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3D-Encoded DENSE MRI with Zonal Excitation for Quantifying Biventricular Myocardial Strain During a Breath-Hold

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Abstract

Purpose

Right ventricular (RV) function is increasingly recognized for its prognostic value in many disease states. As with the left ventricle (LV), strain-based measurements may have better prognostic value than typical chamber volumes or ejection fraction. Complete functional characterization of the RV requires high-resolution, 3D displacement tracking methods, which have been prohibitively challenging to implement. Zonal excitation during Displacement ENcoding with Stimulated Echoes (DENSE) magnetic resonance imaging (MRI) has helped reduce scan time for 2D LV strain quantification. We hypothesized that zonal excitation could alternatively be used to reproducibly acquire higher resolution, 3D-encoded DENSE images for quantification of bi-ventricular strain within a single breath-hold.

Methods

We modified sequence parameters for a 3D zonal excitation DENSE sequence to achieve in-plane resolution < 2 mm and acquired two sets of images in eight healthy adult male volunteers with median (IQR) age 32.5 (32.0–33.8) years. We assessed the inter-test reproducibility of this technique, and compared computed strains and torsion with previously published data.

Results

Data for one subject was excluded based on image artifacts. Reproducibility for LV (CoV: 6.1–9.0%) and RV normal strains (CoV: 6.3–8.2%) and LV torsion (CoV = 7.1%) were all very good. Reproducibility of RV torsion was lower (CoV = 16.7%), but still within acceptable limits. Computed global strains and torsion were within reasonable agreement with published data, but further studies in larger cohorts are needed to confirm.

Conclusion

Reproducible acquisition of 3D-encoded biventricular myocardial strain data in a breath-hold is feasible using DENSE with zonal excitation.

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Abbreviations

RV:

Right ventricle

LV:

Left ventricle

DENSE:

Displacement ENcoding with Stimulated Echoes

MRI:

Magnetic resonance imaging

CoV:

Coefficient of variation

SENC:

Strain encoded

ARVC:

Arrhythmogenic right ventricular cardiomyopathy

ZE:

Zonal excitation

RF:

Radiofrequency

FOV:

Field of view

TR:

Repetition time

TE:

Echo time

SNR:

Signal to noise ratio

IQR:

Inter-quartile range

SD:

Standard deviation

E RR, E CC, E LL :

Radial, circumferential, longitudinal normal strain, respectively

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Funding

Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL141901. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Availability of Data and Material

Data for this work will not be made available.

Code Availability

DENSEanalysis software used for this work is freely available for public use: (http://www.github.com/suever/denseanalysis/denseanalysis).

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Translational Data Science and Informatics, Geisinger, Danville, PA, USA

    Eric D. Carruth, Samuel W. Fielden, Christopher D. Nevius, Brandon K. Fornwalt & Christopher M. Haggerty

  2. Medical and Health Physics, Geisinger, Danville, PA, USA

    Samuel W. Fielden

  3. The Heart Institute, Geisinger, Danville, PA, USA

    Brandon K. Fornwalt & Christopher M. Haggerty

  4. Department of Radiology, Geisinger, Danville, PA, USA

    Brandon K. Fornwalt

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  1. Eric D. Carruth
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  2. Samuel W. Fielden
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  3. Christopher D. Nevius
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  5. Christopher M. Haggerty
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Correspondence to Christopher M. Haggerty.

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Associate Editor Ajit P. Yoganathan oversaw the review of this article.

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Carruth, E.D., Fielden, S.W., Nevius, C.D. et al. 3D-Encoded DENSE MRI with Zonal Excitation for Quantifying Biventricular Myocardial Strain During a Breath-Hold. Cardiovasc Eng Tech 12, 589–597 (2021). https://doi.org/10.1007/s13239-021-00561-8

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