Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Technical Notes

Nico Merkle¹  Henning Steen²  Dirk Lossnitzer²  Andreas Schuster³  Matthias Paul³  Geraint Morton³  Shazia Hussain³  Eike Nagel³  Amedeo Chiribiri³  Masaki Ishida³  Sven Plein⁴  Khaled Alfakih⁵  Bernhard Schnackenburg⁶ 

[1] Internal Medicine II, University of Ulm, Germany;Internal Medicine III, University of Heidelberg, Germany;King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK;King's College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Welcome Trust and EPSRC Medical Engineering Centre at Guy's and St. Thomas' NHS Foundation Trust, Division of Imaging Sciences, The Rayne Institute, London, UK;Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK;Kings College Hospital, London, UK;Philips Healthcare, Hamburg, Germany;

关键词: Cardiovascular Magnetic Resonance;    Myocardial Blood Flow;    Regadenoson;    Arterial Input Function;    Perfusion Cardiovascular Magnetic Resonance;   

DOI  :  10.1186/1532-429X-13-28

 received in 2009-12-15, accepted in 2011-05-24,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe dual-bolus protocol enables accurate quantification of myocardial blood flow (MBF) by first-pass perfusion cardiovascular magnetic resonance (CMR). However, despite the advantages and increasing demand for the dual-bolus method for accurate quantification of MBF, thus far, it has not been widely used in the field of quantitative perfusion CMR. The main reasons for this are that the setup for the dual-bolus method is complex and requires a state-of-the-art injector and there is also a lack of post processing software. As a solution to one of these problems, we have devised a universal dual-bolus injection scheme for use in a clinical setting. The purpose of this study is to show the setup and feasibility of the universal dual-bolus injection scheme.MethodsThe universal dual-bolus injection scheme was tested using multiple combinations of different contrast agents, contrast agent dose, power injectors, perfusion sequences, and CMR scanners. This included 3 different contrast agents (Gd-DO3A-butrol, Gd-DTPA and Gd-DOTA), 4 different doses (0.025 mmol/kg, 0.05 mmol/kg, 0.075 mmol/kg and 0.1 mmol/kg), 2 different types of injectors (with and without "pause" function), 5 different sequences (turbo field echo (TFE), balanced TFE, k-space and time (k-t) accelerated TFE, k-t accelerated balanced TFE, turbo fast low-angle shot) and 3 different CMR scanners from 2 different manufacturers. The relation between the time width of dilute contrast agent bolus curve and cardiac output was obtained to determine the optimal predefined pause duration between dilute and neat contrast agent injection.Results161 dual-bolus perfusion scans were performed. Three non-injector-related technical errors were observed (1.9%). No injector-related errors were observed. The dual-bolus scheme worked well in all the combinations of parameters if the optimal predefined pause was used. Linear regression analysis showed that the optimal duration for the predefined pause is 25s to separate the dilute and neat contrast agent bolus curves if 0.1 mmol/kg dose of Gd-DO3A-butrol is used.ConclusionThe universal dual-bolus injection scheme does not require sophisticated double-head power injector function and is a feasible technique to obtain reasonable arterial input function curves for absolute MBF quantification.

【 授权许可】

CC BY   
© Ishida et al; licensee BioMed Central Ltd. 2011