Feasibility study of highly accelerated phase-sensitive inversion recovery myocardial viability imaging using simultaneous multislice and parallel imaging techniques.

Background: Phase-sensitive inversion recovery (PSIR) is a powerful cardiac MRI method to assess myocardial viability, which can eliminate the background phase and preserve the sign of the desired magnetization during inversion recovery.

Purpose/hypothesis: To shorten the acquisition time of myocardial viability imaging by introducing both simultaneous multislice (SMS) and parallel imaging (PI) into PSIR without additional acquisitions for calibration data.

Study Type: Prospective study.

Subjects: A high-resolution phantom and three vials with doped solutions matching typical postcontrast T and T values of scar, healthy myocardium, and blood; 18 patients (six with known myocardial infarction) were included in this study.

Field Strength/sequence: 3T/segmented fast spoiled gradient echo pulse sequence.

Assessment: Phantom and in vivo experiments were performed to compare the performance of conventional PSIR, SMS accelerated PSIR (SMS-PSIR, 2× acceleration), and SMS as well as PI accelerated PSIR (SMS + PI-PSIR, 4× acceleration). In phantom experiments, the error maps, local signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. In in vivo experiments, the image quality and artifact level of each study were qualitatively graded (by three radiologists). G-factor maps were calculated. The infarct size presented as a percentage of the left ventricle was measured (full-width half-maximum). Acquisition time of each study was recorded.

Statistical Test: One-way analysis of variance, Kruskal-Wallis test.

Results: In phantom experiments, SNR and CNR were well preserved for SMS-PSIR, while they dropped for SMS + PI-PSIR, as expected. In 15 subjects, the overall image quality scores were not significantly different among conventional PSIR (3.70 ± 1.06), SMS-PSIR (3.78 ± 0.99), and SMS + PI-PSIR (3.47 ± 0.94; P = 0.20). The artifact level scores were also comparable among conventional PSIR (3.67 ± 1.04), SMS-PSIR (3.77 ± 1.03), and SMS + PI-PSIR (3.45 ± 1.00; P = 0.22). SMS-PSIR achieved negligible g-factor noise amplification (1.04 ± 0.03) and SMS + PI-PSIR showed higher g-factors (2.83 ± 0.48). The infarct size was consistent among conventional PSIR (22.51 ± 25.05%) and SMS-PSIR (22.98 ± 26.19%), as well as SMS + PI-PSIR (22.93 ± 25.68%; P = 0.98). The acquisition time of two short-axis slices for SMS-PSIR (17.6 ± 1.7 sec, 16 heartbeats) and SMS + PI-PSIR (9.8 ± 1.9 sec, 8 heartbeats) was 30% and 17% of that for conventional PSIR (56.2 ± 8.5 sec, 32 heartbeats), respectively.

Data Conclusion: SMS can be implemented in PSIR without additional reference scan. The image quality is comparable with conventional PSIR, while the acquisition time is much shorter. The proposed method is also compatible with PI to further reduce the scan time.

Level Of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1964-1972.