First-pass myocardial perfusion assessment using eight-fold accelerated k-t BLAST stress DCE-MRI with rapid parametric mapping
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KeywordsMyocardial Perfusion Enhancement Ratio False Positive Lesion Median Percentage Change Significant Coronary Stenos
First-pass myocardial perfusion assessment using dynamic contrast enhanced MRI (DCE-MRI) is still one of the most challenging CMR applications. Image quality, spatial and temporal resolution are limited by the need to acquire multiple slices as single shot acquisitions within a single heart beat, as the process of interest is transient and very rapid, especially under pharmacologically induced stress hyperaemia. This is why accelerated acquisition methods, such as k-t BLAST , could provide a significant improvement in the assessment of myocardial perfusion by CMR.
An optimised DCE-MRI sequence with eight-fold k-t BLAST acceleration was shown to provide a significant improvement in spatial resolution without loss of image quality, making these datasets very suitable for parametric mapping.
To investigate the ability of eight-fold k-t BLAST accelerated stress perfusion DCE-MRI combined with a rapid parametric mapping algorithm to detect regions of ischaemia in a pilot cohort of patients with suspected coronary heart disease (CHD).
DCE-MRI sequence parameters
Saturation recovery pre-pulse delay
TR/TE/φ = 3.6/1.7/15°
k-t acceleration factor
192 × 187
Median Enhancement Ratios (ER%)
Coronary artery X-ray (number of affected territories)
Median Enhancement Ratio%
Motion correction was not required in three datasets, and 1–2 voxel displacement was applied in seven datasets. In patients with no significant coronary stenoses, the average ratio was 71.2% (n = 2), in single-vessel disease it was 66.0% (n = 4). In a patient with two-vessel disease ER was 33.1% and in a patient with three-vessel disease ER was 19.1%.
The results of this pilot study suggest that the proposed methods for acquisition and analysis of first-pass myocardial perfusion are robust and ready for use in clinical studies, where its diagnostic utility needs to be assessed formally in a larger patient cohort. The methods allow the assessment of regional differences in perfusion, as well as global changes in perfusion. There is scope for further improvement, notably in increasing resistance to motion artefact and reducing signal inhomogeneity, which can lead to the appearance of false positive lesions.
This article is published under license to BioMed Central Ltd.