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Assessment of Myocardial Function with Interactive Non–Breath-hold Real-time MR Imaging: Comparison with Echocardiography and Breath-hold Cine MR Imaging¹

¹ From Medical Clinic I (H.P.K., A.W., A.F., J.S., P.H.) and the Departments of Diagnostic Radiology (E.S., R.W.G., A.B.) and Medical Statistics (N.H.), University Hospital Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany. Received September 29, 2002; revision requested December 10; final revision received September 20, 2003; accepted September 29. Address correspondence to H.P.K. (e-mail: hkuehl@ukaachen.de).

PURPOSE: To compare a spiral gradient-echo sequence with a radial steady-state free precession sequence and to compare these two interactive real-time cardiac magnetic resonance (MR) imaging examinations with harmonic two-dimensional echocardiography (ECHO) for the evaluation of regional myocardial function.

MATERIALS AND METHODS: Electrocardiographically triggered breath-hold steady-state free precession (BH-SSFP) MR imaging was the reference standard. Thirty-five nonselected patients scheduled for routine ECHO were included. Data from corresponding two-, three-, and four-chamber long-axis views and a midventricular short-axis view were acquired with each modality. Image quality and depiction of segmental wall motion were scored semiquantitatively by using the 16-segment model of the American Society of Echocardiography. Repeated-measures analysis of variance was performed to assess differences in image quality and wall motion depiction scores among the four imaging methods. Agreement was assessed by using Cohen statistics.

RESULTS: Compared with the image quality achieved with BH-SSFP MR imaging, the image quality achieved with radial MR imaging was similar (nonsignificant difference), but that achieved with spiral MR imaging and ECHO was significantly inferior (P < .0001). There were no significant differences in the image quality of the long- and short-axis views between the radial and BH-SSFP sequences, while the image quality of the long-axis spiral (P < .05) and the short- and long-axis ECHO (P < .0001) views was lower than that of the BH-SSFP views. Compared with the mean wall motion score for BH-SSFP MR imaging, the mean wall motion score for radial MR imaging was not significantly different, but those for ECHO (P < .05) and spiral MR imaging (P = .0003) were significantly lower. Cohen coefficients for agreement with the BH-SSFP sequence regarding wall motion scoring were 0.47 for ECHO, 0.67 for the spiral sequence, and 0.89 for the radial sequence.

CONCLUSION: The radial sequence enables similar accurate assessment of regional wall motion compared with the BH-SSFP sequence and yields image quality that is superior to that yielded by the spiral sequence and ECHO.

Supplemental material: radiology.rsnajnls.org/cgi/content/full/2311021237/DC1

© RSNA, 2004

Index terms: Heart, MR, 511.121412, 511.121416, 511.12144, 511.12149 • Heart, US, 511.12981 • Magnetic resonance (MR), cine study, 511.12144 • Magnetic resonance (MR), comparative studies, 511.121412, 511.121416, 511.12144, 511.12149 • Magnetic resonance (MR), functional imaging, 511.121412, 511.121416, 511.12144, 511.12149

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