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

Carlos Eduardo Rochitte1, *, Clerio F Azevedo2, Miguel A Rosário 1, Maria H.R Siqueira1, Victor Monsão1, Manoj Saranathan3, Thomas K Foo3, Roberto Kalil Filho1, Giovanni G Cerri1, José A. F Ramires1
1 Heart Institute (InCor) University of São Paulo Medical School, São Paulo, Brazil
2 D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
3 GE Healthcare, Baltimore, MD, USA

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© Rochitte et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at Instituto do Coração (InCor) – Setor de Ressonância Magnéti- ca Cardiovascular, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP, Brazil, 05403-000; Tel: 55-11-3069-5587; Fax: 55-11-3069-5587; E-mail:



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.

Keywords: Magnetic resonance imaging, left ventricular function, cine imaging, three-dimensional, steady-state free precession, fast imaging..