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Breath-hold FLASH and FISP Cardiovascular MR Imaging: Left Ventricular Volume Differences and Reproducibility¹

¹ From the Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney St, London SW3 6NP, England (J.C.C.M., C.H.L., J.M.F., G.C.S., D.J.P.); and Siemens Medical Solutions, Erlangen, Germany (C.H.L.). Received July 11, 2001; revision requested August 20; final revision received December 10; accepted December 20. Supported by CORDA and the Wellcome Trust. J.C.C.M. supported by the British Heart Foundation. Address correspondence to J.C.C.M. (e-mail: j.moon@rbh.nthames.nhs.uk).

View larger version (130K): [in a new window]   Figure 1a. (a) Sample short-axis stack volume acquisitions at ED in a healthy subject. Top panel is FLASH acquisition, the lower, FISP. The superior image quality of FISP is evident. Imaging parameters for FLASH imaging were echo time, 6.1 msec; pixel size, 2.1 x 1.4 x 7.0 mm; flip angle, 20°; and 15-heartbeat acquisition time. FISP parameters were 3.2/1.6; pixel size, 2.3 x 1.4 x 7.0 mm; flip angle, 60°; and acquisition time, 12 heartbeats (b) Sample short-axis stack volume acquisitions at ED in a patient. Images presented in same order as for a.

View larger version (139K): [in a new window]   Figure 1b. (a) Sample short-axis stack volume acquisitions at ED in a healthy subject. Top panel is FLASH acquisition, the lower, FISP. The superior image quality of FISP is evident. Imaging parameters for FLASH imaging were echo time, 6.1 msec; pixel size, 2.1 x 1.4 x 7.0 mm; flip angle, 20°; and 15-heartbeat acquisition time. FISP parameters were 3.2/1.6; pixel size, 2.3 x 1.4 x 7.0 mm; flip angle, 60°; and acquisition time, 12 heartbeats (b) Sample short-axis stack volume acquisitions at ED in a patient. Images presented in same order as for a.

View larger version (131K): [in a new window]   Figure 2. Single short-axis section obtained in a healthy subject (upper left quadrant) and a patient (lower left quadrant). Left panel shows the raw image, middle panel shows the epicardial and endocardial contours (drawn independently), and right panel shows the overlaid FISP and FLASH imaging contours. Short arrows indicate areas where the FISP endocardial contour increases ED volume, reducing LV mass. Long arrow indicates example of FLASH imaging epicardial contour, including epicardial fat in the LV mass. Imaging parameters for FLASH imaging were echo time, 6.1; pixel size, 2.1 x 1.4 x 7.0 mm; flip angle, 20°; and acquisition time, 15 heartbeats. FISP parameters were 3.2/1.6; pixel size, 2.3 x 1.4 x 7.0 mm; flip angle, 60°; and acquisition time, 12 heartbeats.

View larger version (21K): [in a new window]   Figure 3a. Graphs show differences in (a) healthy subjects and (b) patients for section-by-section comparison of the area enclosed by the FISP contour minus that enclosed by FLASH from base to apex. LV mass is smaller at FISP in all locations from base to apex. In healthy subjects, this arises from the larger FISP endocardial area; in patients it arises from a larger FISP endocardial area and a smaller FISP epicardial contour. Dashed line = diastolic epicardial area, thin solid line = diastolic endocardial area, dotted line = systolic endocardial area, thick solid line = myocardial area.

View larger version (21K): [in a new window]   Figure 3b. Graphs show differences in (a) healthy subjects and (b) patients for section-by-section comparison of the area enclosed by the FISP contour minus that enclosed by FLASH from base to apex. LV mass is smaller at FISP in all locations from base to apex. In healthy subjects, this arises from the larger FISP endocardial area; in patients it arises from a larger FISP endocardial area and a smaller FISP epicardial contour. Dashed line = diastolic epicardial area, thin solid line = diastolic endocardial area, dotted line = systolic endocardial area, thick solid line = myocardial area.

View larger version (23K): [in a new window]   Figure 4. Graphs show interobserver (A, C) and interstudy (B, D) reproducibility of FISP (white bars) versus FLASH (black bars) imaging quantified by the coefficients of variability in the healthy subjects (A, B) and patients (C, D). EDV = ED volume, ESV = ES volume. In B, * = P = .05; this is the only significant result.