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New real-time interactive cardiac magnetic resonance imaging system complements echocardiography

Phillip C. Yang, MD^a, Adam B. Kerr, PhD^*, Alex C. Liu, MD^a, David H. Liang, MD, PhD^a, Chris Hardy, PhD, Craig H. Meyer, MS^*, Albert Macovski, PhD^*, John M. Pauly, PhD^* and Bob S. Hu, MD, FACC^a

^a Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California, USA
^* Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
General Electric Corporate Research and Development, Schenectady, New York, USA

View larger version (37K): [in a new window]   Figure 1 Block diagram of system architecture. A GE 1.5T Signa scanner components: console, TPS and magnet. The bus adaptor links the workstation to the TPS for rapid access to the raw data. The local Ethernet connects the workstation to the console and to the reconstruction servers.

View larger version (16K): [in a new window]   Figure 2 The pulse sequence used for data acquisition: a 7.68-ms spectral spatial pulse, a short repetition time (30 ms), low flip angle (20–40 degrees), and gradient-recalled ECHO sequence is shown. The spiral read-out results from the time-varying gradients, Gx and Gy and constant gradient spoiler Gz.

View larger version (13K): [in a new window]   Figure 3 The six spiral interleaf kappa space trajectories. The six interleaves constitute one complete image. Each interleaf shifts 60 degrees, completing a full cycle for each image. A sliding window reconstruction of an image using the most recently acquired six spiral interleaves is shown. Each subsequent image is updated by one or two spiral interleaves.

View larger version (103K): [in a new window]   Figure 4 Four X-windows. The graphical user interface windows are imaging scan control window, image display window, imaging extra control window and imaging display control.

View larger version (17K): [in a new window]   Figure 5 Interobserver agreement in group A patients. The level of agreement (0%–100%) between the two observers in the analysis of segmental wall motion in the following three categories is shown: echocardiography vs. echocardiography, echocardiography vs. MRI and MRI vs. MRI. For each category, there was no statistically significant difference between the two observers.

View larger version (140K): [in a new window]   Figure 6 Two long-axis views of a heart and two short-axis views of different phases of cardiac cycle obtained by CMRI. (a) Two-chamber view of a heart obtained by CMRI. Note the closed mitral leaflets (arrow) in this view and the detailed image of the myocardium and the endocardium. (b) Four-chamber view of a heart. Note the detailed image of the myocardium and the endocardial border. (c) Short axis view of end-diastole. (d) Short axis view of end-systole.

View larger version (77K): [in a new window]   Figure 7 Short-axis view of a heart. (a) Suboptimal short-axis echocardiographic image of a heart. Note the multiple atrial ectopies in the bottom of the image. (b) Corresponding short-axis CMRI image. Note the detailed image of the myocardium, the endocardial border and the papillary muscles not appreciated in the echocardiography.