Second-Order Motion-Compensated Echo-Planar Cardiac Diffusion-Weighted MRI: Usefulness of Compressed Sensitivity Encoding

Rui Chen; Ruohong Luo; Yongzhou Xu; Jiehao Ou; Xiaodan Li; Yuelong Yang; Liqi Cao; Zhigang Wu; Wei Luo; Hui Liu

doi:10.1002/jmri.29383

Second-Order Motion-Compensated Echo-Planar Cardiac Diffusion-Weighted MRI: Usefulness of Compressed Sensitivity Encoding

J Magn Reson Imaging. 2024 Apr 8. doi: 10.1002/jmri.29383. Online ahead of print.

Authors

Rui Chen^{1

2}, Ruohong Luo^{1

2

3}, Yongzhou Xu⁴, Jiehao Ou^{1

2}, Xiaodan Li^{1

2}, Yuelong Yang^{1

2}, Liqi Cao^{1

2}, Zhigang Wu⁴, Wei Luo^{1

2}, Hui Liu^{1

2

3}

Affiliations

¹ Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
² Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
³ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
⁴ Department of MSC Clinical & Technical Solutions, Philips Healthcare, Shenzhen, China.

PMID: 38587265
DOI: 10.1002/jmri.29383

Abstract

Background: Cardiac diffusion-weighted imaging (DWI) using second-order motion-compensated spin echo (M2C) can provide noninvasive in-vivo microstructural assessment, but limited by relatively low signal-to-noise ratio (SNR). Echo-planar imaging (EPI) with compressed sensitivity encoding (EPICS) could address these issues.

Purpose: To combine M2C DWI and EPCIS (M2C EPICS DWI), and compare image quality for M2C DWI.

Study type: Prospective.

Population: Ten ex-vivo hearts, 10 healthy volunteers (females, 5 [50%]; mean ± SD of age, 25 ± 4 years), and 12 patients with diseased hearts (female, 1 [8.3%]; mean ± SD of age, 44 ± 16 years; including coronary artery heart disease, congenital heart disease, dilated cardiomyopathy, amyloidosis, and myocarditis).

Field strength/sequence: 3-T, M2C EPICS DWI, and M2C DWI.

Assessment: The apparent SNR (aSNR) and the rating scores were used to evaluate and compared image quality of all three groups. The aSNR was calculated using $aSNR = {Mean intensity}_{myocardium} / {Standard deviation}_{myocardium}$ , and the myocardium was segmented manually. Three observers independently rated subjective image quality using a 5-point Likert scale.

Statistical tests: Bland-Altman analysis and paired t-tests. The threshold for statistical significance was set at P < 0.05.

Results: In healthy volunteers, the aSNR with a b-value of 450 s/mm² acquired by M2C EPICS DWI was significantly higher than M2C DWI at in-plane resolutions of 3.0 × 3.0, 2.5 × 2.5, and 2.0 × 2.0 mm². In patients with diseased hearts, the aSNR ofM2C EPICS DWI was also significantly higher than that for M2C DWI (bias of M2C EPICS-M2C = 1.999, 95% limits of agreement, 0.362 to 3.636; mean ± SD, 7.80 ± 1.37 vs. 5.80 ± 0.81). The ADC values of M2C EPICS was significantly higher than M2C DWI in in-vivo hearts. Over 80% of the images with rating scores for M2C EPICS DWI were higher than M2C DWI in in-vivo hearts.

Data conclusion: Cardiac imaging by M2C EPICS DWI may demonstrate better overall image quality and higher aSNR than M2C DWI.

Evidence level: 2 TECHNICAL EFFICACY: Stage 1.

Keywords: cardiac diffusion‐weighted imaging; compressed SENSE; echo planar imaging; image quality; second‐order motion‐compensated spin echo.

Abstract

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