Single-Breathhold Four-Dimensional Assessment of Left Ventricular Morphological and Functional Parameters by Magnetic Resonance Imaging Using the VAST Technique

The accurate and reproducible assessment of cardiac volumes, function, and mass is of paramount importance in cardiology. In the present study we sought to determine whether the 3D cine-magnetic resonance (MR) technique, using the variable asymmetric sampling in time (VAST) approach, provided an accurate assessment of LV functional parameters when compared with the conventional 2D cine-MR technique.

A total of 43 consecutive patients referred for a CMR examination for clinical reasons and 14 healthy volunteers were included in the study. Cine images were acquired using a steady-state free precession pulse sequence. Two different multiphase acquisitions were performed: conventional 2D cine-MR and 3D cine-MR. The short-axis cine images acquired by both cine-MR techniques were used for the quantitative assessment of LV end-diastolic, end-systolic and stroke volumes, LV mass and ejection fraction.

All CMR examinations were completed successfully, with both cine-MR imaging techniques yielding interpretable diagnostic results in all patients. Regarding the quantitative assessment, Bland-Altman analyses demonstrated a good agreement between the measurements of both cine-MR techniques for all LV parameters. In addition, the agreement between 2D and 3D cine-MR techniques for the qualitative assessment of LV global function was perfect (kappa = 1.0, P<0.001) for the two observers in consensus. The assessment performed by the third independent observer also demonstrated very good agreement (kappa = 0.88, P<0.001).

The single breathhold 3D cine-MR technique provides an accurate and reproducible quantitative assessment of LV volumes, mass and function when compared with the conventional 2D cine-MR method.