Key result
Fivefold-accelerated wideband perfusion yields comparable resting MBF in CIED patients versus those without devices.
Why the study?
It was unknown whether an accelerated wideband cardiac perfusion pulse sequence could produce diagnostically acceptable image quality and reliably quantify myocardial blood flow in patients with a cardiac implantable electronic device.
Does a fivefold-accelerated wideband perfusion pulse sequence with compressed sensing produce diagnostically acceptable image quality and reliably quantify myocardial blood flow in patients with a CIED?
Observational (n=30)
Single-blind
No
Does a fivefold-accelerated wideband perfusion pulse sequence with compressed sensing produce diagnostically acceptable image quality and reliably quantify myocardial blood flow in patients with a CIED?
Absolute Event Rate: 1.1% vs 1.3%
p-value: p=0.27
A novel fivefold-accelerated wideband perfusion MRI pulse sequence provides diagnostically acceptable image quality and reliable myocardial blood flow quantification in patients with cardiac implantable electronic devices.
Supports MBF quantification in CIED patients via accelerated wideband perfusion MRI; leaves open diagnostic utility.
Purpose To develop an accelerated wideband cardiac perfusion pulse sequence and test whether it can produce diagnostically acceptable image quality and whether it can be used to reliably quantify myocardial blood flow (MBF) in patients with a cardiac implantable electronic device (CIED). Materials and Methods A fivefold-accelerated wideband perfusion pulse sequence was developed using compressed sensing to sample one arterial input function plane and three myocardial perfusion (MP) planes per heartbeat in patients with a CIED with heart rates as high as 102 beats per minute. Resting perfusion scans were performed in 10 patients with a CIED and in 10 patients with no device as a control group. Two clinical readers compared the resulting images and retrospective images of the 10 patients with a CIED, which were obtained by using a previously described twofold-accelerated wideband perfusion pulse sequence with temporal generalized autocalibrating partially parallel acquisition. Summed visual score (SVS) was defined as the sum of conspicuity, artifact, and noise scores individually ranging from 1 (worst) to 5 (best). Resting MBF in the remote zones was quantified using Fermi deconvolution. Results Median SVS was significantly different (P < .05) between the prospective and retrospective CIED groups (13 vs nine) and between the nondevice group and the retrospective CIED group (13.5 vs nine); all median SVSs were nine or greater (clinically acceptable cut point). The median resting MBF in remote zones was not significantly different (P = .27) between patients with a CIED (1.1 mL/min/g; median left ventricular ejection fraction [LVEF], 52.5%) and patients with no device (1.3 mL/min/g; median LVEF, 64.0%). Mean MBF values were consistent with those (mean resting MBF range, 1.0–1.2 mL/min/g) reported by two prior state-of-the-art cardiac perfusion MRI studies. Conclusion The proposed scan yielded diagnostically acceptable image quality and enabled reliable quantification of MBF with three MP planes per heartbeat in patients with a CIED with heart rates as high as 102 beats per minute. Supplemental material is available for this article.
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Hong et al. (2020) conducted an observational in Patients with a cardiac implantable electronic device (CIED) (n=30). Fivefold-accelerated wideband cardiac perfusion pulse sequence with compressed sensing reconstruction vs. Patients with no device and retrospective twofold-accelerated wideband perfusion pulse sequence was evaluated on Resting myocardial blood flow (MBF) in remote zones (p=0.27). A fivefold-accelerated wideband cardiac perfusion pulse sequence with compressed sensing yielded resting myocardial blood flow values in CIED patients (1.1 mL/min/g) comparable to patients without devices (1.3 mL/min/g, P=0.27).
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