-systolic volumes, and EF using SB-MST compared to MB-MST, mean differences were 9 +/- 15 ml, 6 +/- 12 ml, and 2 +/- 5%, and correlations were r = 0.97, 0.98 and 0.95, respectively.
  
  
  CONCLUSIONS
  SB-MST accurately assesses wall motion, volumes and EF. This approach may serve as a screening exam for assessment of WMA and, under select circumstances, may substitute for standard multi-breath-hold method in situations requiring rapid accurate assessments of LV function.
authors.affiliation: Department of Imaging (Division of Cardiology), and CSMC Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Fieno
authors.forename: Louise E J
authors.initials: LE
authors.lastname: Thomson
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: Aiden
authors.initials: A
authors.lastname: Abidov
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.forename: Daisy
authors.initials: D
authors.lastname: Chien
authors.forename: Sean W
authors.initials: SW
authors.lastname: Hayes
authors.forename: Rola
authors.initials: R
authors.lastname: Saouaf
authors.forename: Guido
authors.initials: G
authors.lastname: Germano
authors.forename: John D
authors.initials: JD
authors.lastname: Friedman
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*