Comparability of compressed sensing-based gradient echo perfusion sequence SPARSE and conventional gradient echo sequence in assessment of myocardial ischemia. Issue 131 (October 2020)

• Record Type: Journal Article
• Authors: Muehlberg, Fabian; Stoetzner, Arthur; Forman, Christoph; Schmidt, Michaela; Riazy, Leili; Dieringer, Matthias; der Geest, Rob van; Schwenke, Carsten; Schulz-Menger, Jeanette
• Is Part Of: European journal of radiology. Issue 131(2020)
• Publication Date: 2020-10
• Subjects: 2D two-dimensional -- 3D three-dimensional -- AHA American Heart Association -- BMI body mass index -- CAD coronary artery disease -- CMR cardiovascular magnetic resonance -- CNR contrast-to-noise ratio -- CS compressed sensing -- DRA dark rim artifact -- FISTA Fast Iterative Shrinkage-Thresholding Algorithm -- FLASH fast low angle shot -- FOV field of view -- FFR fractional flow reserve -- LGE late gadolinium enhancement -- LV left ventricular -- LV-EDV left ventricular enddiastolic volume -- LV-EF left ventricular ejection fraction -- LV-M left ventricular mass -- MBF myocardial blow flow -- MPR myocardial perfusion reserve -- MR magnetic resonance -- MRI Magnetic resonance imaging -- ROI region of interest -- SD standard deviation -- SNR signal-to-noise ratio -- SPECT single photon emission computed tomography -- SSFP steady-state free precession -- TE echo time; Perfusion -- Compressed sensing -- CMR -- Stress MRI -- Coronary artery disease -- Non-invasive stress test; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109213
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Compressed sensing-based perfusion sequence yields stable image quality and enhanced contrast-to-noise ratio. No differences in visual and quantitative perfusion analysis were observed between both sequences. Compressed sensing-based perfusion sequences enable for increased coverage and/or higher spatial resolution. Abstract: Purpose: Stress perfusion imaging plays a major role in non-invasive detection of coronary artery disease. We compared a compressed sensing-based and a conventional gradient echo perfusion sequence with regard to image quality and diagnostic performance. Method: Patients sent for coronary angiography due to pathologic stress perfusion CMR were recruited. All patients underwent two adenosine stress CMR using conventional TurboFLASH and prototype SPARSE sequence as well as quantitative coronary angiography with fractional flow reserve (FFR) within 6 weeks. Coronary angiography was considered gold standard with FFR < 0.75 or visual stenosis >90 % for identification of myocardial ischemia. Diagnostic performance of perfusion imaging was assessed in basal, mid-ventricular and apical slices by quantification of myocardial perfusion reserve (MPR) analysis utilizing the signal upslope method and a deconvolution technique using the fermi function model. Results: 23 patients with mean age of 69.6 ± 8.9 years were enrolled. 46 % were female. Image quality was similar in conventional TurboFLASH sequence and SPARSE sequence (2.9 ± 0.5 vs 3.1 ± 0.7, p = 0, 06). SPARSE sequence showed higher contrast-to-noise ratio (52.1 ± 27.4 vs 40.5 ± 17.6, p < 0.01) and signal-to-noise ratio (15.6 ± 6.2 vs 13.2 ± 4.2, p < 0.01) than TurboFLASH sequence. Dark-rim artifacts occurred less often with SPARSE (9 % of segments) than with TurboFLASH (23 %). In visual assessment of perfusion defects, SPARSE sequence detected less false-positive perfusion defects (n = 1) than TurboFLASH sequence (n = 3). Quantitative perfusion analysis on segment basis showed equal detection of perfusion defects for TurboFLASH and SPARSE with both upslope MPR analysis (TurboFLASH 0.88 ± 0.18; SPARSE 0.77 ± 0.26; p = 0.06) and fermi function model (TurboFLASH 0.85 ± 0.24; SPARSE 0.76 ± 0.30; p = 0.13). Conclusions: Compressed sensing perfusion imaging using SPARSE sequence allows reliable detection of myocardial ischemia.