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ObjectivesTo compare volumetric and functional parameters of the atria derived from highly accelerated compressed sensing (CS)–based cine sequences in comparison to conventional (Conv) cine imaging.MethodsCS and Conv cine sequences were acquired in 101 subjects (82 healthy volunteers (HV) and 19 patients with heart failure with reduced ejection fraction (HFrEF)) using a 3T MR scanner in this single-center study. Time-volume analysis of the left (LA) and right atria (RA) were performed in both sequences to evaluate atrial volumes and function (total, passive, and active emptying fraction). Inter-sequence and inter- and intra-reader agreement were analyzed using correlation, intraclass correlation (ICC), and Bland-Altman analysis.ResultsCS-based cine imaging led to a 69% reduction of acquisition time. There was significant difference in atrial parameters between CS and Conv cine, e.g., LA minimal volume (LAVmin) (Conv 24.0 ml (16.7–32.7), CS 25.7 ml (19.2–35.2),p p 0.958) and intra-rater (ICC > 0.934) agreement for both techniques. CS-based parameters (PEF AUC = 0.965, LAVmin AUC = 0.864) showed equivalent diagnostic ability compared to Conv cine imaging (PEF AUC = 0.989, LAVmin AUC = 0.859) to differentiate between HV and HFrEF.ConclusionAtrial volumetric and functional evaluation using CS cine imaging is feasible with relevant reduction of acquisition time, therefore strengthening the role of CS in clinical CMR for atrial imaging.Key Points•Reliable assessment of atrial volumes and function based on compressed sensing cine imaging is feasible.•Compressed sensing reduces scan time and has the potential to overcome obstacles of conventional cine imaging.•No significant differences for subjective image quality, inter- and intra-rater agreement, and ability to differentiate healthy volunteers and heart failure patients were detected between conventional and compressed sensing cine imaging.

Objectives To evaluate an image-navigated isotropic high-resolution 3D late gadolinium enhancement (LGE) prototype sequence with compressed sensing and Dixon water-fat separation in a clinical routine setting. Material and methods Forty consecutive patients scheduled for cardiac MRI were enrolled prospectively and examined with 1.5 T MRI. Overall subjective image quality, LGE pattern and extent, diagnostic confidence for detection of LGE, and scan time were evaluated and compared to standard 2D LGE imaging. Robustness of Dixon fat suppression was evaluated for 3D Dixon LGE imaging. For statistical analysis, the non-parametric Wilcoxon rank sum test was performed. Results LGE was rated as ischemic in 9 patients and non-ischemic in 11 patients while it was absent in 20 patients. Image quality and diagnostic confidence were comparable between both techniques (p = 0.67 and p = 0.66, respectively). LGE extent with respect to segmental or transmural myocardial enhancement was identical between 2D and 3D (water-only and in-phase). LGE size was comparable (3D 8.4 ± 7.2 g, 2D 8.7 ± 7.3 g, p = 0.19). Good or excellent fat suppression was achieved in 93% of the 3D LGE datasets. In 6 patients with pericarditis, the 3D sequence with Dixon fat suppression allowed for a better detection of pericardial LGE. Scan duration was significantly longer for 3D imaging (2D median 9:32 min vs. 3D median 10:46 min, p = 0.001). Conclusion The 3D LGE sequence provides comparable LGE detection compared to 2D imaging and seems to be superior in evaluating the extent of pericardial involvement in patients suspected with pericarditis due to the robust Dixon fat suppression. Key Points • Three-dimensional LGE imaging provides high-resolution detection of myocardial scarring. • Robust Dixon water-fat separation aids in the assessment of pericardial disease. • The 2D image navigator technique enables 100% respiratory scan efficacy and permits predictable scan times.

Decreased levels of Brain-Derived Neurotrophic Factor (BDNF) are a common finding in schizophrenia. Another well-documented protein linked to schizophrenia is intracellular Ca2+-independent Phospholipase (PLA2). However, the potential association between PLA2 and BDNF with regard to schizophrenia has yet to be examined. In the present study, male and female BDNF knockout mice, a possible genetic model of schizophrenia, were exposed to prenatal stress and tested in the nest test, open field test and T-maze. Following behavioral tests, whole brain and plasma samples were harvested to measure the activity of PLA2. BDNF knockout mice showed cognitive deficits in the T-maze. Furthermore, there was a quadratic association of PLA2 with performance in the open field test. Moreover, BDNF deficiency and female sex were associated with elevated plasma PLA2 levels. The cognitive impairment of BDNF heterozygous mice as well as their increased PLA2 activity in plasma is consistent with findings in schizophrenia patients. The particular elevation of PLA2 activity in females may partly explain sex differences of clinical symptoms in schizophrenia (e.g. age of onset, severity of symptoms). Additionally, PLA2 was significantly correlated with body and adrenal weight after weaning, whereby the latter emphasizes the possible connection of PLA2 with steroidogenesis.

Background Conventional 2D inversion recovery (IR) and phase sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) have been widely incorporated into routine CMR for the assessment of myocardial viability. However, reliable suppression of fat signal, and increased isotropic spatial resolution and volumetric coverage within a clinically feasible scan time remain a challenge. In order to address these challenges, this work proposes a highly efficient respiratory motion-corrected 3D whole-heart water/fat LGE imaging framework. Methods An accelerated IR-prepared 3D dual-echo acquisition and motion-corrected reconstruction framework for whole-heart water/fat LGE imaging was developed. The acquisition sequence includes 2D image navigators (iNAV), which are used to track the respiratory motion of the heart and enable 100% scan efficiency. Non-rigid motion information estimated from the 2D iNAVs and from the data itself is integrated into a high-dimensional patch-based undersampled reconstruction technique (HD-PROST), to produce high-resolution water/fat 3D LGE images. A cohort of 20 patients with known or suspected cardiovascular disease was scanned with the proposed 3D water/fat LGE approach. 3D water LGE images were compared to conventional breath-held 2D LGE images (2-chamber, 4-chamber and stack of short-axis views) in terms of image quality (1: full diagnostic to 4: non-diagnostic) and presence of LGE findings. Results Image quality was considered diagnostic in 18/20 datasets for both 2D and 3D LGE magnitude images, with comparable image quality scores (2D: 2.05 ± 0.72, 3D: 1.88 ± 0.90, p-value = 0.62) and overall agreement in LGE findings. Acquisition time for isotropic high-resolution (1.3mm3) water/fat LGE images was 8.0 ± 1.4 min (3-fold acceleration, 60–88 slices covering the whole heart), while 2D LGE images were acquired in 5.6 ± 2.2 min (12–18 slices, including pauses between breath-holds) albeit with a lower spatial resolution (1.40–1.75 mm in-plane × 8 mm slice thickness). Conclusion A novel framework for motion-corrected whole-heart 3D water/fat LGE imaging has been introduced. The method was validated in patients with known or suspected cardiovascular disease, showing good agreement with conventional breath-held 2D LGE imaging, but offering higher spatial resolution, improved volumetric coverage and good image quality from a free-breathing acquisition with 100% scan efficiency and predictable scan time.

Background Feature tracking (FT) has become an established tool for cardiovascular magnetic resonance (CMR)-based strain analysis. Recently, the compressed sensing (CS) technique has been applied to cine CMR, which has drastically reduced its acquisition time. However, the effects of CS imaging on FT strain analysis need to be carefully studied. This study aimed to investigate the use of CS cine CMR for FT strain analysis compared to conventional cine CMR. Methods Sixty-five patients with different left ventricular (LV) pathologies underwent both retrospective conventional cine CMR and prospective CS cine CMR using a prototype sequence with the comparable temporal and spatial resolution at 3 T. Eight short-axis cine images covering the entire LV were obtained and used for LV volume assessment and FT strain analysis. Prospective CS cine CMR data over 1.5 heartbeats were acquired to capture the complete end-diastolic data between the first and second heartbeats. LV volume assessment and FT strain analysis were performed using a dedicated software (ci42; Circle Cardiovasacular Imaging, Calgary, Canada), and the global circumferential strain (GCS) and GCS rate were calculated from both cine CMR sequences. Results There were no significant differences in the GCS (− 17.1% [− 11.7, − 19.5] vs. − 16.1% [− 11.9, − 19.3; p = 0.508) and GCS rate (− 0.8 [− 0.6, − 1.0] vs. − 0.8 [− 0.7, − 1.0]; p = 0.587) obtained using conventional and CS cine CMR. The GCS obtained using both methods showed excellent agreement (y = 0.99x − 0.24; r = 0.95; p Conclusion CS cine CMR could be used for GCS assessment by CMR-FT as well as conventional cine CMR. This finding further enhances the clinical utility of high-speed CS cine CMR imaging.

Background Coronary magnetic resonance angiography (CMRA) is a promising technique for assessing the coronary arteries. However, a disadvantage of CMRA is the comparatively long acquisition time. Compressed sensing (CS) can considerably reduce the scan time. The aim of this study was to verify the feasibility of CS CMRA scanning during the waiting time between contrast injection and late gadolinium enhancement (LGE) scan in a clinical protocol. Methods Fifty clinical patients underwent contrast-enhanced CS CMRA and conventional CMRA on a 3 T CMR scanner. After contrast injection, CS CMRA was scanned during the waiting time for LGE CMR. A conventional CMRA scan was performed after LGE CMR. We assessed acquisition times and coronary artery image quality for each segment on a 4-point scale. Visible vessel length, sharpness and diameter of right (RCA), left anterior descending (LAD), and left circumflex (LCX) coronary arteries were also quantitatively compared among the scans. Results All CS CMRA scans were successfully performed within the LGE waiting time. The median total scan time was 207 s (163, 259 s) for CS and 785 s (698, 975 s) for conventional CMRA (p Conclusions We could achieve all CS CMRA scans within the LGE waiting time. Contrast-enhanced CS CMRA could considerably shorten the scan time while maintaining image quality compared with conventional CMRA.

Zusammenfassung Hintergrund Die körperdysmorphe Störung (KDS) und die Essstörungen (ESS) weisen erhebliche Symptomüberschneidungen auf, was die Differenzialdiagnose erschwert. Die Psychopathologie der beiden Störungen deutet auf die aussehensbezogene Zurückweisungssensitivität („appearance-based rejection sensitivity“, ARS) als mögliches differenzierendes Merkmal hin. Ziel der Arbeit Die Studie soll Hinweise zu einer Verbesserung der Differenzialdiagnostik zwischen KDS und ESS geben. Dazu wurden die Störungen hinsichtlich der ARS miteinander verglichen. Auf Basis der bisherigen empirischen Forschung wurde davon ausgegangen, dass bei KDS höhere ARS-Werte vorliegen als bei ESS. Weiterhin sollte eine höhere Varianzaufklärung von KDS an der ARS unter Konstanthaltung von Störvariablen (sozialängstliche Symptome, Body-Mass-Index, Geschlecht) geprüft werden. Material und Methoden Eine Verfügbarkeitsstichprobe (n = 736) füllte online die Appearance-based Rejection Sensitivity Scale, die Liebowitz Social Anxiety Scale, den Eating Disorder Examination Questionnaire und ein DSM-5-Screening zu KDS aus. Ergebnisse Teilnehmer mit komorbid positivem KDS-ESS-Screening erzielten den höchsten ARS-Gesamtwert aber ähnlich hohe Werte wie Teilnehmer mit positivem ESS-Screening. Beide Gruppen erzielten signifikant höhere Werte als Teilnehmer mit positivem KDS-Screening, welche wiederum signifikant höhere Werte erzielten als symptomfreie Teilnehmer. Die Regressionsanalyse bestätigte eine höhere Varianzaufklärung an der ARS durch ESS als durch KDS bei Konstanthaltung von Störvariablen. Diskussion Die ARS konnte nicht als differenzierendes Merkmal zwischen KDS und ESS im Sinne der Hypothesen bestätigt werden. Allerdings könnten hohe ARS-Werte einen Hinweis auf eine ESS oder KDS darstellen, sehr hohe Werte für komorbide ESS-KDS-Symptome. Dies sollte diagnostisch abgesichert und ggf. in der Therapie berücksichtigt werden.

The majority of studies examining the consequences of prenatal stress in rodent models analyze pups having been raised by their biological mother, i.e. the female which experienced stress during her pregnancy. To test whether pregnancy stress changes maternal behavior and thereby - in addition to stress exposure in utero – influences behavior and brain function of offspring, we implemented a fostering model, in which mouse pups that were not stressed in utero, are raised by dams which were exposed to stress during their pregnancy. We found that dams, which were stressed during pregnancy (PS foster dams), unexpectedly displayed slightly more active and passive light time nursing compared to unstressed dams (CON foster dams). Adult male offspring which were raised by a PS foster dam showed significantly less anxiety-like behavior compared to males raised by a CON foster dam, whereas adult female offspring which were raised by PS foster dams displayed increased depressive-like behavior as a tendency. Since the arginine vasopressin receptor 1a (AvpR1a) and the structurally related oxytocin receptor (OxtR) are both closely related to stress-responsiveness, anxiety and depression, mRNA expression of these genes were assessed in the hippocampus of adult male and female offspring. No significant differences in mRNA expression of both receptor types were observed, however, in female offspring of PS foster dams maternal licking/grooming correlated positively with AvpR1a and negatively with OxtR mRNA expression. These findings indicate that stress during pregnancy does not reduce, but slightly increase maternal behavior, which might lead to sex-specific behavioral outcomes and changes in hippocampal AvpR1a and OxtR mRNA expression in adult offspring.

Stress during the prenatal period has various effects on social and sexual behavior in both human and animal offspring. The present study examines the effects of chronic restraint stress in the second vs third trimester in pregnancy and glucocorticoid receptor (GR) heterozygous mutation on C57BL/6N male offspring's vocal courtship behavior in adulthood by applying a novel analyzing method. Finally, corticosterone and testosterone levels as well as bone mineral density were measured. Prenatal stress in the third, but not in the second trimester caused a significant qualitative change in males' courtship vocalizations, independent of their GR genotype. Bone mineral density was decreased also by prenatal stress exclusively in the third trimester in GR mutant and wildtype mice and - in contrast to corticosterone and testosterone - highly correlated with courtship vocalizations. In Gr+/- males corticosterone serum levels were significantly increased in animals that had experienced prenatal stress in the third trimester. Testosterone serum levels were overall increased in Gr+/- males in comparison to wildtypes as a tendency - whereas prenatal stress had no influence. Prenatal stress alters adult males' courtship vocalizations exclusively when applied in the third trimester, with closely related changes in bone mineral density. Bone mineral density seems to reflect best the complex neuroendocrine mechanisms underlying the production of courtship vocalizations. Besides, we demonstrated for the first time elevated basal corticosterone levels in Gr+/- males after prenatal stress which suggests that the Gr+/- mouse model of depression might also serve as a model of prenatal stress in male offspring.

We aimed to investigate the utility of compressed sensing time-of-flight magnetic resonance angiography (CS TOF-MRA) for diagnosing intracranial and cervical arterial stenosis by using digital subtraction angiography (DSA) as the reference standard. Thirty-seven patients with head and neck arterial stenoses who underwent CS TOF-MRA and DSA were retrospectively enrolled. The reconstructed resolution of CS TOF-MRA was 0.4 × 0.4 × 0.4 mm3. The scan time was 5 min and 2 s. The image quality of CS TOF-MRA was independently ranked by two neuroradiologists in 1031 arterial segments. The luminal stenosis grades on CS TOF-MRA and DSA were analyzed in 61 arterial segments and were compared using the Wilcoxon signed-rank test. The ability of CS TOF-MRA to predict moderate to severe stenosis or occlusion was analyzed. The image quality of most arterial segments (95.2%) on CS TOF-MRA was excellent. Arterial segments with low image quality were mainly the V3–4 segments of the vertebral artery. The majority of arterial stenoses (62.3%) were located in the cervical internal carotid artery. The luminal stenosis grades of CS TOF-MRA were concordant with that of DSA in 50 of 61 segments (p = 0.366). CS TOF-MRA had a sensitivity of 84.4% and a specificity of 88.5% for predicting moderate to severe stenosis. For detecting occlusion lesions, it had a sensitivity of 100% and a specificity of 94.1%. CS TOF-MRA provides adequate image quality within a reasonable acquisition time and is a reliable tool for diagnosing head and neck arterial steno-occlusive disease. • CS TOF-MRA provides a relatively large coverage (16 cm), high resolution (0.4 × 0.4 × 0.4 mm 3 ) and good image quality of head and neck arteries within 5 min and 2 s. • The diagnostic accuracy of CS TOF-MRA in the assessment of moderate to severe stenosis and occlusion was comparable with that of DSA. • Arterial segments with low image quality were mainly the V3 and V4 segments of the vertebral artery.

This study was conducted in order to evaluate the accuracy of a compressed sensing (CS) real-time single-breath-hold cine sequence for the assessment of left and right ventricular functional parameters in daily practice. Cardiac magnetic resonance (CMR) cine images were acquired from 100 consecutive patients using both the reference segmented multi-breath-hold steady-state free precession (SSFP) acquisition and a prototype single-breath-hold real-time CS sequence, providing the same slice number, position, and thickness. For both sequences, the left (LV) and right ventricular (RV) ejection fractions (EF) and end-diastolic volumes (EDV) were assessed as well as LV mass (LVM). The visualization of wall-motion disorders (WMD) and signal void related to mitral or tricuspid regurgitation was also analyzed. The CS sequence mean scan time was 23 ± 6 versus 510 ± 109 s for the multi-breath-hold SSFP sequence (p

Prenatal stress defines long-term phenotypes through epigenetic programming of the offspring. These effects are potentially mediated by glucocorticoid release and by sex. We hypothesized that the glucocorticoid receptor (Gr, Nr3c1) fashions the DNA methylation profile of offspring. Consistent with this hypothesis, fetal Nr3c1 heterozygosity leads to altered DNA methylation landscape in fetal placenta in a sex-specific manner. There was a significant overlap of differentially methylated genes in fetal placenta and adult frontal cortex in Nr3c1 heterozygotes. Phenotypically, Nr3c1 heterozygotes show significantly more anxiety-like behavior than wildtype. DNA methylation status of fetal placental tissue is significantly correlated with anxiety-like behavior of the same animals in adulthood. Thus, placental DNA methylation might predict behavioral phenotypes in adulthood. Our data supports the hypothesis that Nr3c1 influences DNA methylation at birth and that DNA methylation in placenta correlates with adult frontal cortex DNA methylation and anxiety-like phenotypes.

Congenital anomalies of the coronary ostia can lead to sudden death. A screening solution would be useful to prevent adverse outcomes for the affected individuals. To be considered for integration into clinical routine, such a procedure must meet strict constraints in terms of invasiveness, time and user interaction. Imaging must be fast and seamlessly integrable into the clinical process. Non-contrast enhanced coronary magnetic resonance angiography (MRA) is well suited for this. Furthermore, planar reformations proved effective to reduce the acquired volumetric datasets to 2D images. These usually require time consuming user interaction, though. To fulfill the aforementioned challenges, we present a fully automated solution for imaging and reformatting of the proximal coronary arteries which enables rapid screening of these. The proposed pipeline consists of: (I) highly accelerated single breath-hold MRA data acquisition, (II) coronary ostia detection and vessel centerline extraction, and (III) curved planar reformation of the proximal coronary arteries, as well as multiplanar reformation of the coronary ostia. The procedure proved robust and effective in ten volunteer data sets. Imaging of the proximal coronary arteries took 24 &plusmn, 5 s and was successful within one breath-hold for all patients. The extracted centerlines achieve an overlap of 0.76 &plusmn, 0.18 compared to the reference standard and the average distance of the centerline points from the spherical surface for reformation was 1.1 &plusmn, 0.51 mm. The promising results encourage further experiments on patient data, particularly in coronary ostia anomaly screening.

Compressed sensing (CS) MRI has just been introduced to research areas as an innovative approach to accelerate MRI. CS is expected to achieve higher k-space undersampling by exploiting the underlying sparsity in an appropriate transform domain. MR angiography (MRA) provides high spatial resolution information on arteries; however, a relatively long acquisition time is necessary to cover a wide volume. Reduction of acquisition time by CS for time-of-flight (TOF) MR angiography (Sparse-TOF) is beneficial in clinical examinations; therefore, the clinical validity of Sparse-TOF needs to be investigated. The aim of this study was to compare the diagnostic capability of TOF MRA between parallel imaging (PI)-TOF with an acceleration factor of 3 (annotated as 3×) and Sparse-TOF (3× and 5×) in patients with cerebral aneurysms. PI-TOF (3×) and Sparse-TOF (3× and 5×) imaging were performed in 20 patients using a 3 T MRI system. Aneurysms in PI-TOF (3×) and Sparse-TOF (3× and 5×) were blindly rated as visible or scarcely visible by neuroradiologists. The neck, height and width of aneurysms were also measured. Twenty-six aneurysms were visualized and rated as visible in PI-TOF (3×) and Sparse-TOF (3× and 5×), with excellent agreement between two raters. No significant differences were found in measured neck, height or width of aneurysms among them. Sparse-TOF (3× and 5×) were acquired and reconstructed within 6 min, and cerebral aneurysms were visible in both of them with equivalent quality to PI-TOF (3×). Sparse-TOF (5×) is a good alternative to PI-TOF (3×) to visualize cerebral aneurysms.

To compare accelerated real-time cardiac MRI (CMR) using sparse spatial and temporal undersampling and non-linear iterative SENSE reconstruction (RT IS SENSE) with real-time CMR (RT) and segmented CMR (SEG) in a cohort that included atrial fibrillation (AF) patients. We evaluated 27 subjects, including 11 AF patients, by acquiring steady-state free precession cine images covering the left ventricle (LV) at 1.5 T with SEG (acceleration factor 2, TR 42 ms, 1.8 × 1.8 × 6 mm3), RT (acceleration factor 3, TR 62 ms, 3.0 × 3.0 × 7 mm3), and RT IS SENSE (acceleration factor 9.9-12, TR 42 ms, 2.0 × 2.0 × 7 mm3). We performed quantitative LV functional analysis in sinus rhythm (SR) patients and qualitatively scored image quality, noise and artefact using a 5-point Likert scale in the complete cohort and AF and SR subgroups. There was no difference between LV functional parameters between acquisitions in SR patients. RT IS SENSE short-axis image quality was superior to SEG (4.5 ± 0.6 vs. 3.9 ± 1.1, p = 0.007) and RT (3.8 ± 0.4, p = 0.003). There was reduced artefact in RT IS SENSE compared to SEG (4.4 ± 0.6 vs. 3.8 ± 1.2, p = 0.04), driven by arrhythmia performance. RT IS SENSE short-axis image quality was superior to SEG (4.6 ± 0.5 vs. 3.1 ± 1.0, p < 0.001) in the AF subgroup. Accelerated real-time CMR with iterative sparse SENSE provides excellent clinical performance, especially in patients with AF. • Iterative sparse SENSE significantly accelerates real-time cardiovascular MRI acquisitions. • It provides excellent qualitative and quantitative performance in sinus rhythm patients. • It outperforms standard segmented acquisitions in patients with atrial fibrillation. • It improves the trade-off between temporal and spatial resolution in real-time imaging.

Cardiac resynchronization therapy is a treatment option for patients suffering from symptomatic heart failure. The problem with this treatment option is, that 30% to 40% of the patients do not respond. One reason might be the inappropriate placement of the left ventricular lead via the coronary sinus. Therefore, endocardial pacing systems have been developed. Nonetheless, the implantation of these devices requires in addition to the knowledge of the anatomy and scar of the left ventricle (LV), the information of the papillary muscles. As pacing in a papillary muscles may lead to severe problems. To overcome this issue, a fully automatic papillary muscle segmentation in 3D LGE-MRI is presented. First, the left ventricle is initialized using a registration basedapproach, afterwards the short axis view of the LV is estimated. In the next step, the blood pool is segmented. Finally, the papillary muscles are extracted using a threshold based approach. The proposed method was evaluated on six 3D LGE-MRI data sets and were compared to gold standard annotations from clinical experts. This comparison resulted in a Dice coefficient of 0.72.

Purpose Use repeated stress paradigms and an approach taken from neurological blood oxygen level dependent (BOLD) functional MRI (fMRI) to derive robust cardiac BOLD measurements. Methods Multiple-repetition, single-shot, electrocardiograph-triggered, T2-prepared BOLD balanced steady-state free precession was performed during repeated long breath-holds in 13 volunteers. Nonrigid motion correction was applied to the continuously acquired data and it was analyzed with a general linear model (GLM) taking into account the effects of the breath-hold duration, RR interval, motion, and baseline variations. Both voxel- and region of interest-based analyses were performed. Results The GLM model was able to isolate the component of the BOLD signal arising from the breath-holds and separate it from the background effects due to the changing heart rate and motion. A significant (P

Background Cardiovascular cine magnetic resonance (CMR) accelerated by compressed sensing (CS) is used to assess left ventricular (LV) function. However, it is difficult for prospective CS cine CMR to capture the complete end-diastolic phase, which can lead to underestimation of the end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), compared to retrospective standard cine CMR. This prospective study aimed to evaluate the diagnostic quality and accuracy of single-breath-hold full cardiac cycle CS cine CMR, acquired over two heart beats, to quantify LV volume in comparison to multi-breath-hold standard cine CMR. Methods Eighty-one participants underwent standard segmented breath-hold cine and CS real-time cine CMR examinations to obtain a stack of eight contiguous short-axis images with same high spatial (1.7 × 1.7 mm2) and temporal resolution (41 ms). Two radiologists independently performed qualitative analysis of image quality (score, 1 [i.e., “nondiagnostic”] to 5 [i.e., “excellent”]) and quantitative analysis of the LV volume measurements. Results The total examination time was 113 ± 7 s for standard cine CMR and 24 ± 4 s for CS cine CMR (p

In well-compensated PAH, early RV maladaptation is best captured by changes in SV/ESV at exercise by cardiac MRI http://ow.ly/MyEi302UUeL

Background CE-MRA following the injection of a gadolinium-based contrast agent (GBCA) bolus is widely used in clinical assessment of vascular dynamics and tissue perfusion (1,2). Although keyhole techniques with an increased number of central k-space updates further improved contrast kinetics information, spatial resolution remains limited. Alternatively applied view sharing approaches also result in prolonged temporal footprints with possible temporal blurring or reconstruction artifacts. Sparse, incoherent sampling approaches and iterative reconstruction techniques have proven successful particularly in dynamic MR imaging (3). We sought to evaluate the impact of iterative reconstruction techniques on dynamic contrast enhanced MRA of the thoracic aorta.

Delayed contrast-enhanced cardiovascular magnetic resonance (DE-CMR) allows assessment of reversibility of myocardial dysfunction. Comparative data to other modalities is scarce. Purpose of this study was to compare DE-CMR and (201)Thallium single photon emission computed tomography (SPECT) for prediction of reversible left ventricular (LV) dysfunction in patients with chronic ischaemic heart disease. Fifty-four patients with LV dysfunction (mean ejection fraction (EF) 35 ± 8%) scheduled to undergo myocardial revascularization underwent DE-CMR and SPECT. Cine CMR was performed at baseline and at 8 months follow-up for assessment of regional and global myocardial function. Myocardial viability was determined by the segmental extent of delayed enhancement for DE-CMR, and by quantitative analysis of tracer uptake for SPECT, and was correlated to functional recovery after revascularization. After revascularization, 172 (49%) of 350 dysfunctional segments improved at follow-up cine CMR. Sensitivity and specificity for the prediction of functional recovery was 92 and 88%, respectively, for DE-CMR as compared to 86% (P = 0.4) and 56% (P = 0.001) for SPECT. Global LV function showed an increase of EF > 5% in 22 (41%) patients. The DE-CMR derived viability ratio (dysfunctional but viable myocardium) of 0.46 (sensitivity 91%, specificity 91%) was identified as predictor of increase in EF > 5% (P = 0.02), whereas the corresponding SPECT parameters were not predictive. DE-CMR compares favorably to SPECT for the prediction of regional and global improvement in LV function in the setting of chronic myocardial ischemia.

Morc1 gene has recently been identified by a DNA methylation and genome-wide association study as a candidate gene for major depressive disorder related to early life stress in rodents, primates and humans. So far, no transgenic animal model has been established to validate these findings on a behavioral level. In the present study, we examined the effects of a Morc1 loss of function mutation in female C57BL/6N mice on behavioral correlates of mood disorders like the Forced Swim Test, the Learned Helplessness Paradigm, O-Maze and Dark-Light-Box. We could show that Morc1(-/-) mice display increased depressive-like behavior whereas no behavioral abnormalities regarding locomotor activity or anxiety-like behavior were detectable. CORT plasma levels did not differ significantly between Morc1(-/-) mice and their wildtype littermates, yet - surprisingly - total Bdnf mRNA-levels in the hippocampus were up-regulated in Morc1(-/-) animals. Although further work would be clarifying, Morc1(-/-) mice seem to be a promising epigenetically validated mouse model for depression associated with early life stress.

Carrying out invasive procedures in animals requires the administration of anesthesia. Xenon gas offers advantages as an anesthetic agent compared with other agents, such as its protection of the brain and heart from hypoxia-induced damage. The high cost of xenon gas has limited its use as an anesthetic in animal experiments, however. The authors designed and constructed simple boxes for the induction and maintenance of xenon gas and isoflurane anesthesia in small rodents in order to minimize the amount of xenon gas that is wasted. While using their anesthesia delivery system to anesthetize pregnant mice undergoing caesarean sections, they measured the respiratory rates of the anesthetized mice, the survival of the pups and the percentages of oxygen and carbon dioxide within the system to confirm the system's safety.

Background Recently developed compressed sensing (CS) SSFP sequences significantly reduce data acquisition time thereby reducing patient breath-hold and scan time relative to standard techniques. The variability of ventricular functional (VF) analysis of CS data is not known so this study investigated the inter-observer variation of left ventricular (LV) mass and volume measurements compared to standard SSFP acquisitions.

The aim of this study was to compare the performance of 3D MRI in conjunction with an intravascular contrast agent to spiral contrast-enhanced CT, regarding the detection of abdominal parenchymal injuries as well as peritoneal hemorrhage in an animal model. Liver and kidney injuries were created surgically in six female pigs under general anesthesia. All pigs underwent contrast-enhanced spiral CT and 3D MR imaging following administration of an intravascular contrast agent (NC100150 Injection). Two readers rated their confidence independently on MR and CT data sets using a five-point scale for the presence of organ injury and hemoperitoneum. Autopsy findings served as standard of reference. Sensitivity and specificity for MR in detecting hepatic and renal injuries as well as hemoperitoneum was 100 %. Computed tomography was less accurate with sensitivity and specificity values of 90 and 94 %, respectively. Receiver operating characteristics (ROC) analysis revealed a higher confidence when interpretation was based on MR images. In an animal model 3D MR imaging in conjunction with an intravascular contrast agent proved highly accurate in detecting and localizing parenchymal injuries to the upper abdomen as well as in detecting intraperitoneal blood collections.

The purpose of this study was to determine the diagnostic usefulness of a new blood pool contrast agent, NC100150, for assessing the aortoiliac and renal arteries.Twenty patients with hemodynamically significant stenosis (or =50% of luminal diameter) of the iliac or renal arteries or an aortic aneurysm documented by digital subtraction angiography underwent MR angiography at 1.5 T after administration of NC100150. Three-dimensional MR angiographic data sets were collected ill the equilibrium phase. In a prospective analysis, each vascular segment (16 segments per arterial tree) was evaluated.All patients tolerated the NC100150 administration well. Mean contrast-to-noise ratios of the vascular data collected in the equilibrium phase of NC100150 was 3.3+/-15.9. Compared with digital subtraction angiography, the sensitivity and specificity of MR angiography for the renal arteries were 82% and 98%, respectively; for the common iliac arteries, 86% and 97%, respectively; for the external iliac arteries, 80% and 100%, respectively; and for the internal iliac arteries, 71% and 977, respectively. All 83 aneurysmal changes revealed by digital subtraction angiograpy of the aortoiliac arteries were well displayed on the MR angiographic data sets.Equilibrium-phase NC 00150-enhanced three-dimensional MR angiography shows high specificity when evaluating the abdominal and pelvic vascular systems, but the attendant venous overlap can limit the assessment of stenosis in renal and pelvic arterial segments.

The aim of this article was to obtain initial experiences with fluoroscopically triggered contrast-enhanced (CE) 3D MR DSA with elliptical centric k-space order and 3D time-of-flight (TOF) turbo MRA of the carotid arteries. In this prospective study we examined 16 consecutive patients with suspicion of atherosclerotic disease involving the carotid arteries. Ultrasound was available in all, x-ray angiography in 12, surgical correlation in 9, and intraoperative x-ray angiography in 4 patients. All examinations were done on a 1.5 T unit applying: transverse plain 3D TOF turbo MRA and coronal CE MRA with fluoroscopic triggering. Combining head and neck array coils allowed the visualization of supraaortic arteries from the aortic arch to the circle of Willis. MRA results (maximum intensity projections) were compared with x-ray angiography, ultrasound, and inspection of endarterectomy specimens. Volume rendering was performed in selected cases additionally. Agreement between CE MRA, 3D TOF turbo MRA and x-ray angiography regarding stenoses of the internal and external carotid artery was very good. CE MRA was able to detect correctly intracranial stenoses, but delineation of the aortic arch and proximal common carotid arteries was sometimes reduced. Volume rendering was suited for visualization of MRA images providing a realistic three-dimensional impression. In conclusion, high-resolution fluoroscopically triggered CE MRA as non-invasive technique is another important step on the way to replace invasive x-ray angiography for the evaluation of atherosclerotic carotid artery disease. High resolution 3D TOF turbo MRA might be a helpful adjunct to increase the diagnostic reliability for the carotid bifurcation.

Objective: To assess heating- and 3D MRA imaging characteristics of a commonly used aortic stent graft in a 1.5T MR-environment. Materials and methods: A bifurcated stent graft (Vanguard; Boston Scientific, Oakland, N. J.) was evaluated in vitro regarding localized heating effects as well as imaging appearance using fast 3D GRE sequences. To quantitate stent related artifacts, stent wall thickness and luminal diameters were measured. Subsequently eight patients were imaged three months following placement of an aortic stentgraft with 3D MRA. Images were assessed for the presence of stent leaks, luminal patency, and stent configuration. Results: There were no temperature changes associated with the stent during scanning. Wall thickness measurements overestimated true stent thickness, resulting in minimal underestimation of luminal diameters on 3D MRA images. In vivo imaging confirmed these results. Stent patency was confirmed in all 8 patients. Conclusion: Contrast-enhanced 3D MRA appears well suited for the evaluation of the abdominal and pelvic vasculature following aortic implantation of a Vanguard stent.

Characterization of renal artery stenoses based on magnetic resonance renal flow and volume measurements. Background The benefits of percutaneous angioplasty of renal artery stenosis is not known. In an attempt to better define the patient subgroup most likely to benefit from a revascularization procedure, the relationship between renal arterial morphology, blood flow volume, and renal volume was investigated using magnetic resonance (MR) techniques. Methods Analysis was based on arterial flow volume and renal volume measurements of 130 kidneys in 65 patients with clinically suspected renal vascular disease. Significant renal arterial stenosis (RAS), documented by contrast-enhanced three-dimensional MR angiography, compromised blood supply to 31 kidneys. Renal volume measurements were related to the body mass index to derive the renal volume index (RVI). The RVI of 72 kidneys in 36 patients without evidence of RAS or severe renal insufficiency was used as a standard of reference to differentiate normal-volume from reduced-volume kidneys. Results Eighteen out of 31 RAS kidneys were significantly reduced in volume (3.08 ± 0.75); the volume of the remaining 13 kidneys was within one standard deviation of the normal reference value. Flow volumes in kidneys with RAS were significantly reduced compared with kidneys without RAS (91.56 vs. 279.15 ml/min). Based on the RFI values (RFI = flow volume/renal volume), there was only minimal overlap between normal volume kidneys with RAS (0.73 ± 0.34) and kidneys without RAS (2.02 ± 0.59). RFI values of small volume kidneys with RAS (1.55 ± 0.47), on the other hand, overlapped with both groups. Conclusions Normal volume kidneys with impaired arterial flow caused by RAS can be differentiated from those without based on a flow index (RFI). These data suggest the existence of a critical cut-off value (flow index 3 of renal tissue) beyond which the renal parenchyma starts shrinking.

Percutaneous stent-grafting is increasingly employed as a less invasive alternative to surgery for the treatment of infrarenal abdominal aortic aneurysms. It requires long-term imaging follow-up, to document the structural integrity of the device, to exclude perigraft channels and endograft leakages, as well as the shrinkage of the aneurysmal sac. The expectation of severe stent induced artifacts and safety concerns have prevented 3D MRA from being used. The purpose of this in vitro study was to investigate the imaging characteristics of a bifurcated stent graft with 3D MRA (3D Fourier transform fast spoiled GRE) at 1.5 T in comparison to those of CTA. Measurement of the stent wall thickness and luminal diameter were made on a agar gel embedded stent graft at five locations on both CTA and MRA images. The stent graft was depicted as a dark ring on MR images. Wall thickness measurements at the five locations of the stent graft overestimated the true stent thickness, while luminal diameters were slightly underestimated. Measurement differences between MR and CT were not statistically significant (P = 0.67; P = 0.85). Artifacts emanating from the platinum markers were considerably less severe on the MR-images. A wider area of signal loss was seen only at the insertion of the iliac stent leg into the aortic stent portion due to the overlap of two radio-opaque platinum markers. 3D MRA images should permit a comprehensive assessment of the arterial lumen, and of perivascular tissues.

RATIONALE AND OBJECTIVES.To develop a comprehensive noninvasive magnetic resonance angiography (MRA) strategy for the morphologic and functional assessment of the splanchnic arteries, based on a combination of breath-held contrastenhanced 3D MRA and segmented k-space 2D phase-contrast acquisitions a

Purpose: To determine the value of gadolinium-enhanced, three-dimensional breathhold Magnetic Resonance Angiography (MRA) in the assessment of the aorta and renal arteries in comparison to conventional arteriography (CA). Patients and methods: 49 patients were evaluated with both CA and 3D MRA. 0.3 mmol/kg BW gadolinium-DTPA was administered intravenously in a bolus, using an automated injector. A test bolus method was used for timing of the bolus and beginning of the data acquisition. The intraarterial CA was used as the gold standard. Results: MRA-based assessment of renal artery stenosis was identical with CA in 31 of 45 stenoses (68.8 %). Sensitivity and specificity for assessment of renal arterial disease by MRA were 84 % and 96 %; for clinically relevant lesions they amounted to 90 % and 98 %. Conclusion: The presented contrast-enhanced 3D MRA technique allows for the reliable assessment of renal arterial morphology and pathology.

Background MR stress perfusion is a non-invasive, reliable and safe test for ischemic heart disease [1]. Recent publications reported sensitivity and specificity of 89% and 80% respectively [2]. Image quality improvements seem to be essential for improving the predictive value of the method. This leads to the dilemma of finding a compromise between high spatial resolution and sufficient SNR. Lately iterative reconstruction demonstrated great promise in improving SNR [3]. The aim of the current study was to compare cardiac perfusion in 24 patients reconstructed with product and a novel prototype iterative reconstruction. Methods 24 patients (mean age 62 ±15) were examined on a 1.5T clinical MR scanner (MAGNETOM Aera, Siemens AG, Erlangen, Germany) using a saturation prepared TFL product sequence with the following parameters: TR/TE=331/1.4ms ; Flip angle = 12°; BW = 668Hz/Px; Voxel size=0.8×0.8×10.0 mm (inplane interpolated); FOV=290mm2; Matrix = 170x192; Slice thickness=10mm; Acceleration=2; Inversion time= 180ms; Phase oversampling=60%; Motion correction. Pharmacological stress was applied using Adenosine (Adenoscan, Sanofi-Synthelabo). Gadolinium-based contrast agent (Magnevist, Bayer Schering Pharma) was

To prospectively assess the accuracy of breath-hold three-dimensional magnetic resonance (MR) coronary angiography with the gadolinium-based intravascular contrast agent SH L 643 A in patients with coronary artery disease.Twelve patients (seven men, five women; age range, 46-78 years; mean age, 61.3 years) with angiographically proved coronary artery disease (luminal narrowing50%) underwent breath-hold three-dimensional MR coronary angiography before and after injection of SH L 643 A (0.1 mmol gadolinium per kilogram body weight). For all MR examinations, signal-to-noise ratio and contrast-to-noise ratio were measured. Image quality was assessed with a four-point scale. Conventional angiograms and MR angiograms were evaluated for depiction of the left main, proximal and middle left anterior descending, proximal left circumflex, and proximal and middle right coronary artery segments in a blinded fashion by two experienced readers in consensus. Results of this evaluation were compared by using a paired Student t test. P.05 was considered to indicate a statistically significant difference.For the 72 coronary artery segments, the contrast-to-noise ratio significantly improved after administration of SH L 643 A, compared with the prior ratio (9.8 +/- 5.1 [standard deviation] vs 23.0 +/- 8.7; P.01), whereas the difference in signal-to-noise ratio did not reach statistical significance (25.2 +/- 11.4 vs 29.5 +/- 9.8; P.3). Image quality significantly improved from a mean of 2.0 +/- 0.9 for nonenhanced images to 2.9 +/- 0.9 (P.03) for contrast material-enhanced images. The proportion of segments for which images were nondiagnostic decreased from 38% to 10% with application of SH L 643 A. Overall sensitivity and specificity of contrast-enhanced MR coronary angiography for detection of coronary artery disease were 80% and 93%, respectively, and accuracy was 87%.Use of SH L 643 A improves detection of coronary artery disease at three-dimensional MR coronary angiography.

The aim of our study was to compare the signal-to-noise ratio and the diagnostic accuracy of moving-table MR angiography of the peripheral arteries with body coil and dedicated phased array coil systems.Forty patients were examined with digital subtraction angiography and moving-table MR angiography with a 1.5-T MR imaging system either with a body coil (n = 20) or with a dedicated phased array coil (n = 20). The timing of contrast material was performed with real-time MR fluoroscopy.For the iliac artery, upper leg, and lower leg, the mean values for signal-to-noise ratios were 56, 51, and 17, respectively, for the body coil, and 54, 74, and 64, respectively, for the dedicated phased array coil. For the body coil, sensitivity and specificity in identifying stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 96%, respectively, for the upper leg. For the dedicated phased array coil, sensitivity and specificity for stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 98%, respectively, for the upper leg. Sensitivity and specificity were inferior for the body coil (88% and 85%) compared with the dedicated phased array coil (100% and 96%) in the lower leg. A significant difference of the mean values of contrast-to-noise ratio was found before and after subtraction for the dedicated phased array coil and body-coil techniques (Student's t test, p0.01).In comparison with the body coil, the dedicated peripheral phased array surface coil system improves signal-to-noise ratio for the upper and lower leg and diagnostic accuracy in the lower leg.

Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system. An impaired hypothalamopituitary axis and stress reactivity have extensively been discussed without convincing experimental evidence. We choose a standardized acute psychological stressor to determine whether MS patients show altered endocrine and immune responses to stress. In 35 relapsing-remitting MS patients we found elevated baseline levels for catecholamines, prolactin, and IL-6 compared to 15 healthy controls. All neuroendocrine parameters declined during the stress intervention in MS as well as in stress-exposed controls. But only prolactin showed a significantly larger decline in stressed MS patients versus controls. During exposure to the stress we found no significant changes in serum levels of IL-6, IL-6 receptor, or TNF-alpha in either MS patients or controls after stimulation of a whole blood culture. An altered neural immune signaling in relapsing-remitting MS patients during acute experimental stress could not be proven for the parameters analyzed.

Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure15% or (b) a reduction in serum creatinine20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm3).Clinical success was observed in patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm3 predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm3 identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p0.001).A combination of cine phase-contrast MR renal flow and parenchymal volume measurements enables identification of patients benefiting from PTRA with a high sensitivity and NPV, but only moderate specificity and PPV.

Background While SSFP CMR is the gold standard for assessing left ventricular (LV) function, it requires a regular cardiac rhythm and frequent breath-holds and not all patients with cardiovascular disease are able to achieve this. It is known that Compressed Sensing (CS) greatly reduces data acquisition time however its accuracy for LV volume and mass is currently unknown. This study compares ventricular function measurements by CS to those obtained from standard SSFP cines.

Background The use of gated CMR can be limited by motion artifacts secondary to cardiac and respiratory motion. Imaging is especially challenging in patients with arrhythmias or those who cannot perform adequate breath-holds. Realtime CMR is a non-gated technique that has been successfully applied in scenarios where standard segmented acquisitions break down. In this study, we sought to accelerate real-time acquisition by using sparse sampling with an iterative SENSE reconstruction.

Background Changes in myocardial strain have been shown to precede onset of systolic dysfunction in patients with cardiomyopathy. Traditionally performed with echocardiography, acoustic windows can limit strain evaluation. Preliminary work has shown good agreement between myocardial strain derived from deformation field analysis at balanced steady-state free-precession (bSSFP) cine MRI and speckle tracking echocardiography. The application of a novel prototype iterative SENSE reconstruction with L1 regularization (IRSENSE) to highly accelerated segmented bSSFP cine acquisitions can maintain or improve the effective temporal resolution with a shorter breath-hold. The purpose of this study is to evaluate left- and right-ventricular stain analysis from bSSFP cine acquisitions using conventional GRAPPA and highly accelerated T-PAT with IR-SENSE. We hypothesize that myocardial strain parameters derived from accelerated T-PAT cine acquisitions with IR-SENSE are similar to those obtained using conventional segmented bSSFP with comparable effective temporal resolutions.

To describe the three-dimensional magnetic resonance angiography (3D MRA) imaging appearance of the pulmonary arteries following administration of a superparamagnetic iron oxide blood pool agent to human volunteers, and to demonstrate in an animal model (pigs) how this technique can be used to detect pulmonary parenchymal hemorrhage.Two volunteers were examined following the intravenous administration of a superparamagnetic iron oxide blood pool agent (NC100150 Injection, Nycomed Amersham Imaging, Wayne, PA, USA). T1-weighted 3D gradient recalled echo (GRE) image sets (TR/TE 5.1/1.4 msec, flip angle 30 degrees ) were acquired breath-held over 24 sec. To assess the detectability of pulmonary bleeding with intravascular MR contrast, pulmonary parenchymal injuries were created in two animals under general anesthesia, and fast T1-weighted 3D GRE image sets collected before and after the injury.Administration of the intravascular contrast in the two volunteers resulted in selective enhancement of the pulmonary vasculature permitting complete visualization and excellent delineation of central, segmental, and subsegmental arteries. Following iatrogenic injury in the two animals, pulmonary hemorrhage was readily detected on the 3D image sets.The data presented illustrate that ultrafast 3D GRE MR imaging in conjunction with an intravenously administered intravascular blood pool agent can be used to perform high-quality pulmonary MRA as well as to detect pulmonary hemorrhage.

The purpose of this study was to determine the added diagnostic value of various three-dimensional (3D) data viewing techniques when analyzing contrast-enhanced 3D MR angiography.Twenty patients (mean age, 62 years) with symptomatic peripheral vascular disease were assessed with breath-hold, contrast-enhanced 3D MR angiography and catheter angiography, which served as the standard of reference. After an initial interpretation of the 3D MR angiographic data sets based only on standardized maximum intensity projections (MIP), the diagnostic gain of the stepwise addition of interactive multiplanar reformations, shaded-surface displays (SSD), and virtual intraarterial endoscopy (VIE) images was calculated. Time required for each step of postprocessing was measured.Pathologic changes were revealed by catheter angiography in 60 vascular segments (50 severe stenoses, seven aneurysms, and three occlusions). The average postprocessing times were MIP, 8 min (range, 5-12 min); multiplanar reformations, 9 min (range, 3-11 min); SSD, 15 min (range, 8-25 min); and VIE, 40 min (range, 18-63 min). Addition of multiplanar reformations to MIPs resulted in the greatest gain of diagnostic accuracy, from 92% to 96%, and diagnostic confidence. When analysis was based on all four techniques, receiver operating characteristic curve analysis revealed only minimal improvements in diagnostic confidence, whereas diagnostic accuracy remained unchanged at 96%.Accurate and time-effective analysis of contrast-enhanced 3D MR angiography should be based on MIP algorithms and multiplanar reformations. Additional evaluation with VIE or SSD techniques is time-consuming and provides little diagnostic gain.

Background Strong evidence in favour of an ischaemia-guided approach to coronary revascularisation for PCI has led to a huge increase in demand for ischaemia imaging. In our General Hospital setting we have seen a 300% increase in demand for stress MRI over 3 years to more than 800 examinations per year. We therefore sought to optimise patient throughput by process mapping and by the introduction of new semiautomated scanning software. The aim of the study was to assess the impact of these changes on MRI study time.

Background Magnetic Resonance (MR) cardiac cine is generally accepted as the gold standard for left ventricular (LV) volume assessment. Recently, Real-Time (RT) cine with sparse sampling technique and iterative reconstruction has been applied to accelerate cine MR. However, in prospective electrocardiogram (ECG) triggered RT cine MR, it may be difficult to capture the true end diastole phase because of the finite time needed to detect the next ECG trigger, which may lead to underestimation of end diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF) when compared with retrospective ECG gated standard cine MR. In this study we propose an alternative approach to overcome this limitation, by acquiring sparse RT cine MR data over two heart beats, to capture the complete end diastole between the first and second heart beats. The purpose of this study was to evaluate the diagnostic quality and accuracy of RT-based single-breath-hold cine MR for the quantification of LV function compared with standard multi-breath-hold cine MR.

regularization of the SENSE type dataset. Datasets were analysed by two experienced readers (>10 years CMR analysis), with papillary muscles and trabeculae included in the blood pool. Comparison of TrueFISP and CV_sparse was assessed using paired t-test and Pearson’s correlation, and inter-observery reproducibility by Bland-Altman Results 26 clinical patients had both TrueFISP and CV_sparse imaging successfully performed (figure1A,B), mean LVEF 49% (range 16-65%). Strong positive correlation was present for end-diastolic volumes (r=0.98, P< 0.0001), end-systolic volume (r=0.99, P< 0.0001), LVmass (r=0.97, P< 0.0001) and LVEF (r=0.97, P< 0.0001), with no difference between the groups (P=0.95 NS), figure1C. Reproducibility was excellent with bias 0.3%, limits-of-agreement -3.7 to 4.3% (figure1D). Acquisition time for the LVSAX series was significantly shorter for CV_sparse compared to TrueFISP (p