Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approachReportar como inadecuado




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Journal of Cardiovascular Magnetic Resonance

, 17:47

First Online: 11 June 2015Received: 18 November 2014Accepted: 11 May 2015

Abstract

BackgroundLeft atrial LA dilatation is associated with a large variety of cardiac diseases.
Current cardiovascular magnetic resonance CMR strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration.

AimTo develop a time-efficient single breath-hold 3D CMR acquisition and reconstruction method to precisely measure LA volumes and function.

MethodsA highly accelerated compressed-sensing multi-slice cine sequence CS-cineCMR was combined with a non-model-based 3D reconstruction method to measure LA volumes with high temporal and spatial resolution during a single breath-hold.
This approach was validated in LA phantoms of different shapes and applied in 3 patients.
In addition, the influence of slice orientations on accuracy was evaluated in the LA phantoms for the new approach in comparison with a conventional model-based biplane area-length reconstruction.
As a reference in patients, a self-navigated high-resolution whole-heart 3D dataset 3D-HR-CMR was acquired during mid-diastole to yield accurate LA volumes.

ResultsPhantom studies.
LA volumes were accurately measured by CS-cineCMR with a mean difference of −4.73 ± 1.75 ml −8.67 ± 3.54 %, r = 0.94.
For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms.
Long-axis -aligned- vs -not aligned- with the phantom long-axis yielded similar differences vs the reference volume −4.87 ± 1.73 ml vs −4.45 ± 1.97 ml, p = 0.67 and short-axis -perpendicular- vs -not-perpendicular- with the LA long-axis −4.72 ± 1.66 ml vs −4.75 ± 2.13 ml; p = 0.98.
The conventional bi-plane area-length method was susceptible for slice orientations p = 0.0085 for the interaction of -slice orientation- and -reconstruction technique-, 2-way ANOVA for repeated measures.
To use the 3D-HR-CMR as the reference for LA volumes in patients, it was validated in the LA phantoms mean difference: −1.37 ± 1.35 ml, −2.38 ± 2.44 %, r = 0.97.
Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume measured by 3D-HR-CMR with a difference of −2.66 ± 6.5 ml 3.0 % underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml.
Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown.

ConclusionsThe proposed method combines a highly accelerated single-breathhold compressed-sensing multi-slice CMR technique with a non-model-based 3D reconstruction to accurately and reproducibly measure LA volumes and function.

Orestis Vardoulis and Pierre Monney contributed equally to this work.

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Autor: Orestis Vardoulis - Pierre Monney - Amit Bermano - Amir Vaxman - Craig Gotsman - Janine Schwitter - Matthias Stuber - Nikol

Fuente: https://link.springer.com/article/10.1186/s12968-015-0147-8



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