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. 2015 Aug;74(2):336-45.
doi: 10.1002/mrm.25712. Epub 2015 May 14.

Wideband arrhythmia-Insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by an implantable-cardioverter-defibrillator

KyungPyo Hong  1   2 , Eun-Kee Jeong  2 , T Scott Wall  3 , Stavros G Drakos  3 , Daniel Kim  2
Affiliations

Wideband arrhythmia-Insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by an implantable-cardioverter-defibrillator

KyungPyo Hong et al. Magn Reson Med. 2015 Aug.

Abstract

Purpose: To develop and evaluate a wideband arrhythmia-insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by implantable-cardioverter-defibrillator (ICD).

Methods: We developed a wideband AIR pulse sequence by incorporating a saturation pulse with wide frequency bandwidth (8.9 kHz) to achieve uniform T1 weighting in the heart with ICD. We tested the performance of original and "wideband" AIR cardiac T1 mapping pulse sequences in phantom and human experiments at 1.5 Tesla.

Results: In five phantoms representing native myocardium and blood and postcontrast blood/tissue T1 values, compared with the control T1 values measured with an inversion-recovery pulse sequence without ICD, T1 values measured with original AIR with ICD were considerably lower (absolute percent error > 29%), whereas T1 values measured with wideband AIR with ICD were similar (absolute percent error < 5%). Similarly, in 11 human subjects, compared with the control T1 values measured with original AIR without ICD, T1 measured with original AIR with ICD was significantly lower (absolute percent error > 10.1%), whereas T1 measured with wideband AIR with ICD was similar (absolute percent error < 2.0%).

Conclusion: This study demonstrates the feasibility of a wideband pulse sequence for cardiac T1 mapping without significant image artifacts induced by ICD.

Keywords: ECV; ICD; cardiac T1 mapping; heart failure; myocardial fibrosis; sudden cardiac death; wideband.

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Figures

Figure 1
Figure 1
Pulse sequence diagram of a wideband saturation pulse module (BISTRO), which is comprised of 15 hyperbolic secant inversion RF pulses that do not meet the adiabatic condition on purpose. The spoiler gradients are applied before the first RF pulse and after the last RF pulse to dephase the transverse magnetization. The crusher gradients in between RF pulses are played to minimize stimulated echoes. While duration of the wideband saturation pulse module is 151 ms, the total RF time is only 46.05 ms, whereas the remaining time is used to play crusher and spoiler magnetic field gradients. These diagrams are drawn to approximate proportions but not to exact scale. Gz: slice-select gradient; Gy: phase-encoding gradient; Gx: frequency-encoding gradient.
Figure 2
Figure 2
(A) Plots of residual Mz (as a fraction of M0) as a function of center frequency shift. Note that residual Mz = 0 corresponds to complete saturation of magnetization, whereas residual Mz = 1 corresponds to no saturation. Compared with the original saturation pulse module (gray line), wideband pulse module (black line) had 256% higher frequency bandwidth (FWHM = 2.5 kHz and 8.9 kHz for original and wideband, respectively). Δf = center frequency shift. (B) Plots of T1 as a function of center frequency shift. Consistent with the frequency bandwidth experiment, wideband AIR (black line) produced consistent T1 results over 8.9 kHz, whereas original AIR (gray line) produced consistent T1 results over 2.5 kHz.
Figure 3
Figure 3
Coronal T1 maps of a phantom acquired with original AIR (middle column) and wideband AIR (right column): without anything taped (top row), with ICD leads (middle row), and with ICD taped on one side of the phantom as shown (bottom row). The corresponding B0 maps are also shown (left column). Regions near the ICD were removed because of significant signal dropout. Arrows display the distance between ICD and outer boundary of the contaminated region.
Figure 4
Figure 4
Representative native T1 maps in short-axis (rows 2 and 4) and long-axis (rows 1 and 3) planes of the heart of two different volunteers with and without ICD taped on their left shoulder (~5–10 cm from the heart): original AIR without ICD (column 1), wideband AIR without ICD (column 2), original AIR with ICD (column 3), and wideband AIR with ICD (column 4). Compared with original AIR without ICD as the control, original AIR with ICD produced less accurate T1 results, whereas wideband AIR with ICD produced more accurate T1 results. White arrows point to cardiac regions compromised by ICD. Blood and cardiac contours superimposed on the left column only. See Supporting Table S1 for the corresponding T1 values.
Figure 5
Figure 5
Representative native and post-contrast (15 and 35 min after MultiHance administration) T1 maps in a 2-chamber plane of the heart acquired with and without ICD taped on his left shoulder (~5–10 cm from the heart): original AIR without ICD (column 1), wideband AIR without ICD (column 2), original AIR with ICD (column 3), and wideband AIR with ICD (column 4). Compared with original AIR without ICD as the control, original AIR with ICD produced less accurate T1 results, whereas wideband AIR with ICD produced more accurate T1 results. White arrows point to cardiac regions compromised by ICD. See Supporting Table S2 for the corresponding T1 values.
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