Julie Magat1, Arnaud Fouillet1, Jérôme Naulin1, David Benoist1, Yunbo Guo1, Olivier Bernus1, Bruno Stuyvers1, and Bruno Quesson1
1IHU LIRYC, Université de Bordeaux, Pessac, France
Synopsis
The
motivation of this study was to investigate Magnetization Transfer MRI as a
technique of contrast for visualization of the Purkinje Fiber (PF) network in
ex vivo cardiac sample of a large animal. We first optimized MT parameters to
obtain the best contrast: offset frequency, duration of the module and
radiofrequency field. We performed 2D and 3D acquisition on pig ex vivo heart.
We were able to enhance contrast between PF network and muscle and visualize
insert points inside the myocardium in 3D.
Purpose
The Purkinje conduction network plays a crucial
role in normal cardiac function but has also been implicated in
arrhythmogenesis and sudden cardiac death. Free running fibers are present
inside the ventricle and connect to the myocardium at different entry points before
subdividing to form a tree inside the cardiac muscle and allow propagation of
the electrical impulse that triggers the mechanical contraction of the cardiac
chambers. 3D imaging of its architecture
1 is therefore of high
importance to better understand propagation patterns in cardiac arrhythmias and
improve their diagnosis and treatment. Most commonly used techniques to study
cardiac electrical conduction system remain destructive: histological
sectioning, endocardial staining or ink injection
2. In order to
address this challenging problem, we investigate the possibility to exploit
high field (9.4T) MRI to acquire high resolution images of ventricular
myocardium. Since Purkinje fibers (PF) have a distinct cellular structure and
are surrounded by connective tissue, we propose to use the Magnetization Transfer
(MT) imaging technique
3. The aim of this study was to optimize MT
parameters to enhance contrast between collagen fibers (surrounding PF) and
myocardium
Methods
A 40 kg mal pig was anaesthetized and the heart was
removed (sternal thoracotomy), flushed with cold cardioplegic solution and
immersed in 4% formaldehyde in PBS. A sample of anterior left ventricle
including interventricular septum was selected (3x4.5x8 cm) displaying several
free-running PF in the endocardium at visual inspection. All experiments were
performed at 9.4T/30cm (Bruker Biospin MRI, Ettlingen Germany). A cylindrical (72
mm inner diameter) 8 channels volume array Tx/Rx was used for ex vivo imaging. The
cardiac structure was assessed through 2D T1w images with: TE/TR/matrix/FA NA/TA=
3.7/2000ms/225x150/75°/15/1 min15s; Resolution= 200x200 µm and a slice
thickness of 0.5mm. A preparation module of MT was used and different
parameters were tested: frequency offset Δf=2000, 3000, 5000 and 10000 Hz, RF field B1=5, 10
and 15 μT, finally the module duration D varied between: 50 to 450 ms. However,
due to the maximal acceptable energy (0.5 W for the coil in continuous wave),
MT module duration of 250, 350 and 450 ms at 15 μT could not be performed with
this TR. Region of Interest were manually drawn and duplicated for each image:
one surrounding the free PF in the cavity, one located in the parenchyma and
one in the noise, respectively. Signal to noise ratio of PF and tissue were
computed as the mean value of the signal in both ROI divided by the standard
deviation in the noisy region. The MT contrast (MTC) between fiber and tissue
was calculated as follow: MTC=$$$\frac{2(SNR_{f}-SNR_{t})}{SNR_{f}+SNR_{t}}$$$
Where SNR
f and SNR
t are the SNR
of the fibers and tissue (parenchyma), respectively. With such a formulation,
MTC is the contrast to noise ratio (CNR) divided by the mean SNR of both ROIs .
Results
Without MT module (Fig.1.1), almost no contrast
appears on the image, whereas several tissue structures appear in presence of
MT (Fig.1.2). MTC values were plot in function of D, B1 and Δf (graphs on
fig.2). Whatever the MT pulse parameters, MTC was systematically found higher
than without (0.17). However, MTC curves show different values depending on MT
parameters, with a maximal value of 0.4 for an offset frequency around 3 to 5
kHz at a B1 amplitude of 10 µT and a pulse duration of 350 ms (red circle).
Similar values were observed at this B1 value and Δf for pulse duration ranging
between 250 and 450 ms, or for stronger B1 (15 µT) at a 150 ms pulse duration.
Under these conditions, the increase of contrast compared to reference image is
around 55%. Fig. 3 displays three orthogonal views extracted from the 3D
acquisition performed with MT (Δf f=3 kHz, B1=10 µT and D=250 ms) at an
isotropic resolution of 200 μm on the same sample. Insertion points from the
free running PF can be visualized and their connexions followed inside the muscle
(red arrows).
Discussion
First results of MT technique show an improved
contrast in ex vivo heart tissue. Although all tissues exhibited a reduction in
SNR in presence of MT, the contrast between PF and the cardiac tissue has been
increased by more than 50% as compared to standard proton density weighted
sequence. The decrease in SNR was expected since structural proteins (typically
collagen) are present everywhere in the cardiac muscle. Fibrous structures are
well defined in the myocardium and are associated to collagen fibers which are
structural proteins surrounding PF.
Conclusion
MT
significantly improves contrast in ventricular myocardium and appears promising
in imaging the 3D architecture of the Purkinje network.
Acknowledgements
No acknowledgement found.References
1- Elsika O., Casopis Lekaru Ceskych 2006, 145,
329–335. 2-Burton R., Ann N Y Acad Sci 2006, 1080 :301-19. 3- Henkelman
R.M., et al. NMR Biomed 2001, 14, 57-64.