Breath-hold FLASH and FISP Cardiovascular MR Imaging: Left Ventricular Volume Differences and Reproducibility
Abstract
PURPOSE: To compare fast imaging with steady-state precession (FISP) and fast low-angle shot (FLASH) magnetic resonance acquisitions to quantify left ventricular volumes, mass, and function and to determine if the two techniques are comparable.
MATERIALS AND METHODS: Left ventricular volume studies were performed in 10 patients with heart failure and in 10 healthy subjects by using FISP and FLASH imaging. Identical section positions were used for section-by-section contour comparisons. Manual analysis was performed by two experienced observers. The study was repeated on a different day and interobserver and interstudy reproducibility assessed.
RESULTS: With FISP, end-diastolic volume was larger (healthy subjects: +18 mL [13%], P < .001; patients: +6 mL [3%], not significant), end-systolic volume larger (healthy subjects: +9 mL [17%], P = .001; patients: +8 mL [6%], P = .001) and left ventricular mass smaller (healthy subjects: −25 g (19%), P < .001; patients: −21 g (11%), P < .001). There were no significant differences in ejection fraction. Both sequences had excellent interstudy and interobserver reproducibility, with statistically better reproducibility for interstudy healthy-subject ejection fraction on FISP images (P = .05). Section-by-section analysis determined that at FISP, endocardial contours were drawn larger and the epicardial contours smaller than on FLASH images. FISP enabled better delineation of epicardial fat from myocardium, of blood-myocardium interface in areas of trabeculation or papillary muscles, and of the atrioventricular ring.
CONCLUSION: FISP produces small but significantly higher left ventricular volume measurements, as compared with FLASH imaging. FLASH imaging and FISP have similar reproducibility.
© RSNA, 2002
References
- 1 Semelka RC, Tomei E, Wagner S, et al. Normal left ventricular dimensions and function: interstudy reproducibility of measurements with cine MR imaging. Radiology 1990; 174:763-768.
- 2 Semelka RC, Tomei E, Wagner S, et al. Interstudy reproducibility of dimensional and functional measurement between cine magnetic resonance imaging studies in the morphologically abnormal left ventricle. Am Heart J 1990; 119:1367-1373.
- 3 Pattynama PM, Lamb HJ, Van der Velde EA, et al. Left ventricular measurements with cine and spin echo MR imaging: a study of reproducibility with variance component analysis. Radiology 1993; 187:261-268.
- 4 Shapiro EP, Rogers WJ, Beyar R, et al. Determination of left ventricular mass by MRI in hearts deformed by acute infarction. Circulation 1989; 79:706-711.
- 5 Lorenz CH, Walker ES, Morgan VL, Klein SS, Graham TP. Normal human right and left ventricular mass, systolic function and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson 1999; 1:7-21.
- 6 Ostrzega E, Maddahi J, Honma H, et al. Quantification of left ventricular myocardial mass in humans by nuclear magnetic resonance imaging. Am Heart J 1989; 117:444-452.
- 7 Sakuma H, Fujita N, Foo TK, et al. Evaluation of left ventricular volume and mass with breath-hold cine MR imaging. Radiology 1993; 188:377-380.
- 8 Katz J, Milliken MC, Stray-Gundersen J, et al. Estimation of human myocardial mass with MR imaging. Radiology 1988; 169:495-498.
- 9 van Rossum AC, Visser FC, van Eenige MJ, Valk J, Roos JP. Magnetic resonance imaging of the heart for determination of ejection fraction. Int J Cardiol 1988; 18:53-63.
- 10 Mogelvang J, Thomsen C, Mehlsen J, Brackle G, Stubgaard M, Henriksen O. Evaluation of left ventricular volumes measured by magnetic resonance imaging. Eur Heart J 1986; 7:1016-1021.
- 11 Brown MA, Semelka RC. MR imaging abbreviations, definitions and descriptions: a review. Radiology 1999; 213:647-662.
- 12 Oppelt A, Graumann R, Barfuss H. Fisp-a new fast MRI sequence. Electromedica 1986; 54:15-18.
- 13 Francis J, Moon J, Smith G, et al. The benefit of TrueFISP versus FLASH imaging in patients with poor left ventricular function (abstr). Proceedings of the Fourth Annual Meeting of the Society for Cardiovascular Magnetic Resonance 2001; 99-100.
- 14 Scheffler K. A pictorial description of steady states in rapid magnetic resonance imaging. Concepts Magn Reson 1999; 11:291-304.
- 15 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1:307-310.
- 16 Rehr RB, Malloy CR, Filipchuk NG, et al. Left ventricular volumes measured by MR imaging. Radiology 1985; 156:717-719.
- 17 Keller AM, Peshock RM, Malloy CR, et al. In vivo measurement of myocardial mass using nuclear magnetic resonance imaging. J Am Coll Cardiol 1986; 8:113-117.
- 18 Florentine MS, Grosskreutz CL, Chang W, et al. Measurement of left ventricular mass in vivo using gated nuclear magnetic resonance imaging. J Am Coll Cardiol 1986; 8:107-112.
- 19 Caputo GR, Tscholakoff D, Sechtem U, et al. Measurement of canine left ventricular mass by using MR imaging. AJR Am J Roentgenol 1987; 148:33-38.
- 20 Katz J, Millikem MC, Stray-Gunderson J, et al. Estimation of human myocardial mass with MR imaging. Radiology 1988; 169:495-498.
- 21 Maddahi J, Crues J, Berman DS, et al. Noninvasive quantification of left ventricular myocardial mass by gated proton nuclear magnetic resonance imaging. J Am Coll Cardiol 1987; 10:682-692.
- 22 McDonald KM, Parrish T, Wennberg P, et al. Rapid, accurate and simultaneous noninvasive assessment of right and left ventricular mass with nuclear magnetic resonance imaging using the snapshot gradient method. J Am Coll Cardiol 1992; 19:1601-1607.
- 23 Bottini PB, Carr AA, Prisant M, et al. Magnetic resonance imaging compared to echocardiography to assess left ventricular mass in the hypertensive patient. Am J Hypertens 1995; 8:221-228.
- 24 Bloomgarden DC, Fayad ZA, Ferrari VA, Chin B, Sutton MG, Axel L. Global cardiac function using fast breath-hold MRI: validation of new acquisition and analysis techniques. Magn Reson Med 1997; 37:683-692.
- 25 Michaelsson M, Ho SY. Normal hearts: a comparison In: Congenital heart malformations in mammals. London, England: Imperial College Press, 2000.
- 26 Nousiainen T, Vanninen E, Jantunen E, et al. Comparison of echocardiography and radionuclide ventriculography in the follow-up of left ventricular systolic function in adult lymphoma patients during doxorubicin therapy. J Intern Med 2001; 249:297-303.
- 27 Bellenger NG, Ceri Davies L, Francis JM. Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2000; 2:271-278.
- 28 Marcus JT, Kuijer JPA, Gotte RM, et al. Left ventricular mass measured by magnetic resonance imaging: effect of endocardial trabeculae on the observed wall thickness (abstr). J Cardiovasc Magn Reson 2000; 2:301-302.
- 29 Ibrahim T, Weniger M, Schwaiger M. Effect of papillary muscles and trabeculae on left ventricular parameters in cine-magnetic resonance images (MRI) (abstr). J Cardiovasc Magn Reson 1999; 1:319.
- 30 Bellenger NG, Burgess MI, Ray SG, et al. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance: are they interchangeable? Eur Heart J 2000; 21:1387-1396.
- 31 Schalla S, Nagel E, Lehmkuhl H, et al. Comparison of magnetic resonance real-time imaging of left ventricular function with conventional magnetic resonance imaging and echocardiography. Am J Cardiol 2001; 87:95-99.
- 32 Cowan BR, Young AA, Thrupp SF, et al. Correction of through-plane motion errors in cardiac MR volume measurements (abstr). J Cardiovasc Magn Reson 1999; 1:315-316.