Christopher W. Roy1,2, Mike Seed3,4, and Christopher K. Macgowan1,2
1Medical Biophysics, University of Toronto, Toronto, ON, Canada, 2Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, ON, Canada, 3Pediatric Cardiology, Hospital for Sick Children, ON, Canada, 4Pediatric and Diagnostic Imaging, University of Toronto, Toronto, ON, Canada
Synopsis
Fetal cardiac MRI requires high spatial and
temporal resolution but is often limited by stochastic and periodic motion. To
compensate for these sources of artifact, a radial golden-angle acquisition was
used to acquire and reconstruct real-time fetal cardiac images. In-plane
motion and fetal heart rate were then calculated from the real-time images and
used to reconstruct reordered CINE images at high spatial and temporal
resolution. Using this approach, motion-robust imaging of the fetal heart was
successful in seven pregnant volunteers for both short-axis and long-axis multi-slice
acquisitions.
Introduction
Time-resolved MRI of the fetal heart is
challenging due to the size of fetal cardiac structures (vessel size: 5-10 mm),
the relatively fast fetal heart rate (110-180 bpm), and both stochastic (gross
fetal movement) and periodic (maternal respiration) sources of motion. Building
on our previously published methods for accelerated fetal cardiac imaging with
retrospective gating (1,2), in this work, we develop
and evaluate a novel framework for reconstructing high spatial and high
temporal resolution images of the fetal heart in the presence of motion.
Fetal
data are acquired using a continuous golden angle radial trajectory (Fig. 1a) and
real-time images are reconstructed using compressed sensing. These real-time
images enable assessment and correction of both stochastic and periodic motion
(Fig. 1b) by retrospectively rejecting data undergoing through-plane motion,
correcting data corrupted by in-plane motion using rigid registration of the
real-time images (3–5), and extracting
cardiac gating signals using metric optimized gating applied to the real-time
images (2,6). The corrected data
are sorted by cardiac phase and reconstructed, again using compressed sensing,
to produce motion-robust reordered CINE images of the fetal heart (Fig. 1c).Methods
A steady state free precession sequence with
continuous golden angle radial sampling was applied to seven human fetuses (normal fetal cardiac
anatomy = 3, congenital heart disease = 4, gestational age 34-38 weeks). Slices were prescribed in both short-axis and long-axis views on a
Siemens 1.5T clinical system using both body and spine matrices with
approximately thirty active channels (Avanto Fit, Siemens Healthcare
– Germany). For each view, 10-15 slices were prescribed spanning
the heart, resulting in 127 slices of cardiac anatomy across all volunteers. Scans
were performed free-breathing with the following acquisition parameters: flip
angle: 70°, acquired spokes: 3000, TR: 4.95 ms, samples per spoke: 256,
field-of-view: 256 x 256 mm2, spatial resolution: 1 x 1 x 4 mm3,
and scan length: ~15 s per slice. Compressed sensing was used for both
real-time and reordered CINE reconstructions using spatial total-variation,
temporal total-variation, and temporal Fourier transforms for regularization (1). Quantitative comparison of images with and without motion correction
was performed using the image error as described previously (7).Results
Overall, dynamic fetal cardiac anatomy could be
assessed by both the real-time and reordered CINE reconstructions. In-plane
motion was estimated from the real-time images, and the root-mean-squared (RMS)
heart displacement over time ranged from 0.5 to 2.2 mm across all subjects. The
fetal heart rate was also calculated from the real-time images and the average ranged
from 118 to 170 bpm.
Fig. 2 shows representative displacement curves for
cases with minor (Fig. 2 a) and more dramatic (Fig. 2 b) in-plane motion. Real-time
and reordered CINE reconstructions corresponding to these cases are presented
in Figs. 3 and 4 respectively (click on figures to play videos). For the case with minor in-plane motion (Fig. 3),
reordered CINEs (Fig. 3 b & c) showed improved image quality over real-time
reconstructions (Fig. 3a). For example, a right ventricular diverticulum (Fig.
3b), and hepatic vessels (Fig. 3c) are better resolved in the reordered CINE
reconstructions. However, there were negligible differences between
reconstructions pre (Fig. 3b) and post (Fig. 3c) motion correction for this
case due to the minor level of in-plane displacement. Conversely, the case with
significant in-plane motion (Fig. 4) showed differences in spatial blur when
comparing reconstructions pre (Fig. 4b) and post (Fig. 4c) motion-correction.
These
qualitative results agree with quantitative evaluation of reconstructions (Fig.
5). Image error, obtained by comparing images pre and post motion correction, increased
with increasing displacement of the fetal heart. In particular, for RMS displacements
larger then the acquired spatial resolution (1 mm) the image error is greater
then 10% indicating a significant increase in image blur (1). These
results highlight the need for motion correction strategies in fetal cardiac
MRI.Discussion
High resolution imaging of the fetal heart was
possible using a golden-angle radial acquisition. Real-time image
reconstruction of the data enabled calculation of in-plane displacement and
fetal heart rate. These parameters were then used to create motion-robust
reordered CINE reconstructions. Dynamic cardiac anatomy was well visualized in
both real-time and reordered CINE reconstructions, with fine cardiac structures
best assessed using the motion-corrected reordered CINE images. This
reconstruction framework has the potential to facilitate studies of the fetal
heart using MRI, and scanning of fetuses at younger gestation where movement is
more problematic.Acknowledgements
No acknowledgement found.References
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