Quantification of cardiac flow and ventricular volumes comprise essential goals of many congenital heart MRI examinations, often requiring acquisition of multiple two-dimensional phase contrast (2DPC) and bright blood cine SSFP planes. Scan prescription however, is lengthy and highly reliant on an imager well-versed in structural heart disease. Though also lengthy, 3D time-resolved phase-contrast (4DPC) MRI yields global flow patterns and is simpler to prescribe. We therefore sought to accelerate 4DPC and determine whether equivalent flow and volume measurements could be extracted.
Materials and Methods
4DPC was modified for higher acceleration with compressed-sensing. Custom software was developed to process 4DPC images. With IRB-approval and HIPAA-compliance, we studied 29 patients referred for congenital cardiac MRI, who underwent a routine clinical protocol including cine short-axis stack SSFP and 2DPC, followed by contrast-enhanced 4DPC. To compare quantitative measurements, Bland-Altman analysis, paired t-tests, and F-tests were used.
Ventricular end-diastolic, end-systolic and stroke volumes obtained from 4DPC and SSFP were well-correlated (ρ=0.91–0.95, r2=0.83–0.90), with no statistically significant difference. Ejection fractions were well-correlated in a subpopulation that underwent higher-resolution compressed-sensing 4DPC (ρ=0.88, r2=0.77). 4DPC and 2DPC flow rates were also well-correlated (ρ=0.90, r2=0.82). Excluding ventricles with valvular insufficiency, cardiac outputs derived from outlet valve flow and stroke volumes were more consistent by 4DPC than by 2DPC and SSFP.
Combined parallel imaging and compressed sensing can be applied to 4DPC. With custom software, flow and ventricular volumes may be extracted with comparable accuracy to SSFP and 2DPC. Further, cardiac outputs were more consistent by 4DPC.