title: Pulmonary vein inflow artifact reduction for free-breathing left atrium late gadolinium enhancement.
abstract: Two-dimensional "pencil-beam" navigator, placed on the right hemidiaphragm, is used for free-breathing late gadolinium enhancement of the left atrium in patients with atrial fibrillation. The pencil-beam navigator creates an inflow artifact in the right pulmonary veins and atrial wall that may obscure local pulmonary vein and left atrium scars. To reduce this artifact, we propose a large slab right hemidiaphragm projection navigator that measures the respiratory motion while reducing the associated inflow artifact. Eighteen subjects underwent pulmonary vein late gadolinium enhancement using the pencil-beam and projection navigator. Subjective inflow and respiratory motion artifact scores (1 = severe, 2 = moderate, 3 = mild, and 4 = none) from two blinded readers were compared. The artifact scores were 3.8 ± 0.4 and 2.1 ± 0.7 for the projection and pencil-beam navigators, respectively (P < 0.001). Respiratory motion artifact scores were similar between the two techniques (3.0 ± 0.5 vs. 3.1 ± 0.5 for projection vs. pencil-beam navigator). The proposed method greatly reduces the inflow artifact in free-breathing pulmonary vein late gadolinium enhancement while allowing adequate respiratory motion compensation.
authors.affiliation: Department of Medicine, Cardiovascular Division, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
authors.forename: Mehdi H
authors.initials: MH
authors.lastname: Moghari
authors.forename: Dana C
authors.initials: DC
authors.lastname: Peters
authors.forename: Jouke
authors.initials: J
authors.lastname: Smink
authors.forename: Lois
authors.initials: L
authors.lastname: Goepfert
authors.forename: Kraig V
authors.initials: KV
authors.lastname: Kissinger
authors.forename: Beth
authors.initials: B
authors.lastname: Goddu
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Hauser
authors.forename: Mark E
authors.initials: ME
authors.lastname: Josephson
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
authors.forename: Reza
authors.initials: R
authors.lastname: Nezafat
mesh_terms: D000328:Adult; D016477:Artifacts; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005682:Gadolinium / Q000378:metabolism; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000473:pathology*; D012119:Respiration
chemical_list: D005682:Gadolinium