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. 2023 Apr;31(2):71-82.
doi: 10.4250/jcvi.2022.0080.

Dynamic Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing Maneuvers: First Results

Luuk H G A Hopman #  1   2 , Elizabeth Hillier #  1   3 , Yuchi Liu  4 , Jesse Hamilton  4 , Kady Fischer  5 , Nicole Seiberlich  4   6 , Matthias G Friedrich  1   7
Affiliations

Dynamic Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing Maneuvers: First Results

Luuk H G A Hopman et al. J Cardiovasc Imaging. 2023 Apr.

Abstract

Background: Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes.

Methods: We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver.

Results: In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF15-hb 1,359 ± 97 ms, and cMRF5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF15-hb 29.6 ± 5.8 ms and cMRF5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed.

Conclusions: cMRF5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

Keywords: Breathing exercises; Magnetic resonance imaging; Multiparametric magnetic resonance imaging; Myocardium.

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Conflict of interest statement

Matthias G. Friedrich is listed as a holder of United States Patent No. 14/419,877: Inducing and measuring myocardial oxygenation changes as a marker for heart disease; United States Patent No. 15/483,712: Measuring oxygenation changes in tissue as a marker for vascular function; United States Patent No. 10,653,394: Measuring oxygenation changes in tissue as a marker for vascular function - continuation; and Canadian Patent CA2020/051776: Method and apparatus for determining biomarkers of vascular function utilizing bold CMR images.

Figures

Figure 1
Figure 1. Magnetic resonance imaging protocol used to scan healthy volunteers.
cMRF: cardiac magnetic resonance fingerprinting, D-cMRF: dynamic cardiac magnetic resonance fingerprinting.
Figure 2
Figure 2. Phantom results. (A) Results of the cMRF15-hb sequence compared to the phantom T1 reference values. (B) Bland-Altman plot to describe agreement between the cMRF15-hb T1 values and the phantom T1 reference values. The solid black line indicated the mean bias and the dashed red lines indicate the limits of agreement. (C) Results of the cMRF5-hb sequence compared to the phantom T1 reference values. (D) Bland-Altman plot to describe agreement between the cMRF5-hb T1 values and the phantom T1 reference values. The solid black line indicated the mean bias and the dashed red lines indicate the limits of agreement. (E) T1 map of the phantom acquired with the cMRF15-hb sequence. (F) Results of the cMRF15-hb sequence compared to the phantom T2 reference values. (G) Bland-Altman plot to describe agreement between the cMRF15-hb T2 values and the phantom T2 reference values. The solid black line indicated the mean bias and the dashed red lines indicate the limits of agreement. (H) Results of the cMRF5-hb sequence compared to the phantom T2 reference values. (I) Bland-Altman plot to describe agreement between the cMRF5-hb T2 values and the phantom T2 reference values. The solid black line indicated the mean bias and the dashed red lines indicate the limits of agreement. (J) T2 map of the phantom acquired with the cMRF15-hb sequence.
cMRF: cardiac magnetic resonance fingerprinting, hb: heartbeat.
Figure 3
Figure 3. Comparison of T1 and T2 maps in a healthy volunteer. The maps represent results acquired using conventional techniques: (A) T1: MOLLI, (D) T2: T2 prepared balanced SSFP sequence; and cMRF maps acquired using the 15-hb protocol (B, E), and the 5-hb protocol (C, F).
cMRF: cardiac magnetic resonance fingerprinting, hb: heartbeat, MOLLI: modified look locker inversion, SSFP: steady state free precession.
Figure 4
Figure 4. Comparison of T1 and T2 values between conventional mapping techniques and cMRF. Quantitative comparison of T1 between MOLLI cMRF15-hb and cMRF5-hb (A, B), and of T2 between cMRF15-hb and cMRF5-hb and a T2 prepared balanced SSFP sequence (C, D).
cMRF: cardiac magnetic resonance fingerprinting, hb: heartbeat, MOLLI: modified look locker inversion, SSFP: steady state free precession. *p < 0.01.
Figure 5
Figure 5. Dynamic cMRF in healthy volunteers during breathing manoeuvre. Myocardial relaxation times T1 (A) and T2 (B) pre-hyperventilation and during a post-hyperventilation breath-hold as measured by dynamic cMRF mapping.
cMRF: cardiac magnetic resonance fingerprinting.
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