Respiratory motion corrected 4D flow using golden radial phase encoding.

PURPOSE: To minimize respiratory motion artifacts while achieving predictable scan times with 100% scan efficiency for thoracic 4D flow MRI. METHODS: A 4D flow sequence with golden radial phase encoding (GRPE) was acquired in 9 healthy volunteers covering the heart, aorta, and venae cavae. Scan time was 15 min, and data were acquired without motion gating during acquisition. Data were retrospectively re-binned into respiratory and cardiac phases based on respiratory self-navigation and the electrocardiograph signals, respectively. Nonrigid respiratory motion fields were extracted and corrected for during the k-t SENSE reconstruction. A respiratory-motion corrected (GRPE-MOCO) and a free-breathing (GRPE-UNCORR) 4D flow dataset was reconstructed using 100% of the acquired data. For comparison, a respiratory gated Cartesian 4D flow acquisition (CART-REF) covering the aorta was acquired. Stroke volumes and peak flows were compared. Additionally, an internal flow validation based on mass conservation was performed on the GRPE-MOCO and GRPE-UNCORR. Statistically significant differences were analyzed using a paired Wilcoxon test. RESULTS: Stroke volumes and peak flows in the aorta between GRPE-MOCO and the CART-REF showed a mean difference of -1.5 ± 10.3 mL (P > 0.05) and 25.2 ± 55.9 mL/s (P > 0.05), respectively. Peak flow in the GRPE-UNCORR data was significantly different compared with CART-REF (P < 0.05). GRPE-MOCO showed higher accuracy for internal consistency analysis than GRPE-UNCORR. CONCLUSION: The proposed 4D flow sequence allows a straight-forward planning by covering the entire thorax and ensures a predictable scan time independent of cardiac cycle variations and breathing patterns.

MedalCare-XL: 16,900 healthy and pathological synthetic 12 lead ECGs from electrophysiological simulations.

Mechanistic cardiac electrophysiology models allow for personalized simulations of the electrical activity in the heart and the ensuing electrocardiogram (ECG) on the body surface. As such, synthetic signals possess known ground truth labels of the underlying disease and can be employed for validation of machine learning ECG analysis tools in addition to clinical signals. Recently, synthetic ECGs were used to enrich sparse clinical data or even replace them completely during training leading to improved performance on real-world clinical test data. We thus generated a novel synthetic database comprising a total of 16,900 12 lead ECGs based on electrophysiological simulations equally distributed into healthy control and 7 pathology classes. The pathological case of myocardial infraction had 6 sub-classes. A comparison of extracted features between the virtual cohort and a publicly available clinical ECG database demonstrated that the synthetic signals represent clinical ECGs for healthy and pathological subpopulations with high fidelity. The ECG database is split into training, validation, and test folds for development and objective assessment of novel machine learning algorithms.

Pulmonary embolism: comparison of angiography with spiral computed tomography, magnetic resonance angiography, and real-time magnetic resonance imaging.

In the last decade, spiral computed tomography (CT) and magnetic resonance (MR) angiography (MRA) have become a viable alternative to conventional angiography in the diagnosis of acute pulmonary embolism. However, patients with dyspnea are often unable to hold their breath for a longer time and thus image degradation is frequently observed. Consequently, an imaging sequence that allows free breathing is desirable. The aim of this animal study was to compare contrast-enhanced spiral CT, MRA and a real-time MR sequence, the latter without breath-hold, with pulmonary angiography as reference gold standard. Nine pigs with artificially induced pulmonary embolism underwent this multimodality comparison. All images were independently evaluated for the presence of pulmonary emboli by two reviewers. Forty-three filling defects were detected by conventional angiography on lobar and segmental levels. Sensitivity of CT images was 72.1 and 69.8% for Readers 1 and 2, respectively, and sensitivity of MRA images was 79.1 and 81.4%. With real-time MR imaging, however, the detection rate was 97.7% for both readers. We conclude that, under experimental conditions, real-time MR imaging without the use of radiation or iodinated contrast material is comparable with angiography in the detection of pulmonary emboli.