title: Improved dark blood imaging of the heart using radial balanced steady-state free precession.
abstract: BACKGROUND
  Dark blood imaging of the heart is conventionally performed using a breath-hold, dual-inversion Cartesian fast spin-echo pulse sequence. Our aim was to develop a faster, more flexible approach that would be less motion-sensitive and provide better image quality. For this purpose, we implemented a prototype radial balanced steady-state free precession (bSSFP) pulse sequence.
  
  
  METHODS
  The study was approved by the institutional review board. Six healthy volunteers and 27 subjects undergoing clinically-indicated cardiovascular magnetic resonance (CMR) were imaged using dark blood Cartesian fast spin-echo and radial bSSFP. For patient studies, overall image quality, fat suppression and blood nulling were scored on a 5-point Likert scale. The quality of visualization of the right and left ventricular free walls and septum were individually scored. Streaking and ghosting artifacts were noted, as well as signal dropout in the free wall of the left ventricle.
  
  
  RESULTS
  In volunteer studies, radial bSSFP showed less degradation by cardiac or respiratory motion than fast spin-echo as indicated by visual analysis and calculation of the temporal signal-to-noise ratio. The least motion sensitivity and maximal imaging efficiency were achieved with a single-shot radial bSSFP acquisition using only 35 views (temporal resolution = 95 ms). In patient studies, radial bSSFP images showed fewer motion artifacts and were judged to provide better myocardial visibility, including depiction of the right ventricular free wall, than fast spin-echo.
  
  
  CONCLUSIONS
  Dual-inversion radial bSSFP provides the benefits of diminished sensitivity to image artifacts from respiratory or cardiac motion, better myocardial visibility, and improved imaging efficiency compared with standard-of-care Cartesian fast spin-echo for dark blood imaging of the heart.
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. Redelman999@gmail.com.|Feinberg School of Medicine, Northwestern University, Chicago, USA. Redelman999@gmail.com.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edelman
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA.|Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors.forename: Marcos
authors.initials: M
authors.lastname: Botelho
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA.|The University of Chicago Pritzker School of Medicine, Chicago, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Pursnani
authors.affiliation: Siemens Medical Solutions USA, Inc., Chicago, USA.
authors.forename: Shivraman
authors.initials: S
authors.lastname: Giri
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA.|The University of Chicago Pritzker School of Medicine, Chicago, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Koktzoglou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D062485:Breath Holding; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Breath-holding; Cardiovascular magnetic resonance; Dark blood imaging; Fast spin-echo; Radial balanced steady-state free precession