title: Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique--comparison of an intravascular and extravascular contrast agent.
abstract: BACKGROUND
  Cardiovascular magnetic resonance (CMR) is the current gold standard for the assessment of left ventricular (LV) function. Repeated breath-holds are needed for standard multi-slice 2D cine steady-state free precession sequences (M2D-SSFP). Accelerated single breath-hold techniques suffer from low contrast between blood pool and myocardium. In this study an intravascular contrast agent was prospectively compared to an extravascular contrast agent for the assessment of LV function using a single-breath-hold 3D-whole-heart cine SSFP sequence (3D-SSFP).
  
  
  METHODS
  LV function was assessed in fourteen patients on a 1.5 T MR-scanner (Philips Healthcare) using 32-channel coil technology. Patients were investigated twice using a 3D-SSFP sequence (acquisition time 18-25 s) after Gadopentetate dimeglumine (GdD, day 1) and Gadofosveset trisodium (GdT, day 2) administration. Image acquisition was accelerated using sensitivity encoding in both phase encoding directions (4xSENSE). CNR and BMC were both measured between blood and myocardium. The CNR incorporated noise measurements, while the BMC represented the coeffiancy between the signal from blood and myocardium [1]. Contrast to noise ratio (CNR), blood to myocardium contrast (BMC), image quality, LV functional parameters and intra-/interobserver variability were compared. A M2D-SSFP sequence was used as a reference standard on both days.
  
  
  RESULTS
  All 3D-SSFP sequences were successfully acquired within one breath-hold after GdD and GdT administration. CNR and BMC were significantly (p < 0.05) higher using GdT compared to GdD, resulting in an improved endocardial definition. Using 3D-SSFP with GdT, Bland-Altman plots showed a smaller bias (95% confidence interval LVEF: 9.0 vs. 23.7) and regression analysis showed a stronger correlation to the reference standard (R2 = 0.92 vs. R2 = 0.71), compared to 3D-SSFP with GdD.
  
  
  CONCLUSIONS
  A single-breath-hold 3D-whole-heart cine SSFP sequence in combination with 32-channel technology and an intravascular contrast agent allows for the accurate and fast assessment of LV function.
authors: King's College London BHF Centre, Division of Imaging Science, Biomedical Research Centre of Guy's and St, Thomas' NHS Foundation Trust, London, UK.
authors: Marcus R
authors: MR
authors: Makowski
authors: Andrea J
authors: AJ
authors: Wiethoff
authors: Christian H P
authors: CH
authors: Jansen
authors: Sergio
authors: S
authors: Uribe
authors: Victoria
authors: V
authors: Parish
authors: Andreas
authors: A
authors: Schuster
authors: Rene M
authors: RM
authors: Botnar
authors: Aaron
authors: A
authors: Bell
authors: Christoph
authors: C
authors: Kiesewetter
authors: Reza
authors: R
authors: Razavi
authors: Tobias
authors: T
authors: Schaeffter
authors: Gerald F
authors: GF
authors: Greil
mesh_terms: D000328:Adult; D062485:Breath Holding; D003287:Contrast Media / Q000008:administration & dosage*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D010496:Pericardium / Q000473:pathology*; D011446:Prospective Studies; D012119:Respiration; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA