Faculty Bibliography

BACKGROUND: We have developed a novel and practical cardiovascular magnetic resonance (CMR) technique to evaluate left ventricular (LV) mitral annular motion by tracking the atrioventricular junction (AVJ). To test AVJ motion analysis as a metric for LV function, we compared AVJ motion variables between patients with hypertrophic cardiomyopathy (HCM), a group with recognized systolic and diastolic dysfunction, and healthy volunteers. METHODS: We retrospectively evaluated 24 HCM patients with normal ejection fractions (EF) and 14 healthy volunteers. Using the 4-chamber view cine images, we tracked the longitudinal motion of the lateral and septal AVJ at 25 time points during the cardiac cycle. Based on AVJ displacement versus time, we calculated maximum AVJ displacement (MD) and velocity in early diastole (MVED), velocity in diastasis (VDS) and the composite index VDS/MVED. RESULTS: Patients with HCM showed significantly slower median lateral and septal AVJ recoil velocities during early diastole, but faster velocities in diastasis. We observed a 16-fold difference in VDS/MVED at the lateral AVJ [median 0.141, interquartile range (IQR) 0.073, 0.166 versus 0.009 IQR -0.006, 0.037, P < 0.001]. Patients with HCM also demonstrated significantly less mitral annular excursion at both the septal and lateral AVJ. Performed offline, AVJ motion analysis took approximately 10 minutes per subject. CONCLUSIONS: Atrioventricular junction motion analysis provides a practical and novel CMR method to assess mitral annular motion. In this proof of concept study we found highly statistically significant differences in mitral annular excursion and recoil between HCM patients and healthy volunteers.

PURPOSE: To assess liver stiffness using magnetization-tagged magnetic resonance imaging (MRI) to measure the cardiac-induced motion in the liver of cirrhosis patients with known Child-Pugh scores. MATERIALS AND METHODS: Tagged MRI was performed using a 3T MR scanner on 52 cirrhosis patients classified into two groups: liver cirrhosis with Child-Pugh A (LCA; n = 39) and liver cirrhosis with Child-Pugh B or C (LCBC; n = 13). We also included 19 healthy controls. Tagged images were acquired encompassing both the liver and the heart. The corresponding displacement and strains were calculated using a Gabor filter bank. The maximum displacement (MaxDisp) was found over the cardiac cycle, as well as the local maximum P1 (MaxP1) and minimum P2 strains (MinP2). Group comparisons were made without and with adjustment for age and gender. RESULTS: In control, LCA, and LCBC groups, the MaxDisp was 3.98 +/- 0.88 mm, 2.52 +/- 0.73 mm, and 1.86 +/- 0.77 mm; the MaxP1 was 0.10 +/- 0.02, 0.04 +/- 0.01, and 0.02 +/- 0.01; and the MinP2 was -0.08 +/- 0.01, -0.05 +/- 0.02, and -0.03 +/- 0.01, respectively. Statistically significant differences were found between groups (P < 0.05 for all). CONCLUSION: This method measures cardiac-induced liver motion and deformation to assess liver stiffness. Significant differences were found in our stiffness measures between control, LCA, and LCBC groups, with more severe disease being associated with greater stiffness. J. Magn. Reson. Imaging 2014;39:1301-1307. (c) 2013 Wiley Periodicals, Inc.

PURPOSE: To develop, and validate in vivo, a robust quantitative first-pass perfusion cardiovascular MR (CMR) method with accurate arterial input function (AIF) and myocardial wall enhancement. MATERIALS AND METHODS: A saturation-recovery (SR) pulse sequence was modified to sequentially acquire multiple slices after a single nonselective saturation pulse at 3 Tesla. In each heartbeat, an AIF image is acquired in the aortic root with a short time delay (TD) (50 ms), followed by the acquisition of myocardial images with longer TD values ( approximately 150-400 ms). Longitudinal relaxation rates (R(1) = 1/T(1) ) were calculated using an ideal saturation recovery equation based on the Bloch equation, and corresponding gadolinium contrast concentrations were calculated assuming fast water exchange condition. The proposed method was validated against a reference multi-point SR method by comparing their respective R(1) measurements in the blood and left ventricular myocardium, before and at multiple time-points following contrast injections, in 7 volunteers. RESULTS: R(1) measurements with the proposed method and reference multi-point method were strongly correlated (r > 0.88, P < 10(-5) ) and in good agreement (mean difference +/-1.96 standard deviation 0.131 +/- 0.317 / 0.018 +/- 0.140 s(-1) for blood/myocardium, respectively). CONCLUSION: The proposed quantitative first-pass perfusion CMR method measured accurate R(1) values for quantification of AIF and myocardial wall contrast agent concentrations in 3 cardiac short-axis slices, in a total acquisition time of 523 ms per heartbeat. J. Magn. Reson. Imaging 2011;. (c) 2011 Wiley-Liss, Inc

Cirrhosis is an important and growing public health problem, affecting millions of Americans and many more people internationally. A pathological hallmark of the progression to cirrhosis is the development of liver fibrosis, so that monitoring the appearance and progression of liver fibrosis can be used to guide therapy. Here, we report a method to use magnetization-tagged magnetic resonance imaging to measure the cardiac-induced motion and deformation in the liver, as a means for noninvasively assessing liver stiffness, which is related to fibrosis. The initial results show statistically significant differences between healthy and cirrhotic subjects in the direct comparisons of the maximum displacement (mm), and the maximum (P1) and minimum (P2) two-dimensional strains, through the cardiac cycle (3.514 +/- 0.793, 2.184 +/- 0.611; 0.116 +/- 0.043, 0.048 +/- 0.011; -0.094 +/- 0.020, -0.041 +/- 0.015; healthy, cirrhosis, respectively; P < 0.005 for all). There are also significant differences in the displacement-normalized P1 and P2 strains (mm(-1) ) (0.030 +/- 0.008, 0.017 +/- 0.007; -0.024 +/- 0.006, -0.013 +/- 0.004; healthy, cirrhosis, respectively; P < 0.005 for all). Therefore, this noninvasive imaging-based method is a promising means to assess liver stiffness using clinically available imaging tools. Magn Reson Med, 2011. (c) 2011 Wiley-Liss, Inc

In MRI, the transmit radiofrequency field (B(1) (+)) inhomogeneity can lead to signal intensity variations and quantitative measurement errors. By independently mapping the local B(1) (+) variation, the radiofrequency-related signal variations can be corrected for. In this study, we present a new fast B(1) (+) mapping method using a slice-selective preconditioning radiofrequency pulse. Immediately after applying a slice-selective preconditioning pulse, a turbo fast low-angle-shot imaging sequence with centric k-space reordering is performed to capture the residual longitudinal magnetization left behind by the slice-selective preconditioning pulse due to B(1) (+) variation. Compared to the reference double-angle method, this method is considerably faster. Specifically, the total scan time for the double-angle method is equal to the product of 2 (number of images), the number of phase-encoding lines, and approximately 5T(1), whereas the slice-selective preconditioning method takes approximately 5T(1). This method was validated in vitro and in vivo with a 3-T whole-body MRI system. The combined brain and pelvis B(1) (+) measurements showed excellent agreement and strong correlation with those by the double-angle method (mean difference = 0.025; upper and lower 95% limits of agreement were -0.07 and 0.12; R = 0.93; P < 0.001). This fast B(1) (+) mapping method can be used for a variety of applications, including body imaging where fast imaging is desirable. Magn Reson Med, 2010. (c) 2010 Wiley-Liss, Inc

Tagged magnetic resonance imaging (tagged MRI or tMRI) provides a means of directly and noninvasively displaying the internal motion of the myocardium. Reconstruction of the motion field is needed to quantify important clinical information, e.g., the myocardial strain, and detect regional heart functional loss. In this paper, we present a three-step method for this task. First, we use a Gabor filter bank to detect and locate tag intersections in the image frames, based on local phase analysis. Next, we use an improved version of the robust point matching (RPM) method to sparsely track the motion of the myocardium, by establishing a transformation function and a one-to-one correspondence between grid tag intersections in different image frames. In particular, the RPM helps to minimize the impact on the motion tracking result of 1) through-plane motion and 2) relatively large deformation and/or relatively small tag spacing. In the final step, a meshless deformable model is initialized using the transformation function computed by RPM. The model refines the motion tracking and generates a dense displacement map, by deforming under the influence of image information, and is constrained by the displacement magnitude to retain its geometric structure. The 2D displacement maps in short and long axis image planes can be combined to drive a 3D deformable model, using the moving least square method, constrained by the minimization of the residual error at tag intersections. The method has been tested on a numerical phantom, as well as on in vivo heart data from normal volunteers and heart disease patients. The experimental results show that the new method has a good performance on both synthetic and real data. Furthermore, the method has been used in an initial clinical study to assess the differences in myocardial strain distributions between heart disease (left ventricular hypertrophy) patients and the normal control group. The final results show that the proposed method is capable of separating patients from healthy individuals. In addition, the method detects and makes possible quantification of local abnormalities in the myocardium strain distribution, which is critical for quantitative analysis of patients' clinical conditions. This motion tracking approach can improve the throughput and reliability of quantitative strain analysis of heart disease patients, and has the potential for further clinical applications

The tracking and reconstruction of myocardial motion is critical to the diagnosis and treatment of heart disease. Currently, little has been done for the analysis of motion in long axis (LA) cardiac images. We propose a new fully automated motion reconstruction method for grid- tagged MRI that combines Gabor filters and deformable models. First, we use a Gabor filter bank to generate the corresponding phase map in the myocardium and estimate the location of grid tag intersections. Second, we use a non-rigid registration module driven by thin plate splines (TPS) to generate a transformation function between tag intersections in two consecutive images. Third, deformable spline models are initialized using Fourier domain analysis and tracked during the cardiac cycle using the TPS generated transformation function. The splines will then locally deform under the influence of gradient flow and image phase information. The final motion is decomposed into tangential and normal components corresponding to the local orientation of the heart wall. The new method has been tested on LA phantoms and in vivo heart data, and its performance has been quantitatively validated. The results show that our method can reconstruct the motion field in LA cardiac tagged MR images accurately and efficiently