Accelerated Real-time Cine and Flow under In-magnet Staged Exercise
arxiv(2024)
摘要
Background: Cardiovascular magnetic resonance imaging (CMR) is a
well-established imaging tool for diagnosing and managing cardiac conditions.
The integration of exercise stress with CMR (ExCMR) can enhance its diagnostic
capacity. Despite recent advances in CMR technology, ExCMR remains technically
challenging due to motion artifacts and limited spatial and temporal
resolution. Methods: This study investigates the feasibility of biventricular
functional and hemodynamic assessment using real-time (RT) ExCMR during a
staged exercise protocol in 26 healthy volunteers. We introduce a coil
reweighting technique to minimize motion artifacts. In addition, we identify
and analyze heartbeats from the end-expiratory phase to enhance the
repeatability of cardiac function quantification. To demonstrate clinical
feasibility, qualitative results from five patients are also presented.
Results: Our findings indicate a consistent decrease in end-systolic volume
(ESV) and stable end-diastolic volume (EDV) across exercise intensities,
leading to increased stroke volume (SV) and ejection fraction (EF). Coil
reweighting effectively reduces motion artifacts, improving image quality in
both healthy volunteers and patients. The repeatability of cardiac function
parameters, demonstrated by scan-rescan tests in nine volunteers, improves with
the selection of end-expiratory beats. Conclusions: The study demonstrates that
RT ExCMR with in-magnet exercise is a feasible and effective method for dynamic
cardiac function monitoring during exercise. The proposed coil reweighting
technique and selection of end-expiratory beats significantly enhance image
quality and repeatability.
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